# Exploring the relationship between economic performance and life expectancy across Europe's regions between 2005 and 2018

Markus Sauerberg, Michael Mühlichen, Laura Ann Cilek, Florian Bonnet, Ina Alliger, Carlo Giovanni Camarda

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## To cite this version:

Markus Sauerberg, Michael Mühlichen, Laura Ann Cilek, Florian Bonnet, Ina Alliger, et al.. Exploring the relationship between economic performance and life expectancy across Europe's regions between 2005 and 2018. Jahrestagung der Deutsche Gesellschaft für Demographie (Annual Conference of the German Demographic Society), Mar 2024, Hamburg, Germany. **hal-05453985**

HAL Id: hal-05453985

https://hal.science/hal-05453985v1

Submitted on 12 Jan 2026

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# Exploring the relationship between economic performance and life expectancy across Europe's regions between 2008 and 2019

Markus Sauerberg<fnref n="1" />, Michael Mühlichen<fnref n="1" />, Laura Ann Cilek<fnref n="1" />, Florian Bonnet<fnref n="2" />, Ina Alliger<fnref n="1" />, and Giancarlo Camarda<fnref n="2" />

<figure><img src="image_3.png" /><figcaption>Scatter-diagram of relations between life expectancy at birth ($e_{0}^{0}$) and national income per head for nations in the 1900s, 1930s, and 1960s.</figcaption></figure>

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European Research Council
Established by the European Commission

<footnote n="1">¹Bundesinstitut für Bevölkerungsforschung (BiB), Wiesbaden, Germany.</footnote>

<footnote n="2">²French Institute for Demographic Studies (INED), Aubervilliers, France.</footnote>
# What is already known on this topic?

## Two facts from Preston's original paper:

1. Strong, positive relationship between income levels and life expectancy

2. Curve is shifting upwards, life expectancy increases over time at all income levels

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## More recently, literature has found...

1. Recent life expectancy gains in Europe have been dependent on economic growth but the curve did not shift much upwards since 1960 (Mackenbach & Looman 2013)

2. Relative income matters more than absolute income, income equality brings gains in life expectancy (Wilkinson 1997)

3. Some countries are laying below the curve, indicating untapped potential (Shkolnikov et al. 2019; Freeman et al. 2020)

<figure><img src="image_7.png" /></figure>

JSTOR

https://www.jstor.org > stable

⋮

### The Changing Relation between Mortality and Level of ...

by SH Preston · 1975
Cited by 2455
**Preston** and Verne E. Nelson. 'Structure and Change in Causes of Death: An International Sum- mary', Population Studies, 28(1) (March 1974), pp....
# What can this study add?

The regional perspective is missing in the previous literature. It can be useful to look at regions because...

1. Both, mortality and income vary substantially within countries

2. A strong relationship between life expectancy and income within countries would highlight the importance of relative income differences

3. Previous studies have found that economic success does not necessarily lead to high life expectancy (Jasilionis et al. 2023 for Germany, Ho 2022 for the US, Leon et al. 2019 for the UK)

## Germany, men

<figure><img src="image_8.png" /></figure>

## Germany, women

<figure><img src="image_9.png" /></figure>
# Data and methods

## Mortality data

* Death and population counts by region, age, sex, and year (REDIM database)

* Mortality data has been smoothed over age and time using the method proposed by Camarda (2019)

## Income data

* GDP per capita in € at the regional level obtained from Eurostat (nama_10r_3gdp)

<figure><img src="image_10.png" /></figure>

Source: REDIM data (2024), own calculations.
# Data and methods

## Important to note:

* Estonia and Latvia only available at the national level

* For Germany, we use *Raumordnungsregionen* instead of NUTS

* For Italy, we have combined some regions to obtain a consistent time series

* Some islands were excluded from the analysis

## Available time series:

* Annual values from 2008 to 2019 (excluding the pandemic years, covers the EU enlargement period but also the financial crises)

