Skip to main content

Determinants of Old-Age Mortality and Its Regional Variation: Composition and Context

  • Chapter
  • First Online:
  • 497 Accesses

Part of the book series: Demographic Research Monographs ((DEMOGRAPHIC))

Abstract

Having addressed the issues of how mortality varies across the districts, how it changes over time, and how it is associated with determinants that are measured at a regional level, this study now looks at the influence of the characteristics of individuals on regional mortality variation. It is clear that the associations at the regional level are partly related to the characteristics of individuals living in different areas of Germany and are partly related to the environmental contexts in these places.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    The last occupation of pensioners is recorded unless the pensioner has ever worked as a miner. In this case, the pensioner’s former occupation is always recorded as miner.

  2. 2.

    Pensions that are not paid out because the pensioners receive income. The pensions of these people are called Nullrenten.

  3. 3.

    This yielded the selection of eight variables: unemployment rate, GDP per capita, voter turnout, income per capita, living space, share of employees without any degree, population change, and the population forecast.

  4. 4.

    The reference district is the urban district of Flensburg, a district situated in Schleswig-Holstein with approximately average mortality.

  5. 5.

    An East-West dummy variable is not introduced here as its effect is small once explanatory variables and random intercepts for the districts are introduced (results not shown).

  6. 6.

    Sextiles were chosen as the division of districts into quartiles or quintiles would mainly leave eastern Germany in one quantile; such an artifact should be avoided.

References

  • Berger, U., Voigtländer, S., & Razum, O. (2008). Die Eignung von Mehrebenenmodellen zur Untersuchung kleinräumiger Effekte. Presented at Internationale Fachtagung Health Inequalities III; AG 5: Gesundheitliche Unterschiede und die Soziologie sozialer Ungleichheit.

    Google Scholar 

  • Blomgren, J., & Valkonen, T. (2007). Characteristics of urban regions and all-cause mortality in working-age population. Effects of social environment and interactions with individual unemployment. Demographic Research, 17(5), 109–134.

    Article  Google Scholar 

  • Blomgren, J., Martikainen, P., Mäkelä, P., & Valkonen, T. (2004). The effects of regional characteristics on alcohol-related mortality–a register-based multilevel analysis of 1.1 million men. Social Science & Medicine, 58(12), 2523–2535.

    Article  Google Scholar 

  • Breckenkamp, J., Mielck, A., & Razum, O. (2007). Health inequalities in Germany: Do regional-level variables explain differentials in cardiovascular risk? BMC Public Health, 7(132).

    Google Scholar 

  • Brockmann, H., Müller, R., & Helmert, U. (2009). Time to retire–Time to die? A prospective cohort study of the effects of early retirement on long-term survival. Social Science & Medicine, 69(2), 160–164.

    Article  Google Scholar 

  • Brzoska, P., & Razum, O. (2008). Privatverschuldung und Mortalität: Untersuchung auf Ebene der Kreise und kreisfreien Städte Deutschlands. Das Gesundheitswesen, 70(7), 387–392.

    Article  Google Scholar 

  • Chaix, B., & Chauvin, P. (2002). L’apport des modèles multiniveau dans l’analyse contextuelle en epidemiologie sociale: une revue da la littérature. Revue d’Épidémiologie et de Santé Publique, 50(5), 489–499.

    Google Scholar 

  • Chaix, B., Rosvall, M., & Merlo, J. (2007). Neighborhood socioeconomic deprivation and residential instability: Effects on incidence of ischemic heart disease and survival after myocardial infarction. Epidemiology, 18(1), 104–111.

    Article  Google Scholar 

  • Cischinsky, H. (2005). Determinanten regionaler Mortalitätsunterschiede am Beispiel Baden-Württembergs. Jahrbuch für Regionalwissenschaft, 25(2), 175–205.

    Google Scholar 

  • Congdon, P., Shouls, S., & Curtis, S. (1997). A multi-level perspective on small-area health and mortality: A case study of England and Wales. International Journal of Population Geography, 3(3), 243–263.

