Income in large residential areas and premature mortality in six countries of the European Union

We study the relation between per capita income and mortality within six countries of the European Union - Finland, the Netherlands, Belgium, France, Italy and Spain - in 1981-1985 and 1996-2000. We obtained information on gross domestic product per capita (GDPpc) and mortality in large residential areas. The areas in each country were grouped in quintiles as a function of GDPpc. In 1996-2000, a negative gradient was seen in premature mortality from all causes in men and women in accordance with the GDPpc quintile, except in the Netherlands and in women in Finland. In Belgium, France, Italy and Spain, the impact of GDPpc on premature mortality was stronger in 1996-2000 than in 1981-1985. All six countries showed a negative gradient in premature mortality from cardiovascular disease by GDPpc. The pathways by which residential area with lower wealth is associated with higher mortality are probably related with investment in economic and social resources over time, although for some causes of death, this association is not seen in some countries due to specific historic and cultural circumstances.