The European Journal of Health Economics

, Volume 16, Issue 5, pp 543–559 | Cite as

Health inequalities in the European Union: an empirical analysis of the dynamics of regional differences

  • Laia Maynou
  • Marc SaezEmail author
  • Jordi Bacaria
  • Guillem Lopez-Casasnovas
Original Paper


In a panel setting, we analyse the speed of (beta) convergence of (cause-specific) mortality and life expectancy at birth in EU countries between 1995 and 2009. Our contribution is threefold. First, in contrast to earlier literature, we allow the convergence rate to vary, and thereby uncover significant differences in the speed of convergence across time and regions. Second, we control for spatial correlations across regions. Third, we estimate convergence among regions, rather than countries, and thereby highlight noteworthy variations within a country. Although we find (beta) convergence on average, we also identify significant differences in the catching-up process across both time and regions. Moreover, we use the coefficient of variation to measure the dynamics of dispersion levels of mortality and life expectancy (sigma convergence) and, surprisingly, find no reduction, on average, in dispersion levels. Consequently, if the reduction of dispersion is the ultimate measure of convergence, then, to the best of our knowledge, our study is the first that shows a lack of convergence in health across EU regions.


Health convergence Beta convergence Sigma convergence Catching-up Spatiotemporal modelling Bayesian models Integrated nested Laplace approximation 

JEL Classification

I14 I15 C33 C11 



This work was partly funded by the Short Term Grant Abroad for PhD European, CIBER of Epidemiology and Public Health (CIBERESP), Spain, benefiting Laia Maynou, who is also a beneficiary of the Grant for Universities and Research Centres for the Recruitment of New Research Personnel (FI-DGR 2012), AGAUR, Government of Catalonia (Generalitat de Catalunya). We appreciate the comments of the attendees at The Health Economists’ Study Group Summer 2013 Conference on 26–28 June 2013 at the University of Warwick, UK, at the New Directions in Welfare III 2013 OECD-Universities Joint Conference on 3–5 July 2013 in Paris, France, and at the 53rd European Regional Science Association on 27–31 August 2013, Palermo, Italy, where a preliminary version of this work was presented. We also appreciate the very valuable comments by the members of the Department of Economics, City University London, UK, and in particular Mireia Jofre-Bonet on a previous version of this article. We appreciate the comments of two anonymous reviewers that, without doubt, helped us improve our work.

Conflict of interest

There are no conflicts of interest for any of the authors. All authors freely disclose any actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within 3 years of beginning the submitted work that could inappropriately influence, or be perceived to influence, their work.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Laia Maynou
    • 1
    • 2
    • 3
  • Marc Saez
    • 1
    • 2
    • 4
    Email author
  • Jordi Bacaria
    • 3
    • 5
  • Guillem Lopez-Casasnovas
    • 6
    • 4
    • 7
  1. 1.Research Group on Statistics, Econometrics and Health (GRECS)University of GironaGironaSpain
  2. 2.CIBER of Epidemiology and Public Health (CIBERESP)MadridSpain
  3. 3.London School of Hygiene and Tropical MedicineLondonUK
  4. 4.Center for Research in Health and Economics (CRES)Universitat Pompeu FabraBarcelonaSpain
  5. 5.Instituto Tecnológico Autónomo de México (ITAM)MexicoMexico
  6. 6.Department of Economics and BusinessUniversitat Pompeu FabraBarcelonaSpain
  7. 7.Barcelona Graduate School (BSGE)Universitat Pompeu FabraBarcelonaSpain

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