Abstract
After several decades of stagnation, mortality in most Central European countries started to decrease after 1989. The Czech Republic and Poland were the first former Communist countries in this region to experience a rapid and sustained increase in life expectancy. This study focuses on the trends in cause-of-death mortality that have contributed to the recent progress in these two countries. The analysis is based on the cause-of-death time series (1968–2013) reconstructed in accordance with the 10th ICD revision, which makes the data fully comparable over the full period under study. Actual trends in cause-specific mortality are presented, and age, sex and causes of death components of life expectancy changes are disentangled. In both countries, the reduction in cardiovascular mortality at adult and old ages was crucial for the increase in life expectancy after 1991. Results are discussed in the context of institutional changes that occurred after the fall of Communism, such as the reorientation of health policies and the emergence of non-governmental organizations. Changes in health-related attitudes and behaviours as well as structural changes in societies, notably the rising share of persons with tertiary education, are also discussed.
Highlights
In the post-World War II period, European countries experienced changes in mortality levels in very different ways
While all European countries registered a steady rise in life expectancy levels, mainly as a result of an accelerated decline in infant mortality and infectious diseases, this rise stalled in the 1960s as new epidemiologic threats emerged in the form of increasing mortality from cardiovascular diseases, traffic accidents and other causes related to risky behaviours
Just after World War II (WWII) Poland, more devastated by warfare, visibly lagged behind the Czech Republic in terms of development (Okólski 1987). This was reflected to some extent by mortality statistics, as by 1950 the registered life expectancy in the Czech Republic already exceeded that of Poland by 5.9 years for males and 5.2 years for females
Summary
In the post-World War II period, European countries experienced changes in mortality levels in very different ways. We want to gain a deeper understanding of the epidemiologic tendencies that contributed both to the unfavourable life expectancy changes in the Communist period and to the more recent progress in these two countries To this end, we analyse the dynamics in cause-specific mortality and identify the most important causes of death that have underlain life expectancy changes. We study large cause-of-death categories that group entities into similar pathophysiologic and behavioural origins, for instance infectious diseases or smoking-related cancers This is because our goal is to indicate that social and economic changes may have been related to the recent changes in cause-specific mortality and to recent improvements in life expectancy.
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