New Article in “Bundesgesundheitsblatt” • 28.04.2021Persisting Mortality Differences between Eastern and Western Germany Are Concentrated on Men

During the German division, two culturally very similar populations were exposed to very disparate socio-economic conditions, which converged again after 1989. The impact of health care and life circumstances on mortality differences can better be estimated when cultural explanations are widely neglectable. Therefore, the example of the German division and reunification is often called a ‘natural experiment’ in this context.

BiB researchers Pavel Grigoriev, Michael Mühlichen and Sebastian Klüsener along with Markéta Pechholdová (University of Economics, Prague) and Rembrandt Scholz (Berlin Institute for Social Research) analysed harmonised cause-of-death data explicitly by age in order to show which ages or birth cohorts were particularly affected by German division and reunification in their mortality, and to which causes of death this is attributable. The German cause-of-death statistics were harmonised by applying an internationally standardised harmonisation process to account for differences and breaks in cause-of-death coding practices. The data were analysed by means of decomposition methods.

The results show that during the 1980s, East-West disparities were increasing, as progress in the reduction of cardiovascular mortality was much stronger in West Germany, notably at older ages. After 1989, East Germany was able to catch up to the West in many areas. This is especially true for elderly persons and women, while particularly among those male adult cohorts born between 1950 and 1970 East-West disparities are still visible. This male “turnaround generation” was strongly affected by the East German transition crisis that led to increased unemployment rates.

The lower life expectancy of the East German population in the late 1980s was primarily caused by a slower pace of the cardiovascular revolution. The remaining present-day disparities are, however, rather an aftermath of the East German transition crisis than direct after-effects of the division.

Grigoriev, Pavel; Pechholdová, Markéta; Mühlichen, Michael; Scholz, Rembrandt D.; Klüsener, Sebastian (2021): 30 Jahre Deutsche Einheit: Errungenschaften und verbliebene Unterschiede in der Mortalitätsentwicklung nach Alter und Todesursachen [30 years of German unification: achievements and remaining differences in mortality trends by age and cause of death]. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 64(4): 481–490.