    Article  Google Scholar 

  • Courgeau, D. (2007). Multilevel synthesis: From the group to the individual. The Springer series on demographic methods and population analysis. Dordrecht: Springer.

    Google Scholar 

  • Cromm, J., & Scholz, R. (Eds.). (2002). Regionale Sterblichkeit in Deutschland. Augsburg/Göttingen: WiSoMed.

    Google Scholar 

  • Deutsche Rentenversicherung Bund. (2006). Rentenzugang des Jahres 2005 einschließlich Rentenwegfall, Rentenänderung/Änderung des Teilrentenanteils in der deutschen gesetzlichen Rentenversicherung. Statistik der Deutschen Rentenversicherung. Berlin: Deutsche Rentenversicherung Bund.

    Google Scholar 

  • Diez-Roux, A. V. (2000). Multilevel analysis in public health research. Annual Review of Public Health, 21(1), 171–192.

    Article  Google Scholar 

  • Diez-Roux, A. V. (2001). Investigating neighborhood and area effects on health. American Journal of Public Health, 91(11), 1783–1789.

    Article  Google Scholar 

  • Diez-Roux, A. V. (2002). A glossary for multilevel analysis. Journal of Epidemiology and Community Health, 56(8), 588–594.

    Article  Google Scholar 

  • Dragano, N., Bobak, M., Wege, N., Peasey, A., Verde, P. E., Kubinova, R., Weyers, S., Moebus, S., Möhlenkamp, S., Stang, A., Erbel, R., Jöckel, K.-H., Siegrist, J., & Pikart, H. (2007). Neighbourhood socioeconomic status and cardiovascular risk factors: A multilevel analysis of nine cities in the Czech Republic and Germany. BMC Public Health, 7, 255.

    Article  Google Scholar 

  • Dragano, N., Hoffmann, B., Moebus, S., Möhlenkamp, S., Stang, A., Verde, P. E., Jöckel, K.-H., Erbel, R., & Siegrist, J. (2009a). Traffic exposure and subclinical cardiovascular disease: is the association modified by socioeconomic characteristics of individuals and neighbourhoods? Results from a multilevel study in an urban region. Journal of Occupational and Environmental Medicine, 66(9), 628–635.

    Article  Google Scholar 

  • Dragano, N., Hoffmann, B., Stang, A., Moebus, S., Verde, P. E., Weyers, S., Möhlenkamp, S., Schmermund, A., Mann, K., Jöckel, K.-H., Erbel, R., Siegrist, J., & on behalf of the Heinz Nixdorf Recall Study Investigative Group. (2009b). Subclinical coronary atherosclerosis and neighbourhood deprivation in an urban region. European Journal of Epidemiology, 24(1), 25–35.

    Article  Google Scholar 

  • DRV Bund. (2007). FDZ-RV SUFRTBNRTWF94-04TDemoKibele; special tabulation of pension payments and pension omissions due to death by long-distance computation (Restricted use). Dataset, German Federal Pension Fund (DRV Bund).

    Google Scholar 

  • Duncan, C., Jones, K., & Moon, G. (1993). Do places matter? A multi-level analysis of regional variations in health-related behaviour in Britain. Social Science & Medicine, 37(6), 725–733.

    Article  Google Scholar 

  • German Federal Agency for Cartography and Geodesy. (2007). Shape files for German federal states and districts; adjusted files based on: Geobasisinformationen, © Bundesamt für Kartographie und Geodäsie (BKG) und Vermessungsverwaltungen der Bundesländer (www.bkg.bund.de).

  • Hank, K. (2003). The differential influence of women’s residential district on the risk of entering first marriage and motherhood in Western Germany. Population and Environment, 25(1), 3–21.

    Article  Google Scholar 

  • Healy, M. J. R. (2001). Multilevel data and their analysis. In A. H. Leyland & H. Goldstein (Eds.), Multilevel modelling of health statistics(pp. 1–12). Chichester: Wiley.

