Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany.
J Epidemiol Community Health. 2019 Jul;73(7):605-611. doi: 10.1136/jech-2018-211742. Epub 2019 Apr 10.
Although estimates of socioeconomic mortality disparities in Germany exist, the trends in these disparities since the 1990s are still unknown. This study examines mortality trends across socioeconomic groups since the late 1990s among retired German men aged 65 and above.
Large administrative data sets were used to estimate mortality among retired German men, grouped according to their working-life biographies. The data covered the years 1997-2016 and included more than 84.1 million person-years and 4.3 million deaths. Individual pension entitlements served as a measure of lifetime income. Changes in total life expectancy at age 65 over time were decomposed into effects of group-specific mortality improvements and effects of compositional change.
Over the two decades studied, male mortality declined in all income groups in both German regions. As mortality improved more rapidly among higher status groups, the social gradient in mortality widened. Since 1997, the distribution of pension entitlements of retired East German men has shifted substantially downwards. As a result, the impact of the most disadvantaged group on total mortality has increased and has partly attenuated the overall improvement.
Our results demonstrate that socioeconomic deprivation has substantial effects on levels of mortality in postreunification Germany. While East German retirees initially profited from the transition to the West German pension system, subsequent cohorts had to face challenges associated with the transition to the market economy. The results suggest that postreunification unemployment and status decline had delayed effects on old-age mortality in East Germany.
尽管德国存在社会经济地位与死亡率差异的估计值,但自 1990 年代以来这些差异的趋势仍不清楚。本研究考察了自 1990 年代末以来,65 岁及以上退休德国男性中各社会经济群体的死亡率趋势。
利用大型行政数据集,根据退休德国男性的工作生涯传记对死亡率进行估计。该数据集涵盖了 1997 年至 2016 年期间,包含超过 8410 万人年和 430 万人死亡。个人养老金权益作为终身收入的衡量标准。65 岁时总预期寿命的变化随时间分解为特定组死亡率改善的影响和组成变化的影响。
在研究的二十年中,德国两个地区所有收入群体的男性死亡率都有所下降。由于较高地位群体的死亡率改善速度更快,死亡率的社会梯度扩大了。自 1997 年以来,东德男性退休人员的养老金权益分配已大幅下降。结果,最弱势群体对总死亡率的影响增加,并部分减弱了整体改善。
我们的研究结果表明,社会经济贫困对后统一德国的死亡率水平有实质性影响。虽然东德退休人员最初从向西德养老金制度的过渡中受益,但随后的几代人必须面对与向市场经济过渡相关的挑战。研究结果表明,后统一时期的失业和地位下降对东德的老年死亡率有延迟影响。