Is East-West Life Expectancy Gap Narrowing in the Enlarged European Union?

Jacques Vallin, Institut National d''Etudes Démographiques
Domantas Jasilionis, Demographic Research Centre, Vytautas Magnus University
France Meslé, Institut National d''Etudes Démographiques

The fall of Berlin wall in 1990 and the EU enlargement in 2004 are two major political events in the recent history of Central and Eastern Europe. What were their impact on life expectancy and trends in the seven Central and Eastern European countries that joined the EU in 2004? After examining mortality changes in terms of age patterns and cause-of-death structures, it appears that the two political events brought quite different consequences for the three Baltic countries on one hand, and for the four Central European countries (Czech Rep., Poland, Slovakia and Hungary) on another hand. The collapse of the communism was accompanied with immediate positive changes in the Central European countries but with a sudden worsening and persisting health disadvantage in the Baltic countries. Conversely, positive effects of joining the EU in 2004 seem to have been more pronounced in the three Baltic countries than in four Central European countries. In the total, the Czech Republic, Poland, and (more recently) Estonia are the clear vanguards in the health convergence towards the EU-15 levels. In all seven new member states, further progress requires much more systematic efforts in combatting cardiovascular diseases and persisting burden of excess male mortality at adult ages.

 

IsEast-West life expectancy gap narrowing in the enlarged European Union?

 

DomantasJasilionis1,2, France Meslé3, Jacques Vallin3

1 Max PlanckInstitute for Demographic Research, Rostock, Germany

2 Demographic Research Centre,Vytautas Magnus University, Vilnius, Lithuania

3 L’Institutnational d’études démographiques (INED), Paris, France

 

The fall of Berlin wall in 1990 and the EU enlargement in 2004 aretwo major political events in the recent history of the Central and Europeanregion. This study attempts to explore life expectancy and age- andcause-specific mortality trends in seven the new EU member states focussing onprospects of convergence towards the levels of the fifteen older EU memberstates. Although health systems mainly remain under the responsibility of theindividual member states, health dimensions including life expectancy and causespecific mortality have been increasingly taken into consideration for assessingthe convergence process between EU countries.

By systematically comparing the changes and differences in both lifeexpectancy at birth and infant, adult, and old age mortality between the sevennew member countries and more advanced countries of the EU-15, we  identify thevanguards and laggards in the health convergence process before and after the fallof communist regimes and then the 2004 EU enlargement. The study also will explorevariations in the progress in reducing the burden of cardiovascular diseases,external causes of death, and alcohol-related deaths which were known to beresponsible for the long-lasting mortality crisis during the period ofcommunist rule.

Despite important life expectancy improvements in the sevenCentral and Eastern European countries that joined the EU in 2004, which led inreductions in the life expectancy gap against the EU-15, this progress was veryuneven (Figure 1). An obvious leader in this process remained the CzechRepublic with regular health improvements since the end of the 1980s. The mostspectacular progress in health and convergence during 2004-2014 was observed inEstonia which managed to reduce the life expectancy gap with the EU-15by twotimes in ten years. Among females, these two countries and Poland clearlycontinued leading the way reaching life expectancy levels of about 81.5 yearsin 2014. This success contrasts with uneven trajectories in the othercountries, especially among males. Lithuanian and Latvian males not onlyremained the laggards in the life expectancy convergence in spite of theirrapid recent progress: they still have huge disadvantage against both the EU-15and the leading Czech Republic.  

The variations in the magnitude of the longevity improvements arerelated to the contradictory changes in mortality due to the leading causes ofdeath (cardiovascular system diseases (both sexes) and external causes of death(for males) (Figure 2). For example, the most rapid health improvement inEstonia was more related to the important reductions in cardiovascularmortality than to quite moderate achievements in combatting external andalcohol-related deaths. After 2004, with the only exception of Estonianfemales, none of the remaining countries managed to achieve at least someconvergence towards the EU-15 levels in mortality due to cardiovascular diseases.Although almost all countries showed some progress in reducing the mortalitydisadvantage for external causes of death, similar achievements inalcohol-related male mortality concerned only Estonia and Hungary. Despiteimportant improvements, the burden alcohol-related mortality remainsexceptionally high in Lithuania and Hungary.

The interpretation of the recent overall longevity progress in theseven countries is not straightforward. The accession to the EU-15did not produce immediate effects on the reduction of life expectancydisadvantage observed in the seven new EU member countries. This concerns bothperiods of a) preceding the accession (negotiation process including theadoption of the EU laws and implementing necessary reforms) and b) short periodfollowing the accession which were not accompanied by any convergence of lifeexpectancy towards the EU-15. levels. However, a subsequent very rapid progressin the initially worst performing Baltic countries (especially Estonia) may suggestabout a delayed positive impact of the EU enlargement.

 

Figure1. Male and female life expectancy at birth in selected seven new EUmember countries, and the EU-15, 1980-2014.

 

Datasource: The Human Mortality Database, 2016; EUROSTAT, 2016; WHO, 2016.

 

 

Figure 2. Cause-specific contributions to the differences in life expectancybetween the seven new member states and EU-15, 2004 and 2014

Note:countries are ranked according to the size of male life expectancy gap in 2014.

Datasources: Human Cause of Death Database, 2016; Human Mortality Database, 2016;WHO, 2016.

 

References

Human Cause Of Death Database (FrenchInstitute For Demographic Studies (Ined) And Max Planck Institute ForDemographic Research (Germany)), 2016.Human Cause of Death Database, Retrieved 15 July 2016(http://www.causesofdeath.org).

Human Mortality Database (University OfCalifornia, Berkeley (Usa), And Max Planck Institute For Demographic Research(Germany)), 2016. – Human Mortality Database, Retrieved 15 July 2016(www.mortality.org).

WHO,2017. – WHO Mortality Database. Retrieved 15 July 2017(www.who.int/healthinfo/mortality_data/en).

Presented in Session 1200: Mortality and Longevity