    Google Scholar 

  • Heilmann, M. (2002). Vorlesung: Sozialpolitik II–System der Sozialen Sicherung. Lectures notes University of Rostock, Summer Semester 2002.

    Google Scholar 

  • Heins, F. (1991). Regional disparities in mortality: The case of North Rhine-Westphalia and Rhineland-Palatinate. Espace, Populaitons, Societé, 1, 101–111.

    Article  Google Scholar 

  • Himmelreicher, R. K., Sewöster, D., Scholz, R., & Schulz, A. (2008). Die fernere Lebenserwartung von Rentnern und Pensionären im Vergleich. WSI Mitteilungen, 5, 274–280.

    Google Scholar 

  • Hoffmann, R. (2005). Do socioeconomic mortality differences decrease with rising age? Demographic Research, 13(2), 35–62.

    Article  Google Scholar 

  • Hox, J. (2002). Multilevel analysis: Techniques and applications. New Jersey: Lawrence Erlbaum Associates.

    Google Scholar 

  • Jaffe, D. H., Eisenbach, Z., Neumark, Y. D., & Manor, O. (2005). Does living in a religiously affiliated neighborhood lower mortality? Annals of Epidemiology, 15(10), 804–810.

    Article  Google Scholar 

  • Jdanov, D. A., Scholz, R. D., & Shkolnikov, V. M. (2005). Official population statistics and the Human Mortality Database estimates of populations aged 80+ in Germany and nine other European countries. Demographic Research, 13(14), 335–362.

    Article  Google Scholar 

  • Kemptner, D., Wildner, M., Abu-Omar, K., Caselmann, W. H., Kerscher, G., Reitmeir, P., Mielck, A., & Rütten, A. (2008). Regionale Unterschiede des Gesundheitsverhaltens in Bayern–Mehrebenenanalyse einer bevölkerungsrepräsentativen Befragung in Verbindung mit sozioökonomischen Strukturdaten. Das Gesundheitswesen, 70(1), 28–37.

    Article  Google Scholar 

  • Kibele, E. (2008). Determinanten von regionalen Mortalitätsunterschieden in der Rentnerbevölkerung. In Deutsche Rentenversicherung Bund (Ed.), Etablierung und Weiterentwicklung. Bericht vom vierten Workshop des Forschungsdatenzentrums der Rentenversicherung (FDZ-RV) vom 28. bis 29. Juni 2007 in Berlin (pp. 143–156). Deutsche Rentenversicherung Bund.

    Google Scholar 

  • Kibele, E., Scholz, R., & Shkolnikov, V. M. (2008). Low migrant mortality in Germany for men aged 65 and older: Fact or artifact? European Journal of Epidemiology, 23(6), 389–393.

    Article  Google Scholar 

  • Klocke, A., & Lipsmeier, G. (2008). Soziale Determinanten der Gesundheit im Kindes- und Jugendalter: Eine Mehrebenenanalyse. In Gesundheit, Ungleichheit und jugendliche Lebenswelten. Ergebnisse der zweiten internationalen Vergleichsstudie im Auftrag der Weltgesundheitsorganisation(pp. 231–254). WHO.

    Google Scholar 

  • Koller, D., & Mielck, A. (2009). Regional and social differences concerning overweight, participation in health check-ups and vaccination. Analysis of data from a whole birth cohort of 6-year old children in a prosperous German city. BMC Public Health, 9, 43.

    Article  Google Scholar 

  • Kravdal, O. (2006). Does place matter for cancer survival in Norway? A multilevel analysis of the importance of hospital affiliation and municipality socio-economic resources. Health & Place, 12(4), 527–537.

    Article  Google Scholar 

  • Kravdal, O. (2007). A fixed-effects multilevel analysis of how community family structure affects individual mortality in Norway. Demography, 44(3), 519–536.

    Article  Google Scholar 

  • Kroll, L. E., & Lampert, T. (2007). Soziales Kapital und Gesundheit eine Mehrebenenanalyse auf Basis der Daten des Sozio-ökonomischen Panels (SOEP) 2003. In Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House.

