Sonja Settele, Department of Economics (Job Market Seminar)

“The drivers of socioeconomic inequality in life expectancy - Evidence from the context of cancer”


Cancer is the leading cause of mortality in high-income countries and accounts for around one fourth of the income gradient in life expectancy. We present a sequential decomposition method, which allows to quantify the contribution of consecutive steps, such as the development of cancer, its diagnosis and treatment, to the overall income gradient in life expectancy. We apply this approach to administrative data covering the population of Denmark. Health-related factors account for the largest part of the cancer-specific difference in life expectancy between the top and bottom income tercile. In particular, low-income patients are more likely to develop the most deadly types of cancer and have a higher mortality conditional on type, stage and treatment of cancer. In contrast, factors related to health care, such as differences in the timeliness of detection and in cancer treatment, play a secondary role. Based on a traditional decomposition method, we find that cancers of the respiratory and of the digestive system – which are known to correlate with unhealthy lifestyles – are the main drivers of cancer-specific inequality in life expectancy. Our findings suggest that to mitigate inequality in cancer-specific mortality, policy makers should focus on cancer prevention, for instance through promoting healthier lifestyles. By contrast, there is little scope for reducing income-related inequality in life expectancy through more equal use of and treatment through the health care system.

Contact person: Søren Leth Petersen