<table><thead><tr><th></th><th>Country</th><th>NUTS level</th><th>Region N</th></tr></thead><tbody><tr><td>1</td><td>Austria</td><td>2</td><td>9</td></tr><tr><td>2</td><td>Belgium</td><td>2</td><td>11</td></tr><tr><td>3</td><td>Switzerland</td><td>2</td><td>7</td></tr><tr><td>4</td><td>Czechia</td><td>2</td><td>8</td></tr><tr><td>5</td><td>Germany</td><td>ROR</td><td>96</td></tr><tr><td>6</td><td>Denmark</td><td>2</td><td>5</td></tr><tr><td>7</td><td>Estonia</td><td>0</td><td>1</td></tr><tr><td>8</td><td>Spain</td><td>3</td><td>50</td></tr><tr><td>9</td><td>Finland</td><td>2</td><td>4</td></tr><tr><td>10</td><td>France</td><td>3</td><td>95</td></tr><tr><td>11</td><td>Hungary</td><td>2</td><td>8</td></tr><tr><td>12</td><td>Italy</td><td>3</td><td>92</td></tr><tr><td>13</td><td>Lithuania</td><td>2</td><td>2</td></tr><tr><td>14</td><td>Latvia</td><td>1</td><td>1</td></tr><tr><td>15</td><td>Netherlands</td><td>2</td><td>12</td></tr><tr><td>16</td><td>Norway</td><td>2</td><td>7</td></tr><tr><td>17</td><td>Poland</td><td>3</td><td>73</td></tr><tr><td>18</td><td>Portugal</td><td>2</td><td>7</td></tr><tr><td>19</td><td>Sweden</td><td>2</td><td>8</td></tr><tr><td>20</td><td>Slovenia</td><td>2</td><td>2</td></tr><tr><td>21</td><td>Slovakia</td><td>3</td><td>8</td></tr></tbody></table>

Total N 506
# Spatial pattern of life expectancy at birth and GDP per capita across Europe's regions

## $e_0$, Men

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Life expectancy at birth in 2014 (in years)

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## GDP per capita

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GDP per capita in 2014 (per 1,000)

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## $e_0$, Women

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Life expectancy at birth in 2014 (in years)

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# Variation in regional life expectancy and GDP per capita between 2008 and 2019

<figure><img src="image_17.png" /><figcaption>## Life expectancy at birth</figcaption></figure>

Regional variation in life expectancy decreases over time, for women on lower level

<figure><img src="image_18.png" /><figcaption>## GDP per capita</figcaption></figure>

Regional variation in GDP per capita does not show a clear trend between 2008 and 2019
# Relationship between national life expectancy and income á la Preston

<figure><img src="image_19.png" /><figcaption>Life expectancy regressed on GDP per capita, 2019</figcaption></figure>

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# Relationship between regional life expectancy and income for 506 regions

<figure><img src="image_21.png" /><figcaption>## Life expectancy regressed on GDP per capita, 2019</figcaption></figure>

<figure><img src="image_22.png" /></figure>
Relationship between regional life expectancy and
income for 506 regions, selected countries in 2019

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Relationship between regional life expectancy and
income over time in selected countries

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# Results from fixed effects model with panel data

$$ \log(e_{0,i,t}) = \alpha + \beta \cdot \log(GDP_{i,t}) + \eta $$

<table><thead><tr><th>Men</th><th>Women</th></tr></thead><tbody><tr><td>Beta = 0.085***<br>R<sup>2</sup> = 0.58</td><td>Beta = 0.050***<br>R<sup>2</sup> = 0.56</td></tr></tbody></table>

For every 1 % increase in GDP per capita, life expectancy is expected to increase by 0.085 % for men and 0.05 % for women.

Or, if GDP per capita doubles, life expectancy is expected to increase by 6 % for men and 3.5 % for women.

For instance, doubling GDP per capita would increase life expectancy for men from 78 to 82.7 years (4.7 years increase), while women's life expectancy would increase from 83 to 85.9 years (2.9 years).
Outlook: Spatial autocorrelation (LISA cluster plots)

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Outlook: Relationship between national life expectancy and income inequality

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# Discussion & Conclusion

## Our first results suggest

* Life expectancy is correlated with GDP per capita at the regional level

* Magnitude of the relationship differs between countries and between women and men

* We do not observe a clear upward shift in the „Preston curve”

## Limitations

* Relatively short time series (2008 to 2019) and effect of the financial crises

* Only correlations, no causation

* Other measures such as the household income or educational attainment might be more appropriate
Thank you

Markus Sauerberg
Federal Institute for
Population Research (BiB)

Phone: +49 611 75 4914
markus.sauerberg@bib.bund.de
https://twitter.com/MarkusSauerberg

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