Earlier death among people in socioeconomically deprived circumstances has been found internationally and for various causes of death, resulting in a considerable life-expectancy gap between socioeconomic groups. We examined how age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy have changed at the area level in Germany over time. In this ecological study, official German population and cause-of-death statistics provided by the Federal Statistical Office of Germany for the period Jan 1, 2003, to Dec 31, 2021, were linked to district-level data of the German Index of Socioeconomic Deprivation. Life-table and decomposition methods were applied to calculate life expectancy by area-level deprivation quintile and decompose the life-expectancy gap between the most and least deprived quintiles into age-specific and cause-specific mortality contributions. Over the study period, population numbers varied between 80 million and 83 million people per year, with the number of deaths ranging from 818 000 to 1 024 000, covering the entire German population. Between Jan 1, 2003, and Dec 31, 2019, the gap in life expectancy between the most and least deprived quintiles of districts increased by 0·7 years among females (from 1·1 to 1·8 years) and by 0·1 years among males (from 3·0 to 3·1 years). Thereafter, during the COVID-19 pandemic, the gap increased more rapidly to 2·2 years in females and 3·5 years in males in 2021. Between 2003 and 2021, the causes of death that contributed the most to the life-expectancy gap were cardiovascular diseases and cancer, with declining contributions of cardiovascular disease deaths among those aged 70 years and older and increasing contributions of cancer deaths among those aged 40–74 years over this period. COVID-19 mortality among individuals aged 45 years and older was the strongest contributor to the increase in life-expectancy gap after 2019. To reduce the socioeconomic gap in life expectancy, effective efforts are needed to prevent early deaths from cardiovascular disease and cancer in socioeconomically deprived populations, with cancer prevention and control becoming an increasingly important field of action in this respect. German Cancer Aid and European Research Council.

中文翻译：

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特定年龄和特定原因死亡率对德国预期寿命社会经济差距的影响，2003-21：一项生态研究


国际上发现，在社会经济贫困的情况下，人们因各种死因而过早死亡，导致社会经济群体之间的预期寿命差距相当大。我们研究了德国各地区随着时间的推移，特定年龄和特定原因死亡率对预期寿命社会经济差距的影响如何变化。在这项生态研究中，德国联邦统计局提供的2003年1月1日至2021年12月31日期间的德国官方人口和死因统计数据与德国社会经济指数的地区级数据相关联。剥夺。应用生命表和分解方法按地区五分位数计算预期寿命，并将最贫困五分位数和最不贫困五分位数之间的预期寿命差距分解为特定年龄和特定原因的死亡率贡献。在研究期间，每年人口数量在8000万至8300万人之间变化，死亡人数从818000人到1024000人不等，涵盖了整个德国人口。 2003年1月1日至2019年12月31日期间，最贫困和最贫困的五分之一地区女性的预期寿命差距扩大了0·7岁（从1·1岁增加到1·8岁），女性的预期寿命差距扩大了0·1岁男性的年龄（从 3·0 到 3·1 年）。此后，在 COVID-19 大流行期间，这一差距增长得更快，到 2021 年，女性为 2·2 年，男性为 3·5 年。 2003年至2021年间，对预期寿命差距影响最大的死因是心血管疾病和癌症，70岁及以上人群中心血管疾病死亡的贡献下降，40岁以上人群中癌症死亡的贡献增加。在此期间已有74年。 45岁及以上人群中的COVID-19死亡率是2019年后预期寿命差距扩大的最大因素。为了缩小预期寿命的社会经济差距，需要采取有效措施，从社会经济角度预防心血管疾病和癌症导致的早期死亡。癌症预防和控制成为这方面日益重要的行动领域。德国癌症援助组织和欧洲研究委员会。