Does community deprivation determine longevity after the age of 75? A cross-national analysis

  • Ana Isabel Ribeiro
  • Elias Teixeira Krainski
  • Marilia Sá Carvalho
  • Guy Launoy
  • Carole Pornet
  • Maria de Fátima de Pina
Original Article



Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender.


Our study incorporated five countries (Portugal, Spain, France, Italy, and England). A 10-year survival rate expressing the proportion of population aged 75–84 years who reached 85–94 years old was calculated at area-level for 2001–11. To estimate associations, we used Bayesian spatial models and a transnational measure of deprivation. Attributable/prevention fractions were calculated.


Overall, there was a significant association between deprivation and survival in both genders. In England that association was stronger, following a dose–response relation. Although lesser in magnitude, significant associations were observed in Spain and Italy, whereas in France and Portugal these were even weaker. The elimination of socioeconomic differences between areas would increase survival by 7.1%, and even a small reduction in socioeconomic differences would lead to a 1.6% increase.


Socioeconomic deprivation was associated with survival among older adults at ecological-level, although with varying magnitude across countries. Reasons for such cross-country differences should be sought. Our results emphasize the importance of reducing socioeconomic differences between areas.


Ageing Elderly Health inequalities Social factors Europe Longevity Mortality 



This work was supported by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia in the framework of project UID/BIM/04293/2013. AIR and MFP would also like to thank to FC—Fundação para a Ciência e a Tecnologia for the Grants PTDC/SAU-EPI/113424/2009 and SFRH/BD/82529/2011. MSC was supported by CNpQ (309692/2013-0) and FAPERJ (E-26/203.557/2014).We are very grateful to the National Statistic Offices for sending us the required data and to all the members of the European Deprivation Index (EDI) team. The authors would like to thank Rogério Ribeiro for the help in preparing visual supports, Alexandra Guttentag for her work as language editor, and the anonymous reviewers for their highly valuable corrections and suggestions.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

38_2018_1081_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Ana Isabel Ribeiro
    • 1
    • 2
    • 3
    • 4
  • Elias Teixeira Krainski
    • 5
    • 6
  • Marilia Sá Carvalho
    • 7
  • Guy Launoy
    • 8
  • Carole Pornet
    • 9
  • Maria de Fátima de Pina
    • 2
    • 3
    • 10
    • 11
  1. 1.EPIUnit-Instituto de Saúde PúblicaUniversidade do PortoPortoPortugal
  2. 2.i3S-Instituto de Investigação e Inovação em SaúdeUniversidade do PortoPortoPortugal
  3. 3.INEB-Instituto de Engenharia BiomédicaUniversidade do PortoPortoPortugal
  4. 4.Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de MedicinaUniversidade do PortoPortoPortugal
  5. 5.The Norwegian University for Science and TechnologyTrondheimNorway
  6. 6.Departamento de EstatísticaUniversidade Federal do ParanáCuritibaBrazil
  7. 7.PROCC-Programa de Computação Científica, Fundação Oswaldo CruzRio De JaneiroBrazil
  8. 8.U1086 INSERM-University of Caen Normandy (FRANCE), CHU CaenCaenFrance
  9. 9.Public Health DepartmentRegional Health Agency of NormandyCaenFrance
  10. 10.ICICT/FIOCRUZ, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde/Fundação Oswaldo CruzRio De JaneiroBrazil
  11. 11.CARTO, FEN/UERJ, Departamento de Engenharia Cartográfica, Faculdade de Engenharia da, Universidade do Estado do Rio de JaneiroRio De JaneiroBrazil

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