Getting closer to each other? Convergence and divergence patterns of life expectancy in 277 border regions of Western Europe 1995–2019

urban hubs to rural peripheries, border regions tend to share structural features that distinguish them from the rest of the country.These regions have a history of marginalisation due to their peripheral position within national economies 7.On the other hand, and especially with the opening of the internal EU border, these regions have a greater exposure to cross-border trade, labour mobility, and economic spillovers.These regions often share similar cultural and historical backgrounds, and their geographical proximity facilitates cross-border work, service provision, and access to healthcare.At the same time, they are governed by country-specific social policies and healthcare frameworks 8,9, allowing for a systematic comparison of how these differing policies can lead to varying health outcomes, even among populations with many shared characteristics.The harmonisation of health and healthcare quality is one of the central aims of the EU, along with the equalisation of living standards and economic prosperity, as set forth by Article 174 of the Treaty on the Functioning of the European Union 10.Following this, the law Directive 2011/24/ EU was established, granting patients the right to access cross-border healthcare within the EU.Its main objective is to allow patients to receive medical treatment in other EU countries and be reimbursed by their home country's healthcare system.Additionally, it aims to promote mutual learning and coordination in healthcare provision to facilitate smooth access to medical treatment across borders 11.Despite these efforts, and even though life expectancy has increased in all 28 EU member states 12, 13, regional and socio-economic inequalities in health outcomes persist both between and within countries (e.g., 14,15).They are often attributed to factors such as varying economic success, health behaviours, and access to healthcare infrastructure.Moreover, the EU's efforts to equalise living standards should also lead to convergence in life expectancy.