Widening socioeconomic differences in mortality among men aged 65 years and older in Germany

Background Although socioeconomic mortality differences in Germany are well documented, trends in group-specific mortality and differences between the eastern and the western parts of the country remain unexplored.

Methods Population and death counts by level of lifetime earnings (1995-1996 to 2007-2008) and broad occupational groups (1995-1996 to 2003-2004) for men aged 65 years and older were obtained from the German Federal Pension Fund. Directly standardised mortality rates and life expectancy at age 65 were used as mortality measures.

Results Mortality declined in all socioeconomic groups in eastern and western Germany and these declines tended to be larger in higher status groups. Relative socioeconomic differences in age-standardised mortality rates and in life expectancy at age 65 widened over time. Absolute differences widened over the majority of time periods. The widening was more pronounced in eastern Germany.

Conclusions Widening socioeconomic mortality differences in Germany, especially in eastern Germany, show that population groups did not benefit equally from the improvements in survival. The results suggest that special efforts have to be taken in order to reduce mortality among people with lower socioeconomic status, especially in eastern Germany. Health equity should be considered a priority when planning policies, practices, and changes in the healthcare system and related sectors.