ArticleBMJ (Clinical research ed.)2016
Changes in mortality inequalities over two decades: register based study of European countries.
Article in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 155 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
155 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Assessing the effects of population-level political, economic and social exposures, interventions and policies on inclusive economy outcomes for health equity in high-income countries: a systematic review of reviews.Systematic reviews · 2024Pooled it
- The Role of Epigenetic Clocks in Explaining Educational Inequalities in Mortality: A Multicohort Study and Meta-analysis.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Pooled it
- Educational inequalities in adult mortality: a systematic review and meta-analysis of the Asia Pacific region.BMJ open · 2022Pooled it
- Incorporating Equity Concerns in Cost-Effectiveness Analyses: A Systematic Literature Review.PharmacoEconomics · 2022Pooled it
- The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Socioeconomic inequalities in effectiveness of and compliance to workplace health promotion programs: an individual participant data (IPD) meta-analysis.The international journal of behavioral nutrition and physical activity · 2020Pooled it
- Socioeconomic status and the 25 × 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1·7 million men and women.Lancet (London, England) · 2017Pooled it
- Proactive automatized multiple health risk behavior change intervention: reach and retention among general hospital patients.European journal of public health · 2025Trial
- Prevalence of behavioural risk factors and their combinations among older adults: cross-sectional results of the nationwide study Gesundheit 65.BMC geriatrics · 2026Article
- Socioeconomic inequalities in functional ageing trajectories in England and Canada: A comparative longitudinal cohort study.PLoS medicine · 2026Article
- Association of General Practice Continuity With Hospital Admissions and Costs: A Retrospective Study.Annals of family medicine · 2026Article
- Cardiovascular Risk Factor Prevalence and Control by Education Strata in Older Adults in 3 Countries.JAMA network open · 2026Article
- Associations of objective and perceived social status with well-being in dyads of people with dementia and their caregivers: findings from the IDEAL programme.Social psychiatry and psychiatric epidemiology · 2026Article
- Parental socioeconomic status and other sociodemographic determinants of health disparities among children and adolescents in Austria.Public health in practice (Oxford, England) · 2026Article
- Development of a comprehensive mortality database in Japan through data linkage of population census and vital statistics.Population health metrics · 2026Article
- Socioeconomic inequalities in life expectancy within and between native-born and foreign-born populations: a comparative study of 10 European countries.International journal of epidemiology · 2026Article
- Impact of legislation of suicide prevention act on suicide rates in the Republic of Korea: an interrupted time-series analysis.BMC public health · 2026Article
- Lifestyle and Cardiovascular Risk Factors by Educational Attainment in a Mediterranean Setting: A Cross-Sectional Analysis of a Population-Based Sample.Global heart · 2026Article
- Does physical and social neighborhood environment matter for two-year changes in functional abilities and cognitive function in the oldest old?The journals of gerontology. Series B, Psychological sciences and social sciences · 2025Article
- Spatial variation in cause-specific premature mortality and its association with socioeconomic deprivation in Belgium from 2000 to 2019.Archives of public health = Archives belges de sante publique · 2025Article
95 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
Abstract
objectiveTo determine whether government efforts in reducing inequalities in health in European countries have actually made a difference to mortality inequalities by socioeconomic group.
designRegister based study. DATA SOURCE: Mortality data by level of education and occupational class in the period 1990-2010, usually collected in a census linked longitudinal study design. We compared changes in mortality between the lowest and highest socioeconomic groups, and calculated their effect on absolute and relative inequalities in mortality (measured as rate differences and rate ratios, respectively).
settingAll European countries for which data on socioeconomic inequalities in mortality were available for the approximate period between years 1990 and 2010. These included Finland, Norway, Sweden, Scotland, England and Wales (data applied to both together), France, Switzerland, Spain (Barcelona), Italy (Turin), Slovenia, and Lithuania.
resultsSubstantial mortality declines occurred in lower socioeconomic groups in most European countries covered by this study. Relative inequalities in mortality widened almost universally, because percentage declines were usually smaller in lower socioeconomic groups. However, as absolute declines were often smaller in higher socioeconomic groups, absolute inequalities narrowed by up to 35%, particularly among men. Narrowing was partly driven by ischaemic heart disease, smoking related causes, and causes amenable to medical intervention. Progress in reducing absolute inequalities was greatest in Spain (Barcelona), Scotland, England and Wales, and Italy (Turin), and absent in Finland and Norway. More detailed studies preferably using individual level data are necessary to identify the causes of these variations.
conclusionsOver the past two decades, trends in inequalities in mortality have been more favourable in most European countries than is commonly assumed. Absolute inequalities have decreased in several countries, probably more as a side effect of population wide behavioural changes and improvements in prevention and treatment, than as an effect of policies explicitly aimed at reducing health inequalities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.