To better understand increasing inequalities in mortality trends, Rianne de Gelder and colleagues took a long-term approach. Using data from 1970-2010, they explored both absolute and relative inequalities in mortality based on level of education and occupational class. They did so by comparing six countries: England and Wales, Finland, France, Hungary, Italy (Turin) and Norway.
The authors found that all-cause mortality was highest among the lowest educated in the 1970s and began to decline in the early 1980s. It has generally declined faster for the better educated, which has resulted in increasing relative inequalities in all-cause mortality. This was especially true in Hungary and Norway, where relative mortality inequalities were very low in the 1970s but are now higher than in the other countries.
Hungary was also found to be an exception because higher educated women had a higher mortality rate in the 1970s and 1980s.
Despite the rise in relative inequalities, however, the authors describe the absolute decline in all-cause mortality due to cardiovascular disease as a great example of the effectiveness of prevention programmes and better access to care. In three out of the six countries, cancer replaced cardiovascular disease as the leading contributing factor to inequalities among both men and women. With comparable data covering such an extensive period for so many countries, the authors strongly recommended the adoption of similar policies to reduce inequalities in mortality for other diseases, like cancer and alcohol-related conditions.