    Google Scholar 

  • Kruse, A., & Doblhammer-Reiter, G. (2008). Determinanten des Pflegebedarfs in den Regionen Deutschlands. In Statistische Woche, Workshop: Sterblichkeit, Gesundheit und Pflege in Deutschland.

    Google Scholar 

  • Kuhn, J., Zirngibl, A., Wildner, M., Caselmann, W. H., & Kerscher, G. (2006). Regionale Sterblichkeitsunterschiede in Bayern. Das Gesundheitswesen, 68(8/9), 551–556.

    Article  Google Scholar 

  • Kühntopf, S., & Tivig, T. (2008). Early retirement in Germany: Loss of income and lifetime? (Thünen-Series of Applied Economic Theory working paper 85).

    Google Scholar 

  • Kulu, H., & Billari, F. C. (2004). Multilevel analysis of internal migration in a transitional country: The case of Estonia. Regional Studies, 38(6), 679–696.

    Article  Google Scholar 

  • Langford, I. H., & Day, R. J. (2001). Poisson regression. In A. H. Leyland & H. Goldstein (Eds.), Multilevel modelling of health statistics(pp. 45–57). Chichester: Wiley.

    Google Scholar 

  • Lauterbach, K., Lüngen, M., Stollenwerk, B., Gerber, A., & Clever-Deichert, G. (2006). Zum Zusammenhang zwischen Einkommen und Lebenserwartung. Studien zu Gesundheit, Medizin und Gesellschaft; Köln Ausgabe 01/2006 vom 25.02.2006.

    Google Scholar 

  • Lillard, L. A., & Panis, C. W. A. (2003). aML: Multilevel multiprocess modeling; version 2, user’s guide and reference manual. Los Angeles: EconWare.

    Google Scholar 

  • Lochner, K., Pamuk, E., Makuc, D., Kennedy, B. P., & Kawachi, I. (2001). State-level income inequality and individual mortality risk: A prospective, multilevel study. American Journal of Public Health, 91(3), 385–391.

    Article  Google Scholar 

  • Luy, M. (2006). Differentielle Sterblichkeit: die ungleiche Verteilung der Lebenserwartung in Deutschland (Rostocker Zentrum–Diskussionspapier 6).

    Google Scholar 

  • Maas, C. J. M., & Hox, J. J. (2005). Sufficient sample sizes for multilevel modeling. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 1(3), 86–92.

    Article  Google Scholar 

  • Macintyre, S., Maciver, S., & Sooman, A. (1993). Area, class and health: Should we be focusing on places or people? Journal of Social Policy, 22(2), 213–234.

    Article  Google Scholar 

  • Martikainen, P., Kauppinen, T. M., & Valkonen, T. (2003). Effects of the characteristics of neighbourhoods and the characteristics of people on cause specific mortality: A register based follow up study of 252 000 men. Journal of Epidemiology and Community Health, 57(3), 210–217.

    Article  Google Scholar 

  • Martikainen, P., Mäki, N., & Blomgren, J. (2004). The effects of area and individual social characteristics on suicide risk: A multilevel study of relative contribution and effect modification. European Journal of Population, 20(4), 323–350.

    Article  Google Scholar 

  • Mika, T. (2006). Potenziale der Migrationsforschung mit dem Rentenbestand und dem Rentenzugang. In Deutsche Rentenversicherung Bund (Ed.), Erfahrungen und Perspektiven, Bericht vom dritten Workshop des Forschungsdatenzentrums der Rentenversicherung (FDZ-RV) vom 26-28. Juni 2006 in Bensheim (pp. 52–81). Deutsche Rentenversicherung Bund.

    Google Scholar 

  • Müller, H.-W., & Rehfeld, U. (1985a). Die Sterblichkeit von Altersrentnern in der gesetzlichen Rentenversicherung in den Jahren 1982-1984: zur Lebenserwartung berufstätiger Frauen und Männer. Deutsche Rentenversicherung, 382–403.

