Top

International Journal of Public Health

Published in:

01-12-2013 | Original Article

Changing patterns of mortality in 25 European countries and their economic and political correlates, 1955–1989

Authors: Johan P. Mackenbach, Caspar W. N. Looman

Published in: International Journal of Public Health | Issue 6/2013

Abstract

Objectives

We investigated trends in mortality in European countries by cause of death in the period 1955–1989, and studied the role of economic and political conditions.

Methods

We extracted data on age-standardised mortality by country (n = 25), sex, cause of death (n = 17) and calendar year from an internationally harmonised dataset. We analysed changes in dispersion of mortality as well as changes in the association of mortality with average income and levels of democracy.

Results

After 1960, dispersion in all-cause mortality in Europe as a whole increased due to diverging trends for many specific causes of death, particularly for cerebrovascular disease. This coincided with widening disparities in average income, and strengthening of the association between levels of democracy and mortality. Divergence in Central and Eastern Europe could largely be explained from stagnating trends in average income and an increasing mortality disadvantage related to its democratic deficit.

Conclusions

Although this was a politically stable period, mortality patterns were highly dynamic, and prefigured the more dramatic mortality trends after 1990. Economic and political stagnation probably explains the diverging trends in Central and Eastern Europe.

Available only for authorised users

Acemoglu D, Johnson S (2006) Disease and development: the effect of life expectancy on economic growth, vol Working Paper 12269. National Bureau for Economic Research, CambridgeCrossRef

Acemoglu D, Johnson S, Robinson JA, Yared P (2008) Income and democracy. Am Econ Rev 98(3):808–842CrossRef

Alvarez-Dardet C, Franco-Giraldo A (2006) Democratisation and health after the fall of the Wall. J Epidemiol Community Health 60(8):669–671. doi:10.1136/jech.2005.038273 CrossRefPubMedCentralPubMed

Barros PP, Machado SR, de Simoes JA (2011) Portugal. Health system review. Health Syst Transit 13(4):1–156PubMed

Besley T, Kudamatsu M (2006) Health and democracy. Polit Econ 96(2):313–318

Black CE, English RD, Helmreich JE, Helmreich PC, McAdams AJ (2000) Rebirth. A political history of Europe since World War II. Westview Press, Boulder

Bloom DE, Canning D (2007) Commentary: the Preston curve 30 years on: still sparking fires. Int J Epidemiol 36(3):498–499. doi:10.1093/ije/dym079 (discussion 502–503)CrossRefPubMed

Caldwell JC (1986) Routes to low mortality in poor countries. Popul Dev Rev 12(2):171–220CrossRef

Cutler DM, Deaton A, Lleras-Muney A (2006) The determinants of mortality. J Econ Perspect 20(3):97–120CrossRef

Ezzati M et al (2005) Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med 2(5):e133. doi:10.1371/journal.pmed.0020133 CrossRefPubMedCentralPubMed

Inglehart R, Welzel C (2005) Modernization, cultural change, and democracy. The human development sequence. Cambridge University Press, Cambridge

Joossens JV, Kesteloot H (1991) Trends in systolic blood pressure, 24-hour sodium excretion, and stroke mortality in the elderly in Belgium. Am J Med 90(3A):5S–11SCrossRefPubMed

Judt T (2005) Postwar. A history of Europe since 2005. Penguin Group, New York

Klomp J, de Haan J (2009) Is the political system really related to health? Soc Sci Med 69(1):36–46. doi:10.1016/j.socscimed.2009.03.033 CrossRefPubMed

Leon DA (2011) Trends in European life expectancy: a salutary view. Int J Epidemiol 40(2):271–277. doi:10.1093/ije/dyr061 CrossRefPubMed

Leon DA, Shkolnikov VM, McKee M (2009) Alcohol and Russian mortality: a continuing crisis. Addiction 104(10):1630–1636. doi:10.1111/j.1360-0443.2009.02655.x CrossRefPubMed

Lipset SM (1959) Some social requisites of democracy: economic development and political legitimacy. Am Polit Sci Rev 53(1):69–105CrossRef

Mackenbach JP (2013a) Convergence and divergence of life expectancy in Europe: a centennial view. Eur J Epidemiol 28(3):229–240CrossRefPubMed

Mackenbach JP (2013b) Political conditions and life expectancy in Europe, 1900–2008. Soc Sci Med 82:134–146. doi:10.1016/j.socscimed.2012.12.022 CrossRefPubMed

Mackenbach JP, Looman CWN (2013) Life expectancy and average income in Europe, 1900–2008: an update of Preston’s analysis. Int J Epidemiol (in press)

Mackenbach JP, McKee M (eds) (2013) Successes and failures of health policy in Europe: four decades of diverging trends and converging challenges. Open University Press, Buckingham

Mackenbach JP et al (2003) Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol 32(5):830–837CrossRefPubMed

Mackenbach JP, Hu Y, Looman CWN (2013) Democratization and life expectancy in Europe, 1960–2008. Soc Sci Med 93:166–175CrossRefPubMed

