Mortality differentials in the Czech Republic during the post-1989 socio–political transformation

doi:10.1016/S1353-8292(00)00016-2

Health & Place

Volume 6, Issue 4, 1 December 2000, Pages 351-362

https://doi.org/10.1016/S1353-8292(00)00016-2 Get rights and content

Abstract

The Czech Republic, together with Slovakia and Poland, forms a region within Central–Eastern Europe in which the values of life expectancy at birth have been increasing during the period of transformation. However, the tempo of mortality reduction has differed spatially within the territory of the Czech Republic, as have other outcomes of the transformation process. This paper discussed possible socio–economic explanations of regional differences in the tempos of mortality change between 1990/91 and 1995/96. Standardized mortality rates for males aged 0–64 years specified for the three most frequent causes of death were examined by means of the regression and correlation analysis.

Section snippets

Introduction — mortality differentials in Europe

Following World War II, a bipolar geopolitical system came into existence in Europe which divided the continent into two blocks. In the early post-war years, demographic trends in the two groups of countries were rather similar: life expectancies were generally increasing, and infant mortality rates as well as levels of mortality due to infectious diseases were declining. However, by the late 1960s mortality patterns started to diverge in the East and the West. The primary reason for the

Current mortality level in the Czech Republic

Studying mortality in the Czech Republic is of particular importance because, unlike in other East European countries, mortality indicators for Czech men and women have improved since the beginning of the post-communist transformation. In 1996, for the first time in its demographic history, the Czech Republic recorded levels of life expectancy at birth that surpassed 70 years for males and 77 years for females. Between 1989 and 1996, the life expectancy at birth increased by 2.26 years for

Method

Increasing differentiation of mortality levels reflects a growing disparity in the risks of illness and dying, be it in a demographic or a regional sense. It is well known that detrimental mortality conditions may typify groups of countries as well as smaller geographic areas within individual countries (Veen, 1994, Dzúrová, 1993; Rychtařı́ková & Dzúrová, 1992). For many years, the Czech Republic exhibited a stable pattern of regional mortality differentials, with very high levels in north-west

Socio–economic explanations of regional differences in mortality

Several explanations for the regional mortality differentials in the Czech Republic can be put forward. The main problem lies in the lack of reliable and representative data. As a preliminary step in the analytical effort to explain the regional variation in mortality levels, an extensive database was compiled using two types of explanatory variables: indicators of social quality and indicators of economic development. Most of the variables used refer to the two time periods discussed above

Discussion

The years of economic transformation, initially announced as a period of ‘the tightening of belts’, have paradoxically become a time of gradually declining mortality levels. One of the underlying reasons was a significant change in nutritional habits. As a result of the abolition of state subsidies and the liberalisation of consumer prices, the prices of food have increased but so has the diversity of available products. Changes in the price system increased the demand for vegetable fats as

Conclusions

The dominant overall trend that has resulted form the socio–economic transformation in post-communist countries is one of differentiation. This differentiation has affected individual citizens as well as families, categories of employees, socio–economic groups, etc. The process has also a distinctive regional dimension. It is therefore not surprising that at present more mortality differences between social and economic groups can be detected than was the case under the conditions of command

Acknowledgements

This work was supported by the Czech Grant Agency, grant No. 403/96/0258.

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