The wounds of post-socialism: a systematic review of the social determinants of mortality in Hungary

Abstract

Eastern Europe underwent one of the most dramatic economic and demographic changes in recent history with skyrocketing mortality rates in some countries during the 1990s. The case of Hungary among the post-socialist transition countries is puzzling for several reasons. Although the Hungarian transition has often been characterized as smooth and successful, a look at the human dimension of the transformation reveals large costs and a slow improvement. Based on the analysis of 29 articles we provide a systematic review of the empirical evidence about the social determinants of mortality in post-socialist Hungary establishing a hierarchy of causes. Socio-economic position, mental health, social capital, alcohol consumption, stress and social integration are the most important explanatory variables that received attention by the researchers. Although economic policies might have played a central role in the rise of mortality there is no empirical research on the political economy of health in Hungary. No critical analysis of post-socialism can be complete without assessing the human costs of economic transformation. Social scientists have much to learn from social epidemiologists who have designed robust methodologies and complex theoretical frameworks to analyse the political economic determinants of health.