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The East–West Health Divide in Europe: Growing and Shifting Eastwards

Published online by Cambridge University Press:  01 February 2010

Denny Vågerö
Affiliation:
Centre for Health Equity Studies, CHESS, Stockholm University/Karolinska Institutet, SE-106 91 Stockholm, Sweden and SCOHOST, Södertön University College, Stockholm, Sweden. E-mail: denny.vagero@chess.su.se

Abstract

Over a four-decade long period, a health gap has opened up between European countries, in particular along the East/West dimension. One could speak of a European health divide. The divide is growing larger and, at the same time, shifting eastwards, leaving countries such as Russia, Ukraine, Belarus and Moldova at an increasing health disadvantage. Health inequalities, or differences between social classes, within European countries also seem to have been growing for the last couple of decades. Those countries that were previously led by communist regimes today show larger health inequalities than do countries in Western Europe. The countries that were once part of the Soviet Union demonstrate the most alarming health trends, with large segments of the population actually experiencing falling life expectancies. Reducing global and European health inequalities so that the health chances of a newborn child are not dependent on which country and social class he or she is born in, is a truly formidable task, which implies an entirely new way of seeing human development.

Type
Focus: Health in Europe
Copyright
Copyright © Academia Europaea 2010

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References

1.Caselli, G., Meslé, F. and Vallin, J. (2002) Epidemiologic transition theory exceptions. Paper presented at IUSSP seminar on ‘determinants of diverging trends in mortality’, Rostock, 19–21 June.Google Scholar
2.Meslé, F., Shkolnikov, V., Hertrich, V. and Vallin, J. (1996) Tendances recentes de la mortalite par cause en Russie 1965–1994. Donnees Statistiques, (2).Google Scholar
3.Patterson, D. (1995) Mortality in late czarist Russia: a reconnaissance. Social History of Medicine, 8, 179210.CrossRefGoogle Scholar
4.Meslé, F. (2002) Mortality in Eastern Europe and the former Soviet Union: long term trends and recent upturns. Paper presented at IUSSP seminar on ‘determinants of diverging trends in mortality’, Rostock, 19–21 June.Google Scholar
5.Barker, D. (1989) Rise and fall of Western disease. Nature, 338, 371372.CrossRefGoogle Scholar
6.Baker, D., Vågerö, D. and Illsley, R. (1993) Today or in the past – the origins of ischaemic heart disease. Journal of Public Health Medicine, 15(3), 243248.Google ScholarPubMed
7.Brown, A. (1997) The Gorbachev Factor (Oxford: Oxford University Press).CrossRefGoogle Scholar
8.Walberg, P., McKee, M., Shkolnikov, V., Chenet, L. and Leon, D. (1998) Economic change, crime and mortality in Russia: regional analysis. British Medical Journal, 317, 312318.CrossRefGoogle ScholarPubMed
9.Leon, D. A., Saburova, L., Tomkins, S., Andreev, E., Kiryanov, N., McKee, M. and Shkolnikov, V. M. (2007) Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study. The Lancet, 369(9578), 20012009.CrossRefGoogle ScholarPubMed
10.Sparén, P., Vågerö, D., Shestov, D. B., Plavinskaja, S., Parfenova, N., Hoptiar, V., Paturot, D. and Galanti, M. R. (2004) Long term mortality after severe starvation during the siege of Leningrad: prospective cohort study. British Medical Journal, 328, 11.CrossRefGoogle ScholarPubMed
11.Koupil, I., Plavinskaja, S., Parfenova, N., Shestov, D. B., Danziger, P. D. and Vågerö, D. (2009) Cancer mortality in women and men who survived the siege of Leningrad (19411944). International Journal of Cancer, 124(6), 14161421.CrossRefGoogle ScholarPubMed
12.World Health Organisation (2008) Closing the Gap in a Generation. Health Equity through Action on the Social Determinants of Health. Final Report from the Commission on Social Determinants of Health (Geneva: WHO).Google Scholar
13.Sen, A. (1999) Development as Freedom (Oxford: Oxford University Press).Google Scholar
14.Mackenbach, J. P., Stirbu, I., Roskam, A. J., Schaap, M. M., Menvielle, G., Leinsalu, M. and Kunst, A. E. (2008) European Union Working Group on Socioeconomic Inequalities in Health. Socioeconomic inequalities in health in 22 European countries. New England Journal of Medicine, 358, 24682481. Erratum in: New England Journal of Medicine, 2008, 359, 14.CrossRefGoogle Scholar
15.Kunst, A. (1997) Cross-national comparisons of socio-economic differences in mortality. Thesis. Erasmus University of Rotterdam, 1997.Google Scholar
16.Shkolnikov, V., Leon, D., Adamets, S., Andreev, E. and Deev, A. (1998) Educational level and adult mortality in Russia: an analysis of routine data 1979–1994. Social Science and Medicine, 47, 357369.CrossRefGoogle Scholar
17.Leinsalu, M., Vågerö, D. and Kunst, A. (2003) Estonia 1989–2000: Enormous increase in mortality differences by education. International Journal of Epidemiology, 32(6), 10811087.CrossRefGoogle ScholarPubMed
18.Murphy, M., Bobak, M., Nicholson, A., Rose, R. and Marmot, M. (2006) The widening gap in mortality by educational level in the Russian Federation, 1980–2001. American Journal of Public Health, 96, 12931299.CrossRefGoogle ScholarPubMed
19.Leinsalu, M., Stirbu, I., Vågerö, D., Kalediene, R., Kovács, K., Wojtyniak, B., Wróblewska, W., Mackenbach, J. P. and Kunst, A. E. (2009) Educational inequalities in mortality in four Eastern European countries: divergence in trends during the post-communist transition from 1990 to 2000. International Journal of Epidemiology, 38(2), 512525.CrossRefGoogle ScholarPubMed
20.Moser, K., Leon, D. and Shkolnikov, V. (2005) World mortality 1950–2000: divergence replaces convergence from the late 1980s. Bulletin of the World Health Organisation, 83, 202209.Google ScholarPubMed
21.World Health Organisation Regional Office for Europe (1985) Targets for Health for All. Targets in Support of the European Regional Strategy for Health for All (Copenhagen: WHO).Google Scholar
22.Rehm, J., Sulkowska, U., Mańczuk, M., Boffetta, P., Powles, J., Popova, S. and Zatoński, W. (2007) Alcohol accounts for a high proportion of premature mortality in central and eastern Europe. International Journal of Epidemiology, 36, 458467.CrossRefGoogle ScholarPubMed
23.Hemström, Ö. (2002) Alcohol-related deaths contribute to socioeconomic differentials in mortality in Sweden. European Journal of Public Health, 12(4), 254262.CrossRefGoogle ScholarPubMed
24.Mäkelä, P., Valkonen, T. and Martelin, T. (1997) Contributions of deaths related to alcohol use to socioeconomic variation in mortality: register based follow-up study. British Medical Journal, 315, 211216.CrossRefGoogle ScholarPubMed