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Social and spatial inequalities in health and mortality

Thierry Eggerickx, Cristina Munno, Jean-Paul Sanderson et Christophe Vandeschrick

Improvement in public and private hygiene and medical innovations have increased the life expectancy in both Western and developing countries in the last two centuries. For the former, the life expectancy at birth has doubled, increasing from approximately 40 years in the mid-19th century to more than 80 years currently (Riley, 2001 ; Adveev et al., 2011). While in Central and South Asia, two of the world's poorest regions, life expectancy at birth (52 and 66 years respectively) remains well below European averages, progress has been rapid. In Africa, after a decline in life expectancy during the 1990s, it has grown rapidly from 52 years in 2003 to approximately 60 years in 2015. Access to antiretroviral medicines, which led to a significant reduction in HIV-AIDS mortality (Pison, 2003; 2015), significantly contributed to this rise.

In a context of a quasi-generalized longevity progress, social class differentials in mortality and health, remain and even worsen (Rican et al., 2003). In the 1990s in France, the life expectancy gap between a professional intellectual and a labor worker at age 35 was seven years (Cambois & Jusot, 2007). In Belgium, in 2001, the life expectancy gap between a man with a higher education diploma and a man without a school diploma at age 25 was 7.5 years (Van Oyen et al., 2010). Geographical variations in mortality and health also exist (Caselli & Vallin, 2002). For example, in Wallonia (Belgium), during the period 2010-2014, there is a 4.5-year gap in life expectancy at birth at the borough level, while this difference rises to 12 years at the municipal level.

These spatial and social inequalities of mortality and health are, separately, well known and deeply rooted in the ancient and recent history of societies (Valkonen, 2002). However, studies that measure the impact of social compositions on spatial disparities in mortality and health are relatively rare (Bengtsson & Van Poppel, 2011; Kesztenbaum et al., 2016). Still these two social and spatial components, are nevertheless strongly linked, taking into account, for example, the effect of the social composition of territories. Still, a few studies show that after controlling for the socio-economic factors, local and regional disparities in mortality remain large at a significant level in both the past and the current societies (Reid & Van den Boomen, 2015; Rican et al., 2003). This means that, in addition to socio-economic characteristics, other factors may contribute to the differences in mortality among regions and districts, such as health attitudes, dieting behaviours, environmental and cultural components, care quality and so on.

How do these different factors interact with each other? What is their respective weight in explaining differences in mortality and health? Answers to these questions would undoubtedly improve our understanding in mortality’s determinants, levels and trends. More importantly, they will provide guidance for the development of future social and health policies.

Furthermore, some studies show a temporal constant in spatial patterns of mortality (Bonneuil, 1993; Gregory, 2009), whereas some others demonstrate both pattern stability and changes (Eggerickx & Sanderson, 2010). How can we explain this stability or change? Do these spatial patterns vary by sex, age, or causes of death? Among considered factors, it will be useful to take into account internal and external migration as well. Could the possible migrants’ selection effect explain the stability or change in spatial patterns of mortality and health? How does this selection effect meddle with mortality issues in the sending and receiving areas?

Papers to be submitted should consider this interaction framework between the social and spatial dimensions of mortality and health. They should concern empirical research for Western countries or developing countries. Both historical and contemporary cases fit in. Papers presenting theoretical and methodological approaches, as well as health systems and public health policies are also welcome.


Deadline proposal submission (title and abstract of approximately 350 words): 28 April 2017
Committee review selection:
June 2017
Deadline for paper submission:
1 November 2017


Titles, abstracts and papers should be sent to
Thierry Eggerickx :
Jean-Paul Sanderson :


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