624 Economic Development and Trends of Cerebrovascular Disease Mortality in Eastern Europe: 1992-2019

Abstract

INTRODUCTION: Several studies have shown that a country's overall mortality rates are inversely related to it's gross domestic product (GDP). Eastern Europe experienced rapid economic growth after the fall of communism, and as such its public health sector swiftly improved. How this economic growth has affected mortality rates due to cerebrovascular disease has never been studied. METHODS: Eight countries were included in this study, representing the Warsaw Pact founding members: Albania, Bulgaria, Poland, Romania, Hungary, and Czechia, with Russia and Ukraine representing the former Soviet Union. As East Germany joined West Germany in 1990, it was excluded. Age standardized death rates from cerebrovascular disease per 100,000 people from 1992-2019 were taken from the World Health Organization (WHO) Mortality Database using the ICD-10 (International Classification of Disease) codes 160-169. Each country’s GDP per capita (inflation adjusted to 2015 dollar amount) during those years was taken from the World Bank World Development Indicators Database. RESULTS: Cerebrovascular disease mortality decreased from 1992-2019 in every country, despite divergent trends in economic development. Indeed, Ukraine’s cerebrovascular disease mortality rate decreased by 42.9% even though its GDP per capita decreased by 4.8%. The countries with the largest decreases in mortality are Czechia (-78.9%), Hungary (-62.7%), and Russia (-49.3%) while Albania had the smallest decrease (-29.4%). CONCLUSIONS: Rates of cerebrovascular disease mortality among the Warsaw Pact’s founding members decreased after the fall of communism, despite differing rates of economic development. Further research is warranted regarding these countries’ healthcare practices during this period. Hopefully, lessons can be gleaned to improve public health and neurosurgical care in other developing nations.