Wilkinson RG. Health and civic society in Eastern Europe before 1989. In: The East-West life expectancy gap in Europe. Edited by C. Hertzman, S. Kelly, M. Bobak. Dordrecht: Kluwer, 1996.

A consistent finding has been that the measures of health of the countries in Central and Eastern Europe declined, especially since 1989. Between 1960 and 1977 it was noted that nine out of ten communist countries improved life expectancy substantially in comparison to many other countries. Comparisons with countries in Western Europe show deterioration in health since the 1970s. Indeed several East European countries had higher life expectancies than some Western European ones. Wilkinson asks why did these communist countries lose their health advantage? The advantage seems to be lost most among single men and women, and among those between age 15 and 65. Diseases for which age standardized death rates increased (where they were falling for Western Europe) included: ischemic heart disease, homicide and purposeful injury, mental disorders and diseases of the nervous system. For chronic liver disease and cirrhosis, they stayed the same, while in Western Europe they declined after a peak in 1980. Wilkinson suggests that it was demoralization of that period, representing a reversal of the confidence in central planning of the early 1960s as well as a growing crisis of legitimacy of the political system that contributed to the social changes resulting in health declines. Work was seen less as a meaningful activity, there was reduced public confidence in friendships and social affiliations to health were weakened. Private life became more important, leaving single people without any obvious source of self-fulfilment.  

Keywords

• cause specific mortality
• civic society
• health
• life expectancy
• Eastern Europe
• communist countries
• homicide