The Short-Term Effects of European Integration on Mortality Convergence: A Case Study of European Union\u2019s 2004 Enlargement

Rok Hrzic,Tobias Vogt,Helmut Brand,Fanny Janssen

doi:10.1007/s10680-021-09596-y

Abstract

Although European integration can be expected to result in mortality convergence (reduced mortality differences), a life expectancy divide persists in the European Union (EU) between the old Member States (OMS) in the west and the new Member States (NMS) in the east. Studies investigating the impact of European integration on mortality convergence are rare and did not consider regional differences. We examine the short-term effects of the 2004 enlargement on mortality convergence at the supranational, national, and subnational levels. Using sex-specific life expectancies for 23 Member States (1990–2017) and the NUTS 2 regions in Czechia, Hungary, and Poland for 1992–2016, we examined the trend in sigma and beta mortality convergence measures at the country and regional levels using joinpoint regression. We found no compelling evidence that EU accession influenced the process of mortality convergence between OMS and NMS, or within the three NMS, over the short term. While there was overall beta and sigma convergence at the national level during 1990–2017, no regional convergence showed, and the trends in convergence did not significantly change at the time of EU accession or soon after (2004–2007). The accession in 2004 did not visibly impact the overall process of mortality convergence over the short term, likely because of the greater influence of country and region-specific policies and characteristics. The interaction of Member State and regional contexts with the mechanisms of European integration requires further study. Future enlargement procedures should emphasise tailored support to ensure more equitable gains from European integration.

Highlights

There is a historical east–west European gap in life expectancy, with life expectancy in the eastern part of the continent—i.e. in the countries that were formerly behind the Iron Curtain—lagging behind life expectancy in the west for the past half century (Bobak & Marmot, 1996; Leon, 2011; Meslé & Vallin, 2002)
Our paper sheds light on whether the current accession procedure is a strong determinant of rapid mortality convergence, clarifying what current European Union (EU) candidate countries in the Western Balkans may reasonably expect from accession in terms of mortality outcomes over the short term, and indicates how they can best seize the opportunities of European integration to improve population health
We focus on the 23 continental post-2004 EU Member States, excluding Malta and Cyprus, and divide them into the new Member States group (NMS: Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovenia, and Slovakia) and the old Member States group (OMS: Austria, Belgium, Denmark, France, Germany, Greece, Finland, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom)

Summary

Introduction

There is a historical east–west European gap in life expectancy, with life expectancy in the eastern part of the continent—i.e. in the countries that were formerly behind the Iron Curtain—lagging behind life expectancy in the west for the past half century (Bobak & Marmot, 1996; Leon, 2011; Meslé & Vallin, 2002). At the time of the first eastward enlargement of the European Union (EU) in 2004, the average gap between the new Member States in the east and the old Member States in the west was seven years for men and four years for women (Eurostat, 2020a). Given that a further eastward expansion of the EU is planned, examining this issue can contribute to the ongoing discussion on revising the accession procedures (European Commission, 2020). Our paper sheds light on whether the current accession procedure is a strong determinant of rapid mortality convergence, clarifying what current EU candidate countries in the Western Balkans may reasonably expect from accession in terms of mortality outcomes over the short term, and indicates how they can best seize the opportunities of European integration to improve population health

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