Educational Differences in Mortality Amenable to Healthcare. A Comparison of European Healthcare Systems

Background Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. More recently, the need to consider national level factors has been acknowledged. We argue that the healthcare system is most directly linkable to health outcomes. The aim of this study is twofold. First, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries. Second, we examine to what extent these cross-national variations can be explained by differences in European healthcare system types. Methods This study uses mortality data for 21 European populations. People aged 30–74 years are included in the analysis. Educational attainment is coded according to the International Standard of Education. Educational inequalities in mortality amenable to healthcare across healthcare systems are calculated by relative indices of inequality (RII) by means of Poisson regression. The article categorizes healthcare systems based on expenditure, financing, service provision and access regulation, resulting in three different healthcare system types: the health service provision-oriented type, the universal coverage – controlled access type and the low budget – restricted access type. Results Preliminary results show that educational inequalities amenable to healthcare are relatively large in the universal coverage healthcare system. Conclusions The educational differences in amenable mortality for European countries indicate an important role for healthcare systems in reducing inequalities in health. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.