Mortality in 272 European regions, 2002-2004. An update.

This paper presents a comprehensive update of life expectancy and mortality in 2002-2004 in the modern European Union (EU-27) and EFTA countries. We focus on causes of death at younger ages (0-64 year). EUROSTAT delivered updated population numbers and mortality data by sex, age and cause of death for 272 NUTS-2 regions. We compared mortality by life tables, cause decomposition life tables and age standardized rates. Gini coefficients estimated inequity of death rates over the regions. Life expectancy at birth in the EU-27 was 75.1 years (men) and 81.3 years (women). The difference between the 10th and 90th percentile of 272 regions was 8.0 (men) and 5.6 years (women). Men lived 6.1 years shorter in the new member states (NMS, new members since 2004) than in the EU-15 (members before 2004), women 3.9 years. 60% (men) and 33% (women) of the differences in life expectancy between EU 15 and NMS were explained by mortality under age 65. The main causes explaining differences in life expectancy were ischemic and other heart disease, stroke, alcohol related mortality, lung cancer and injuries. The fraction of ill defined causes of death was large and very variable between countries. Mortality differences in the EU-27 are dominated by smoking, alcohol, diseases related to diet and a sedentary lifestyle, unsafe roads and differences in health care performance. Closing the health gap is feasible and ought to be a major target of the European Union, but monitoring will need better registration of causes of death.