    Google Scholar 

  • Müller, H.-W., & Rehfeld, U. (1985b). Zur Rentnersterblichkeit unter besonderer Berücksichtigung langjährig berufstätiger Frauen und Männern. Blätter der deutschen Gesellschaft für Versicherungsmathematik, 17(2), 141–162.

    Google Scholar 

  • Pickett, K. E., & Pearl, M. (2001). Multilevel analyses of neighbourhood socioeconomic context and health outcomes: A critical review. Journal of Epidemiology and Community Health, 55(2), 111–122.

    Article  Google Scholar 

  • Queste, A. (2007). Analyse kleinräumiger Mortalitätsraten in Deutschland. Bielefeld: Landesinstitut für den öffentlichen Gesundheitsdienst des Landes Nordrhein-Westfalen (lögd).

    Google Scholar 

  • Rabe-Hesketh, S., & Skrondal, A. (2005). Multilevel and longitudinal modeling using stata. College Station: Stata Press.

    Google Scholar 

  • Rehfeld, U., & Scheitl, O. (1986). Die Rentnersterblichkeit 1985: aktuelle Ergebnisse für Altersrentner und einige spezielle Fallgruppen. Deutsche Rentenversicherung, 11–12, 729–737.

    Google Scholar 

  • Rehfeld, U., & Scheitl, O. (1991). Sterblichkeit und fernere Lebenserwartung von Rentnern der gesetzlichen Rentenversicherung: aktuelle Ergebnisse für 1986/1988 und die Bilanz zum bisherigen Untersuchungsstand. Deutsche Rentenversicherung, 4–5, 289–320.

    Google Scholar 

  • Reil-Held, A. (2000). Einkommen und Sterblichkeit in Deutschland: Leben Reiche länger? Beiträge zur angewandten Wirtschaftsforschung, Universität Mannheim 580-00.

    Google Scholar 

  • Riva, M., Gauvin, L., & Barnett, T. A. (2007). Toward the next generation of research into small area effects on health: A synthesis of multilevel investigations published since July 1998. Journal of Epidemiology and Community Health, 61(10), 853–861.

    Article  Google Scholar 

  • Robinson, W. S. (2009). Ecological correlations and the behavior of individuals. International Journal of Epidemiology, 38(2), 337–341.

    Article  Google Scholar 

  • Scholz, R. (2005). Differentielle Sterblichkeitsanalyse mit den Daten der Deutschen Rentenstatistik. In Deutsche Rentenversicherung Bund (Ed.), Forschungsrelevante Daten der Rentenversicherung(pp. 253–266). Berlin: Deutsche Rentenversicherung Bund.

    Google Scholar 

  • Scholz, R. (2006). Differentielle Mortalität in Deutschland. Schmollers Jahrbuch, 126(3), 375–386.

    Google Scholar 

  • Scholz, R., & Jdanov, D. (2006). Nutzung der Daten des Forschungsdatenzentrums der Rentenversicherung zur wissenschaftlichen Mortalitätsanalyse–Verfahren zur Korrektur der Bevölkerungsbestände der amtlichen Statistik im hohen Alter in Deutschland. In Deutsche Rentenversicherung Bund (Ed.), Erfahrungen und Perspektiven, Bericht vom dritten Workshop des Forschungsdatenzentrums der Rentenversicherung (FDZRV) vom 26-28. Juni 2006 in Bensheim (pp. 200–211). Deutsche Rentenversicherung Bund.

    Google Scholar 

  • Shkolnikov, V. M., Scholz, R., Jdanov, D. A., Stegmann, M., & von Gaudecker, H.-M. (2008). Length of life and the pensions of five million retired German men. European Journal of Public Health, 18(3), 264–269.

    Article  Google Scholar 

  • Sloggett, A., & Joshi, H. (1994). Higher mortality in deprived areas: Community or personal disadvantage? British Medical Journal, 309(6967), 1470–1474.

