Trends in life expectancy by income from 1988 to 2007: decomposition by age and cause of death

Abstract

Background: Less attention has been paid to mortality trends across income groups than those measured by other socioeconomic indicators. This study assessed the change in life expectancy by income over 20 years in the Finnish general population.

Methods: Life expectancy among 35-year-olds by household income quintiles was studied. Change in life expectancy from 1988-92 to 2003-7 was decomposed by age and cause of death. The dataset contained 754,087 deaths by oversample of 80% of all deaths during the period.

Results: The gap in life expectancy between the highest and the lowest income quintiles widened during the study period by 5.1 years among men and 2.9 years among women, and in 2007 it stood at 12.5 years and 6.8 years, respectively. Stagnation in the lowest income group was the main reason for the increased disparity for both sexes. Increasing mortality attributable to alcohol-related diseases and increasing or stagnating mortality for many cancers, as well as a slower decline in mortality due to ischaemic heart disease among men in the lowest income quintile, were the most significant factors increasing the gap.

Conclusions: The increasing gap in life expectancy was mostly due to the stagnation of mortality in the lowest income quintile and especially because of the increasing mortality in alcohol-related diseases. The increase in disparity may be more extreme when using income instead of occupational class or education, possibly because income identifies a lower and economically more deprived segment on a social hierarchy more clearly. The results identify a clear need to tackle the specific health problems of the poorest.