Dataset Information

Health Convergence Between East and West Germany as Reflected in Long-Term Cause-Specific Mortality Trends: To What Extent was it Due to Reunification?

ABSTRACT: The sizeable mortality gap between the German Democratic Republic (East Germany) and the pre-unified Federal Republic of Germany (West Germany) narrowed rapidly after the two states were unified. Despite extensive research, the mechanisms underlying the convergence process are still not fully understood. Significant changes to coding practices and the system of data collection introduced in East Germany shortly after reunification have further complicated the ability of researchers to interpret mortality trends. Our aim is to assess the role of German reunification in the convergence process in light of the evolution of long-term mortality trends by causes of death. Compared to previous studies, we rely on much more detailed mortality data, which we first adjust for notable distortions. We propose an upward correction of cancer mortality, as well as corrections that account for obvious changes in the items selected within the ICD chapter of circulatory diseases. We identify three distinct processes that took place in East Germany around the time of reunification: (1) a sustained reduction in mortality that started before reunification; (2) a temporary increase in mortality in 1990-1991 that was related to the abrupt social transition, as reflected by socially sensitive causes such as accidents, alcohol-related diseases, and acute myocardial infarction; and (3) a reunification-driven process of convergence that was mostly caused by the accelerated decline in mortality from cerebrovascular and chronic heart diseases. Mortality improvements observed in the GDR starting in the 1980s might be interpreted as the first signs of a cardiovascular revolution. Shifts in individual behaviour likely started before reunification, whereas the real progress in medical care occurred later with the implementation of the Western system of health care. We therefore conclude that German reunification per se did not initiate the convergence process, but rather reinforced and accelerated trends that were already apparent.

SUBMITTER: Grigoriev P

PROVIDER: S-EPMC5740210 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Health Convergence Between East and West Germany as Reflected in Long-Term Cause-Specific Mortality Trends: To What Extent was it Due to Reunification?

Grigoriev Pavel P Pechholdová Markéta M

European journal of population = Revue europeenne de demographie 20171204 5

The sizeable mortality gap between the German Democratic Republic (East Germany) and the pre-unified Federal Republic of Germany (West Germany) narrowed rapidly after the two states were unified. Despite extensive research, the mechanisms underlying the convergence process are still not fully understood. Significant changes to coding practices and the system of data collection introduced in East Germany shortly after reunification have further complicated the ability of researchers to interpret ...[more]

PMID: 29299014

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Project description:ObjectiveThe reunification of Germany after the separation between 1949 and 1990 has offered a unique chance of studying the impact of socialization, political transformation, and migration on mental health. The purpose of this article was to compare mental distress, resources, and life satisfaction (1) between residents of East and West Germany and migrants who have fled from East to West Germany before reunification and (2) between three generations.MethodsWe assessed anxiety, depression, resilience, self-esteem, and life satisfaction, comparing groups based on their residency and migration, as well as three different birth cohorts. Using a representative survey of 2006, analyses of variance show the differences between these groups. Based on a representative survey (N = 4,530), the effects of gender (53.6% women), residency/migration (74.4% grown up in the West, 20.4% in the East, 5.3% migrants from the East to the West) from three generations (32% born until 1945, 39% until 1967, and 29% to 1989), and positive and negative mental health indicators were analyzed.ResultsWomen reported higher distress and lower resilience. Residents of the Western states reported the lowest burden of distress (depressive and anxiety symptoms) and the highest overall life satisfaction, exceeding residents from the Eastern states and migrants from the Eastern to the Western states. Migrants from the Eastern to the Western states, however, reported the lowest resilience and self-esteem. They reported lower satisfaction with income, living conditions (compared to the Western residents), and the lowest levels of satisfaction with family (compared to East and West).ConclusionOverall, our data point to inequalities between the Eastern and Western states regarding mental health 16 years after reunification favoring the residents of the Western states by lower distress and life satisfaction. Our data attest to the stresses and adjustments associated with migration from the Eastern to the Western states before reunification. A lower level of mental health and life satisfaction in the oldest generation may be related to the sequelae of World War II and also to aging.

Dataset Information

Health Convergence Between East and West Germany as Reflected in Long-Term Cause-Specific Mortality Trends: To What Extent was it Due to Reunification?

Publications

Health Convergence Between East and West Germany as Reflected in Long-Term Cause-Specific Mortality Trends: To What Extent was it Due to Reunification?

Similar Datasets

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