Maddison A (2003) The world economy: historical statistics. Organisation of Economic Cooperation and Development, ParisCrossRef

Mark L, Katona A, Deli L (1991) An attempt to evaluate the risk factors related to coronary heart disease in Hungary. Cor Vasa 33(4):265–272PubMed

Mark L, Nagy E, Kondacs A, Deli L (1998) The change of attitude of Hungarian physicians towards the importance of risk factors of coronary heart disease over the period 1985–1996. Public Health 112(3):197–201. doi:10.1038/sj.ph.1900449 CrossRefPubMed

Marmot M, Bobak M (2000) Psychosocial and biological mechanisms behind the recent mortality crisis in Central and Eastern Europe. In: Cornia GA, Paniccia R (eds) The mortality crisis in transitional economies. Oxford University Press, Oxford, pp 127–148CrossRef

McKeown TF (1988) The origins of human disease. Blackwell, Oxford

Mirzaei M, Truswell AS, Arnett K, Page A, Taylor R, Leeder SR (2012) Cerebrovascular disease in 48 countries: secular trends in mortality 1950-2005. J Neurol Neurosurg Psychiatry 83(2):138–145. doi:10.1136/jnnp-2011-300408 CrossRefPubMed

Muntaner C et al (2011) Politics, welfare regimes, and population health: controversies and evidence. Sociol Health Illn 33(6):946–964. doi:10.1111/j.1467-9566.2011.01339.x CrossRefPubMed

Nolte E, Scholz R, McKee M (2004) Progress in health care, progress in health? Patterns of amenable mortality in Central and Eastern Europe before and after political transition. Demogr Res Spec Collect 2(6):139–162CrossRef

Olshansky SJ, Ault AB (1986) The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Q 64(3):355–391CrossRefPubMed

Omran AR (1983) The epidemiologic transition theory. A preliminary update. J Trop Pediatr 29(6):305–316CrossRefPubMed

Pamuk ER (1985) Social class inequality in mortality from 1921 to 1972 in England and Wales. Popul Stud 39(1):17–31. doi:10.1080/0032472031000141256 CrossRef

Preston SH (1975) The changing relation between mortality and level of economic development. Popul Stud 29:231–248CrossRef

Roberts B, Stickley A, Balabanova D, McKee M (2010) Irregular treatment of hypertension in the former Soviet Union. J Epidemiol Community Health. doi:10.1136/jech.2010.111377

Rogers EM (1962) Diffusion of innovations. Free Press, Glencoe

Shkolnikov V, Meslé F, Vallin J (1996a) Health crisis in Russia I. Recent trends in life expectancy and causes of death from 1970 to 1993. Population 8:123–154 (an English selection)PubMed

Shkolnikov V, Meslé F, Vallin J (1996b) Health crisis in Russia II. Changes in causes of death: a comparison with France and England and Wales (1970 to 1993). Population 8:155–189 (an English selection)PubMed

Strand BH, Groholt EK, Steingrimsdottir OA, Blakely T, Graff-Iversen S, Naess O (2010) Educational inequalities in mortality over four decades in Norway: prospective study of middle aged men and women followed for cause specific mortality, 1960–2000. BMJ 340:c654. doi:10.1136/bmj.c654 CrossRefPubMedCentralPubMed

Swift R (2011) The relationship between health and GDP in OECD countries in the very long run. Health Econ 20(3):306–322. doi:10.1002/hec.1590 CrossRefPubMed

Teorell J, Samanni M, Holmberg S, Rothstein B (2011) The quality of government dataset, version, version 6 Apr 11. Gothenburg: University of Gothenburg, The Quality of Government Institute.

Vallin J, Meslé F (2004) Convergences and divergences in mortality. A new approach to health transition. Demogr Res Spec Collect 2(2):11–44. doi:10.4054/DemRes.2004.S2.2 CrossRef

Wigley S, Akkoyunlu-Wigley A (2011) The impact of regime type on health: does redistribution explain everything? World Polit 63(4):647–677CrossRefPubMed

Zatonski W (2008) Closing the health gap in the European Union. Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw

Title: Changing patterns of mortality in 25 European countries and their economic and political correlates, 1955–1989
Authors: Johan P. Mackenbach
Caspar W. N. Looman
Publication date: 01-12-2013
Publisher: Springer Basel
Published in: International Journal of Public Health / Issue 6/2013
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-013-0509-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changing patterns of mortality in 25 European countries and their economic and political correlates, 1955–1989

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2013

Education and training of public health professionals in the European Region: variation and convergence

Erratum to: Income and individual deprivation as predictors of health over time

Metabolic syndrome and socioeconomic status in France: The French Nutrition and Health Survey (ENNS, 2006–2007)

Health literacy and substance use in young Swiss men

Importance weighting, expectation fulfilment and satisfaction: an integrative and innovative approach to measuring patient satisfaction with hospital stays

HIV in the Middle East and North Africa: priority, culture, and control