Widening inequality in mortality between 160 regions of 15 European countries in the early 1990s

This paper presents maps of geographical patterns in mortality for the 160 mainland regions of the 15 countries of the European Union. Standardised mortality ratios (SMRs) for all ages are presented for all causes of death and for lung cancer, ischaemic heart disease, road traffic accidents and suicide. All cause standardised mortality ratios (for deaths under the age of 65) for the years 1990 and 1994 are presented. These data show that while most regions of Europe had decreasing SMRs over this time period, SMRs increased for the 10% of the population with the highest SMRs and the gap between the most and least healthy regions grew. Possible:reasons for the observed patterns, the limitations of currently available data and the limitations of studying nation states, are suggested. (C) 2000 Elsevier Science Ltd. All rights reserved.