Are There Differences in Health Inequality in Germany and across German Regions? Evidence for Retired Men Aged 65+ from the German Pension Fund Data.

Pavel Grigoriev, Max Planck Institute for Demographic Research
Vladimir M. Shkolnikov, MPIDR
Georg Wenau, Max Planck Institute for Demographic Research

Background: Socioeconomic differences in mortality have been identified by a large number of studies for nearly all Western societies by now. These studies reveal substantial health disadvantages for groups with lower socioeconomic status. A social gradient in health and mortality can be found in Germany as well. However, there are only a few studies which describe socioeconomic differentials in mortality for the German population as a whole and actually nothing is known about how these inequalities differ across regions. This study is the first to investigate socioeconomic differences in old-age mortality among German men aged 65+ on the level of federal states.

Data: A full administrative sample of all retirees for the year 2015 was available from the German Statutory Insurance Scheme. These individual-level data contain precise information about the working life history for about six million men as well as reliable information about the end of individual annuity payment due to death.

Methods: Average Pension Points per year serve as a proxy for the relative socioeconomic position of a person over the course of working life. Pension Points reflect the amount of income which was subject to social insurance contributions and are the basis for subsequent calculations of individual pension payments. Based on Poisson Regression, mortality rate ratios (MRR) are estimated for population subgroups according to quintiles of average Pension Points, type of health insurance and place of living.

Results: Preliminary results reveal substantial socioeconomic and regional differences in mortality among the sample population. Compared to the most advantaged group, the MRR for the most disadvantaged group is about twice as high in almost all German federal states. Further results show that the mortality level of the advantaged group is relatively equally distributed across German regions, whereas the mortality level of the disadvantaged groups differ substantially between German regions.

Presented in Session 108: Socioeconomic Inequalities in Mortality: The Role of Occupation/Income