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Spatial Differences in Avoidable Mortality Across 581 European Districts, 2002-2019.

Sophie Stroisch1,2, Michael Mühlichen3, Pavel Grigoriev3

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European Journal of Population = Revue Europeenne De Demographie
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Summary
This summary is machine-generated.

Health disparities in Europe persist, with avoidable mortality (deaths preventable by medical care or public health) varying significantly by district. Persistent hotspots and coldspots highlight the need for place-based, transnational strategies to reduce these inequalities.

Keywords:
Avoidable mortalityCross-borderEuropean UnionHot-spot-analysisRegional inequalities

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Area of Science:

  • Public Health
  • Epidemiology
  • Spatial Analysis

Background:

  • Substantial mortality differences persist across and within European countries, despite efforts to reduce health disparities.
  • Avoidable mortality, defined as deaths preventable through timely medical care or effective public health measures, is a key indicator of health inequalities.

Purpose of the Study:

  • To examine spatial differences and trends in avoidable mortality at the district level across 10 European countries.
  • To identify spatiotemporal clusters of avoidable mortality and analyze their persistence over time.

Main Methods:

  • Analysis of official cause-of-death statistics for 581 districts from 2002 to 2019.
  • Calculation of age-standardised death rates (SDR) for avoidable mortality.
  • Application of emerging hotspot analysis to identify spatiotemporal clusters.

Main Results:

  • SDRs for avoidable mortality declined in most districts for both sexes, but significant disparities between men and women, and between amenable and preventable mortality, persist.
  • Districts in Central and Eastern Europe consistently showed higher SDRs than those in Western and Southern Europe.
  • Spatiotemporal hotspot analysis revealed persistent high-mortality (hotspots) and low-mortality (coldspots) clusters, indicating both within-country inequalities and cross-border mortality patterns.

Conclusions:

  • National boundaries are not always the most relevant for understanding health outcomes; local socioeconomic and structural determinants are crucial.
  • Persistent hotspots indicate areas needing targeted interventions, while coldspots may offer insights into best practices.
  • Reducing health inequalities in Europe requires targeted, place-based, and transnational strategies.