Mortality in Europe: The Divergence between East and West

Abstract

After a period of general convergence, the 1960s were marked by the divergence between the life expectancies of eastern European countries, where all progress came to a halt, and those of the rest of Europe where health care made large strides. A hierarchical analysis of age-specific mortality patterns shows that this divergence goes together with the development of very different patterns of age at death; in the countries of eastern Europe, and especially in the USSR, excess mortality at adult ages is spectacularly high.Cause-specific analysis reveals the decisive role played by two kinds of diseases. On the one hand, “man-made diseases” (alcoholism, smoking, car accidents, etc.) have continued to increase in the east, whereas they were curbed in the west starting in the 1960s. On the other hand, eastern Europe was unable to join the cardiovascular revolution that had enabled the west to increase its life expectancy levels. The considerable divergence between eastern and western Europe should not hide the differences that still remain among western countries. Indeed, mortality patterns are changing in the west, and the traditional opposition between north and south is undergoing radical transformations.