Avoidable mortality contributes to the European Union's life expectancy and lifespan dispersion gaps

Abstract Background Mortality differences between established (EMS) and post-2004 European Union member states (NMS) remain large. Contributing to this gap are deaths avoidable through prevention (preventable mortality) or adequate medical treatment (treatable mortality). This study examined the potential of reduced avoidable, preventable, and treatable mortality to close life expectancy and lifespan dispersion gaps between EMS and NMS. Methods Death and population counts were extracted from the WHO Mortality Database to calculate age and cause-specific mortality rates for each EU member state for 2005-2014. Causes of death were categorised as avoidable, amenable, and preventable based on the OECD/Eurostat lists of preventable and treatable causes of death. The gaps in life expectancy at birth and life span dispersion between EMS and NMS were estimated where: 1) all amenable, preventable, and avoidable deaths were averted across the EU, and 2) NMS achieved the same level of avoidable mortality as EMS. Results Averting all avoidable deaths throughout the EU would reduce the life expectancy gap between EMS and NMS from 4.4 to 2.4 years for women and 7.4 to 3.3 years for men. The difference in lifespan dispersion would be reduced from 0.9 (favouring EMS) to 0.1 years (favouring NMS) in women and from 1.5 years to 0.3 years (favouring EMS) in men. Were NMS to achieve the avoidable mortality observed in EMS, the life expectancy gap between EMS and NMS would fall from 4.4 to 2.5 years for women and from 7.4 to 3 years for men, while the difference in lifespan dispersion would be reduced from 0.9 to 0.3 years in women and from 1.5 years to 0.3 years in men. Conclusions NMS achieving the avoidable mortality observed in EMS would have halved the life expectancy gap and almost eliminated the life span dispersion gap between EMS and NMS during 2005-2014. Effective exchange of best practices in prevention and treatment could transform mortality differences across the EU. Key messages • This is the first study to examine the potential of reduced avoidable, preventable, and treatable mortality to close the life expectancy and lifespan dispersion gaps between EMS and NMS. • Achieving the avoidable mortality observed in established EU member states in post-2004 EU member states would greatly reduce mortality differences across the EU.