Department of Sociology and Demography, University of Rostock; Max Planck Institute forDemographic Research, Rostock.
Center for Demography and Population Health, Florida State University, Tallahassee, USA.
Dtsch Arztebl Int. 2020 Jul 20;117(29-30):493-499. doi: 10.3238/arztebl.2020.0493.
Identifying regions with low life expectancy is important to policy makers, in particular for allocating resources in the health system. Life expectancy estimates for small regions are, however, often unreliable and lead to statistical uncertainties when the underlying populations are relatively small.
We combine the most recent German data available (2015-2017) with a Bayesian model that includes several methodological advances. This allows us to estimate male and female life expectancy with good precision for all 402 German districts and to quantify the uncertainty of those estimates.
Across districts, life expectancy varies between 75.8 and 81.2 years for men and from 81.8 to 85.7 years for women. The spatial pattern is similar for women and men. Rural districts in eastern Germany and some districts of the Ruhr region have relatively low life expectancy. Districts with relatively high life expectancies cluster in Baden-Wuerttemberg and southern Bavaria. Exploratory analysis shows that average income, population density, and number of physicians per 100 000 inhabitants are not strongly correlated with life expectancy at district level. In contrast, indicators that point to particularly disadvantaged segments of the population (unemployment rate, welfare benefits) are better predictors of life expectancy.
We do not find a consistent urban-rural gap in life expectancy. Our results suggest that policies that improve living standards for poorer segment of the population are the most likely to reduce the existing differences in life expectancy.
识别预期寿命较低的地区对于政策制定者非常重要，特别是在卫生系统中分配资源方面。然而，对于较小地区的预期寿命估计往往不可靠，并且当基础人口相对较小时会导致统计不确定性。
我们结合了最新的可用德国数据（2015-2017 年）和一个贝叶斯模型，该模型包含了一些方法上的改进。这使我们能够为所有 402 个德国地区准确估计男性和女性的预期寿命，并量化这些估计的不确定性。
在各个地区，男性的预期寿命在 75.8 岁至 81.2 岁之间，女性的预期寿命在 81.8 岁至 85.7 岁之间。男女的空间模式相似。德国东部的农村地区和鲁尔地区的一些地区预期寿命相对较低。预期寿命相对较高的地区集中在巴登-符腾堡州和巴伐利亚南部。探索性分析表明，平均收入、人口密度和每 10 万居民的医生人数与地区一级的预期寿命没有很强的相关性。相比之下，指向人口中特别弱势群体（失业率、福利）的指标是预期寿命更好的预测指标。
我们没有发现预期寿命在城乡之间存在一致的差距。我们的结果表明，改善贫困人口生活水平的政策最有可能缩小现有的预期寿命差距。
