Socioeconomic differences in mortality among 27 million economically active Germans: a cross-sectional analysis of the German Pension Fund data
Objectives. To assess disparities in mortality by socioeconomic status in Germany.
Design and participants. We analyse a large administrative dataset of the German Pension Fund (DRV), including 27 million person-years of exposure and 42 000 deaths in 2013. The data cover the economically active population, stratified by sex and by East and West.
Outcome measures. Age-standardised mortality rates and Poisson regression mortality rate ratios (MRRs).
Results. The risk of dying increases with decreasing income: the MRRs of the lowest to the highest income quintile are 4.66 (95% CI 4.48 to 4.85) among men and 3.06 (95% CI 2.90 to 3.23) among women. The impact of income attenuates after controlling for education and other explanatory variables, especially for females. In the fully controlled model for females, individual income is a weaker predictor of mortality, but there is a clear educational mortality gradient. In the fully controlled model, the MRRs of the unemployed to the employed are 2.09 (95% CI 2.03 to 2.15) among men and 2.01 (95% CI 1.92 to 2.10) among women. The risk of dying is around half as high among foreigners as among German citizens. The socioeconomic disparities are greater among East than West German men.
Conclusions. Low socioeconomic status is a major determinant of excess adult mortality in Germany. The persisting East-West differences in male adult mortality can be explained by the higher socioeconomic status of men living in the West, rather than by contextual differences between East and West. These differences can be further monitored using DRV data.
Regional variation of all features of mortality is quite significant. Being noted for many decades The North-Ost gradient of increased mortality rate continues its trend. In a time despite essential regional variation of mortality the difference in the orientation of its dynamic is not significant at all. An important condition for development of measures to ensure a decrease of mortality rate is information on social and demographic factors.
The monograph is devoted to the problems arising in the analysis of demographic processes, the calculation of net rates and assessment of reserves in the major life insurance contract. The results of studies involving various related parties of the analyzed issues. For example, given a detailed comparative analysis of pre- and disadvantages of organization of the insurance market in Russia and abroad. With used - vaniem various techniques built a ranking of countries in terms of development of the market under study.
The basis of actuarial calculations in the basic life insurance contracts are demo graphic processes: in particular, information about the mortality rate. The foundation for the construction of a net rates and valuation reserves in the life insurance contract is the data of mortality tables, which are based, in turn, is an indicator of how Vero die before reaching next age interval. In this regard, the authors present the theoretical aspects of the construction of the net rates and valuation reserves in life insurance contracts. The paper discusses methods of constructing mortality tables , raised the problem of statistical analysis of demographic processes in actuarial calculations, an overview of the basic formulas used to derive the net rates and valuation reserves in life insurance contracts.
The authors of the classification of the Russian Federation in terms of economic and demographic character. Some representatives of the obtained clusters The results of the study of the dynamics of demographic processes. It analyzes the main trends in life expectancy at age and sex and the regional context.
Of course, the authors have paid special attention to the analysis of the impact of demographic, financial factors on change of the tariff policy of life insurance contracts, as well as the impact on the rate and size of the allowance conditions of the contract. The research data for the city of Moscow as a financial and information center of Russia, which significantly affects the development of the insurance market as a whole (not only in the life insurance sector).
The results of these studies may be interested in a wide range of professionals in the field of economics, actuarial calculations in life insurance analysts.
In the article authors use the vital birh and death registration data on 10 regions exctracted from the Rosstat database to evaluate an input of international migrant into Russian fertility and mortality levels.
This chapter discusses the features of the development of the Russian population and the results of population projections to 2025
After a long decline, life expectancy in Russia substantially increased in 2004-2010; this is the longest period of health improvement that has been observed in the country since 1965. This study is the first analysis of this positive trend.
We seek to determine the causes and age groups that account for the additional years of life gained in 2004-10 and the remaining gap between Russia and Western countries, to assess to what extent these recent trends represent a new development relative to previous mortality fluctuations, and to identify possible explanations for the improvement.
We present an analysis of trends in life expectancy, and in age- and cause-specific mortality in Russia and selected countries in Eastern and Western Europe. We use decomposition techniques to examine the life expectancy rise in 2004-2010 and the Russia-UK life expectancy gap in 2010.
Like the previous mortality fluctuations that have occurred in Russia since the mid-1980s, the increase in life expectancy was driven by deaths at ages 15 to 60 from alcohol-related causes. Uniquely in the recent period, there were also improvements at older ages, especially in cerebrovascular disease mortality among women. In addition, there were reductions in deaths from avoidable causes, such as from tuberculosis and diabetes. The life expectancy gap between Russia and Western countries remains large, and is mostly attributable to deaths from cardiovascular disease, alcohol-related conditions, and violence.
The decrease in alcohol-related mortality may be attributable to measures taken in 2006 to control the production and sale of ethanol. The lower number of cerebrovascular-related deaths may reflect advancements in blood pressure control. The reduction in the number of deaths from tuberculosis and diabetes may be associated with a general improvement in health care. Although the decline in mortality since 2004 has been substantial, the question of whether it can be sustained remains open.
Several approaches to the concept of fatherhood present in Western sociological tradition are analyzed and compared: biological determinism, social constructivism and biosocial theory. The problematics of fatherhood and men’s parental practices is marginalized in modern Russian social research devoted to family and this fact makes the traditional inequality in family relations, when the father’s role is considered secondary compared to that of mother, even stronger. However, in Western critical men’s studies several stages can be outlined: the development of “sex roles” paradigm (biological determinism), the emergence of the hegemonic masculinity concept, inter-disciplinary stage (biosocial theory). According to the approach of biological determinism, the role of a father is that of the patriarch, he continues the family line and serves as a model for his ascendants. Social constructivism looks into man’s functions in the family from the point of view of masculine pressure and establishing hegemony over a woman and children. Biosocial theory aims to unite the biological determinacy of fatherhood with social, cultural and personal context. It is shown that these approaches are directly connected with the level of the society development, marriage and family perceptions, the level of egality of gender order.