Results of an analysis of the mortality in the Ruhr region have shown increased mortality rates and a corresponding lower life expectancy, relative to the federal state of North Rhine Westphalia (NRW) as a whole. For the years 2002-2004 the male life expectancy was 0.86 years below the NRW level, and for females 0.56 years under the NRW level. The analysis of the age- and sex-specific mortality rates be-tween the years 1994 and 2004 has demonstrated in which age groups mortality increased in the Ruhr region. The mortality rates for all 15 municipalities and counties of the Ruhr region have been analysed according to different areas: centre of population (Ballungskern), conurbation areas (Ballungsrandzone), Ruhr City (alias Ruhrgebiet/Ruhr-Region) and NRW without Ruhr City. Eleven average values and three-year mean values were calculated to reduce the range of the year-values. Per cent deviations of the NRW values demonstrate the size of the differences. Comparisons between the centres of population, conurbation areas with NRW without Ruhr City demonstrate an increased mortality especially in the male and female age groups of 40 to 54 years. A comparison of the municipalities with the highest life expectancy level, Bonn, with that with the lowest life expectancy level, Gelsenkirchen, for the years 2002-2004 shows a difference in the life expectancy of 2.7 years for females and 4.3 years for males. The male and female mortality rates of the age groups 40-59 years in Gelsenkirchen exceed the comparable rates in Bonn by 30% on average. In spite of increasing life expectancy in the Ruhr region from 1994 to 2004 the age-specific mortality rates of the 35-54-year-old population are increased, especially in the centres of population. The problem area is the centres of population with a complicated socio-demographic situation and worse indicators of the health status.