Trends of socioeconomic equality in mortality amenable to healthcare and health policy in 1992–2013 in Finland: a population-based register study

OBJECTIVE: To study trends in socioeconomic equality in mortality amenable to healthcare and health policy interventions. DESIGN: A population-based register study. SETTING: Nationwide data on mortality from the Causes of Death statistics for the years 1992–2013. PARTICIPANTS: All deaths of Finnish inhabitants aged 25–74. OUTCOME MEASURES: Yearly age-standardised rates of mortality amenable to healthcare interventions, alcohol-related mortality, ischaemic heart disease mortality and mortality due to all the other causes by income. Concentration index (C) was used to evaluate the magnitude and changes in income group differences. RESULTS: Significant socioeconomic inequalities favouring the better-off were observed in each mortality category among younger (25–64) and older (65–74) age groups. Inequality was highest in alcohol-related mortality, C was −0.58 (95% CI −0.62 to −0.54) among younger men in 2008 and −0.62 (−0.72 to −0.53) among younger women in 2013. Socioeconomic inequality increased significantly during the study period except for alcohol-related mortality among older women. CONCLUSIONS: The increase in socioeconomic inequality in mortality amenable to healthcare and health policy interventions between 1992 and 2013 suggests that either the means or the implementation of the health policies have been inadequate.