Department of International Health, Maastricht University, Care and Public Health Research Institute, CAPHRI, Maastricht, The Netherlands.
Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands.
Eur J Public Health. 2020 Dec 11;30(6):1108-1115. doi: 10.1093/eurpub/ckaa038.
The high mortality rates in the European Union (EU) Member States that acceded in 2004 sparked political interest in mortality convergence. Whether mortality is converging in the EU remains unclear. We reviewed the literature on mortality convergence in the post-2004 EU territory as a whole. We also explored whether the study designs influenced the results and whether any determinants of mortality convergence had been empirically examined.
A systematic literature review was performed. Our search included scientific databases and the websites of international governmental institutions and European demographic research institutes.
We uncovered 94 unique records and included seven studies that reported on 36 analyses. There was marked methodological heterogeneity, including in the convergence measures (beta and sigma convergence). All of the beta convergence analyses found narrowing mortality differentials, whereas most of the sigma convergence analyses found widening mortality differentials. The results are robust to the units of analysis and mortality and dispersion measures. Our results also suggest that there is a lack of evidence on the determinants of mortality convergence in the EU.
There is general agreement that the EU regions and the Member States with high initial mortality rates improved the fastest, but this trend did not lead to overall mortality convergence in the EU. The harmonization of mortality convergence measures and research into determinants of mortality convergence are needed to support future EU cohesion policy. Policy-makers should consider supporting areas that have moderate but stagnant mortality rates, in addition to those with high mortality rates.
2004 年加入欧盟(EU)的成员国死亡率较高,这引起了人们对死亡率趋同的政治关注。欧盟的死亡率是否趋同仍不清楚。我们对整个 2004 年后欧盟领土的死亡率趋同文献进行了综述。我们还探讨了研究设计是否影响了结果,以及是否有任何死亡率趋同的决定因素已被经验检验。
进行了系统的文献综述。我们的搜索包括科学数据库以及国际政府机构和欧洲人口研究机构的网站。
我们发现了 94 条独特的记录,并纳入了 7 项研究,这些研究报告了 36 项分析。方法学的异质性很明显,包括趋同措施(β和σ趋同)。所有的β趋同分析都发现死亡率差异在缩小,而大多数σ趋同分析则发现死亡率差异在扩大。结果对分析单位和死亡率及离散度测量具有稳健性。我们的结果还表明,缺乏关于欧盟死亡率趋同决定因素的证据。
普遍认为,初始死亡率较高的欧盟地区和成员国改善最快,但这一趋势并未导致欧盟整体死亡率趋同。需要协调死亡率趋同措施,并研究死亡率趋同的决定因素,以支持欧盟未来的凝聚力政策。政策制定者除了关注高死亡率地区外,还应考虑支持死亡率适中但停滞不前的地区。