    Article  Google Scholar 

  • Snijders, T. A. B. (2001). Sampling. In A. H. Leyland & H. Goldstein (Eds.), Multilevel modelling of health statistics(pp. 159–174). Chichester: Wiley.

    Google Scholar 

  • Snijders, T. A. B., & Bosker, R. J. (1999). Multilevel analysis an introduction to basic and advanced multilevel modeling. London: SAGE Publications.

    Google Scholar 

  • Stahl, H. (2003). Deutschland. In Rentenversicherung im internationalen Vergleich 2003(pp. 57–78). Frankfurt am Main: Verband Deutscher Rentenversicherungsträger.

    Google Scholar 

  • Statistisches Bundesamt. (Ed.) (2006). Datenreport 2006. Bundeszentrale für politische Bildung.

    Google Scholar 

  • Strohmeier, K. P., Schultz, A., Bardehle, D., Annuss, R., & Lenz, A. (2007). Sozialräumliche Clusteranalyse der Kreise und kreisfreien Städte und Gesundheitsindikatoren in NRW. Das Gesundheitswesen, 69(1), 26–33.

    Article  Google Scholar 

  • Subramanian, S. V., Kawachi, I., & Kennedy, B. P. (2001). Does the state you live in make a difference? Multilevel analysis of self-rated health in the US. Social Science & Medicine, 53(1), 9–19.

    Article  Google Scholar 

  • Turrell, G., Kavanagh, A., Draper, G., & Surbamanian, S. V. (2007). Do places affect the probability of death in Australia? A multilevel study of area-level disadvantage, individual-level socioeconomic position and all-cause mortality, 1998-2000. Journal of Epidemiology and Community Health, 61(1), 13–19.

    Article  Google Scholar 

  • Unger, R. (2003). Soziale Differenzierung der aktiven Lebenserwartung im internationalen Vergleich. Wiesbaden: DUV–Deutscher Universitäts-Verlag.

    Google Scholar 

  • Voigtländer, S., Berg-Beckhoff, G., & Razum, O. (2008). Gesundheitliche Ungleichheit. Der Beitrag kontextueller Merkmale(Challenges in public health). Frankfurt am Main: Peter Lang.

    Google Scholar 

  • von Gaudecker, H. -M. (2004). Regionale Mortalitätsunterschiede in Baden-Württemberg (MEA Discussion Papers 46-2004).

    Google Scholar 

  • von Gaudecker, H.-M., & Scholz, R. D. (2007). Differential mortality by lifetime earnings in Germany. Demographic Research, 17(4), 83–108.

    Article  Google Scholar 

  • Wittwer-Backofen, U. (1999). Disparitäten der Alterssterblichkeit im regionalen Vergleich: biologische versus sozioökonomische Determinanten; regionale Studien für dem Raum Hessen(Materialien zur Bevölkerungswissenschaft, Vol. 95). Wiesbaden: Bundesinstitut für Bevölkerungsforschung beim Statistischen Bundesamt (BiB).

    Google Scholar 

  • Wolf, C. (2004). Wohnquartier und Gesundheit: Eine Mehrebenenanalyse. In R. Kecskes, M. Wagner, & C. Wolf (Eds.), Angewandte Soziologie(pp. 103–126). Wiesbaden: VS Verlag für Sozialwissenschaften.

    Chapter  Google Scholar 

  • Wolfson, M., Rowe, G., Gentleman, J. F., & Tomiak, M. (1993). Career earnings and death: A longitudinal analysis of older Canadian men. Journal of Gerontology: Social Sciences, 48(4), S167–S179.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eva U. B. Kibele .

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media Dordrecht.

About this chapter

Cite this chapter

Kibele, E.U.B. (2012). Determinants of Old-Age Mortality and Its Regional Variation: Composition and Context. In: Regional Mortality Differences in Germany. Demographic Research Monographs. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4432-5_5

Download citation

Publish with us

Policies and ethics