Content and Objectives

The majority of previous studies on international mortality differences have focussed on country comparisons without taking into account the significant regional differences within the countries studied. The aim of the REDIM project is not only to close this obvious research gap, but also to carry out large-scale systematic research into the reasons for existing and emerging spatial disparities in mortality in Europe. One of the main research questions of the project is whether subnational disparities in health have increased or decreased across Europe, and to what extent trends in contextual social, economic and political conditions can explain such divergences or convergences. Anothercentral question is whether pan-European analyses with subnational regional data along national borders between countries also reveal so-called health frontiers with clear differences in levels of cause-specific mortality. Is the influence of national health policies and systems strong enough to generate such level differences along national borders - or do socioeconomic, cultural and other contextual factors reduce the effects of national health systems, so that cross-border contrasts are rather blurred?

The project aims to determine the degree of convergence/divergence in cause-of-death mortality between subnational territorial units in Europe and to identify determinants of these changes. The project will analyse patterns and trends in cause-specific mortality at regional NUTS-2 and NUTS-3 LEVEL (NUTS: Nomenclature of Territorial Units for Statistics) and at local LAU level (LAU: Local Administrative Units) in 26 European countries using advanced research methods. Mortality indicators are interpreted in combination with contextual factors in order to assess the effects of the local context and the effectiveness of national health policy measures. The results of the project are essential for the development and coordination of health and social policy measures aimed at reducing spatial inequalities in mortality between and within European countries. The particular relevance of the project, funded by the European Research Council, arises from the context of the integration process within the European Union, which aims to harmonise access to good medical care and other benefits.

An essential prerequisite for the successful realisation of the project is a large international and interdisciplinary network. Individual researchers provide or support the procurement of the necessary mortality data and share their local expertise. Data on age-, sex- and cause-specific mortality and contextual factors in the European regions come mainly from official statistical sources in 26 European countries.