Dynamics of life expectancy change during the transition to democracy in the ex-Yugoslav countries

Abstract

The break-up of Yugoslavia led to political turmoil, accompanied by socio-economic changes, wars and civil unrest. Health as a social phenomenon is directly and indirectly affected by such changes. To give an overview of the changes in life expectancy, as a measure of population health, during times of crisis and large societal changes. The dynamics of change of life expectancy in the different Balkan countries are analysed by calculating the contributions of age and cause specific mortality to the observed changes of life expectancy.An original dataset of life-tables is used to calculate life expectancy, created based on mortality data from national civil registers from the 6 ex-Yugoslav republics, assessed for accuracy and completeness. Arriaga’s method is used to decompose the contributions of age groups and causes of death to the observed changes in life expectancy during three time periods: Socialist Federation (1975-1985), Transition (1988-2000), Independence (2007-2017). Large improvements in life expectancy at birth are noted in all countries, although there is heterogeneity in the dynamics of change. During the Socialist Federation period, life expectancy increased consistently across countries mainly due to reductions in infant and child mortality, as well as reduction in infectious diseases mortality. During the Transition there was a divergence of trends and some countries noted continuous increase in life expectancy, contrasting the decrease in life expectancy in Serbia and Montenegro. In all countries life expectancy increased during the Independence period, due to a reduction in mortality from non-communicable diseases among the older population.The findings of this study are important not only because they create an understanding of changes in population health during a period of crisis, but also because they provide accurate estimates of life-expectancy and dynamics of mortality change, allowing for further analysis on the social determinants of health.