{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:03:27Z","timestamp":1769105007907,"version":"3.49.0"},"reference-count":52,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[2000,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To examine the long term evolution of mortality in the former German Democratic Republic (GDR) in the period from 1960 and its specific position in health terms compared with the Federal Republic (FRG) in the west and Poland in the east.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Decomposition of life expectancy by age and cause of death. Differences in life expectancy at birth between the former GDR and the old FRG were decomposed by age using data on all cause mortality for the period 1960 to 1997. Changes in life expectancy over time by cause of death were examined using data for 1974 and 1989 for both parts of Germany and for 1974 and 1988 for Poland.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Male life expectancy in the two parts of Germany diverged twice, in the mid-1960s, favouring the GDR, and in the mid-1970s, giving increasing advantage to the FRG, while female life expectancy remained similar until the mid-1970s and began to diverge thereafter. The initial advantage of the GDR was mainly attributable to an improving mortality rate among children compared with that in the west in both sexes. During the 1980s, mortality among men over 15 and women over 40 steadily worsened relative to their western counterparts, although men were doing considerably better than those in Poland who actually experienced deterioration. In the FRG, falling death rates among adults of all ages have contributed substantially to the improvement in life expectancy between 1974 and 1989, largely attributable to falling deaths from cardiovascular disease and from injuries at younger adult ages. In Poland, death rates among male adults have risen at all ages over 35, mostly attributable to worsening death rates from cardiovascular disease and neoplasms while women experienced stagnation. The GDR showed a small worsening among men under 60, counterbalanced by improvements among those over 60, and some improvement in women, attributable to falling deaths from cardiovascular disease among the middle aged and elderly.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This study provides further evidence for the complexity of the east-west mortality differential emerging in the 1960s in Europe, highlighting the intermediate position in health terms the former GDR occupied during much of the communist period. Further research is required to assess the underlying causes for the specific position of the former GDR between east and west.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech.54.12.890","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:33:18Z","timestamp":1027751598000},"page":"890-898","source":"Crossref","is-referenced-by-count":45,"title":["Changing mortality patterns in East and West Germany and Poland. I: Long term trends (1960\u20131997)"],"prefix":"10.1136","volume":"54","author":[{"given":"Ellen","family":"Nolte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Shkolnikov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"McKee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2000,12,1]]},"reference":[{"key":"2025100704551981000_54.12.890.1","unstructured":"Okolski M (1993) East-West mortality differentials. in Demographic dynamics. European population, vol 2. eds Blum A Rallu JL (John Libbey, Paris), pp 165\u00e2\u0080\u0093189."},{"key":"2025100704551981000_54.12.890.2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S1361-2611(98)80081-X","article-title":"How the cardiovascular burden of illness is changing in Eastern Europe.","volume":"2","author":"McKee","year":"1998","journal-title":"Evidence-based Cardiovascular Medicine"},{"key":"2025100704551981000_54.12.890.3","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.3.272"},{"key":"2025100704551981000_54.12.890.4","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1136\/jech.51.3.272","article-title":"Political changes and trends in cardiovascular risk factors in the Czech Republic, 1985\u00e2\u0080\u009392.","volume":"51","author":"Bobak","year":"1997","journal-title":"J Epidemiol Community Health"},{"key":"2025100704551981000_54.12.890.5","doi-asserted-by":"crossref","unstructured":"Wasem J (1997) Health care reform in the Federal Republic of Germany: the new and the old L\u00c3\u00a4nder. in Health policy reform, national variations and globalization. eds Altenstetter C Bj\u00c3\u00b6rkman JW (Macmillan, London), pp 161\u00e2\u0080\u0093174.","DOI":"10.1007\/978-1-349-25319-7_8"},{"key":"2025100704551981000_54.12.890.6","first-page":"187","article-title":"Der Lebensverl\u00c3\u00a4ngerungsproze\u00ce\u00b2\u00e2\u0080\u0094ein Vergleich zwischen West- und Ostdeutschland.","volume":"20","author":"Schott","year":"1995","journal-title":"Z Bev\u00c3\u00b6lkerungswissenschaft"},{"key":"2025100704551981000_54.12.890.7","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1080\/14631379008427651","article-title":"Health and mortality in eastern Europe.","volume":"2","author":"Eberstadt","year":"1990","journal-title":"Communist Economies"},{"key":"2025100704551981000_54.12.890.8","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/BF02966550","article-title":"Explaining the health divide in Germany: contribution of major causes of death to the difference in life expectancy at birth between east and west.","volume":"4","author":"McKee","year":"1996","journal-title":"Z Gesundheitswissenschaften"},{"key":"2025100704551981000_54.12.890.9","unstructured":"United Nations (1979) Demographic Yearbook. Historical Supplement. (United Nations, New York)."},{"key":"2025100704551981000_54.12.890.10","unstructured":"Staatliche Zentralverwaltung f\u00c3\u00bcr Statistik (1961) Statistisches Jahrbuch der Deutschen Demokratischen Republik. Vols 1960\/61 and 1972. (Deutscher Zentralverlag Berlin\/Staatsverlag der Deutschen Demokratischen Republik, Berlin) and 1972.."},{"key":"2025100704551981000_54.12.890.11","unstructured":"http:\/\/www.who.int\/whosis\/mort\/download.htm."},{"key":"2025100704551981000_54.12.890.12","unstructured":"Statistisches Bundesamt.Todesursachenstatistik. Wiesbaden: Statistisches Bundesamt, 1990\u00e2\u0080\u00931997.."},{"key":"2025100704551981000_54.12.890.13","unstructured":"Statistisches Bundesamt (1995) Gesundheits- und Sozialwesen in \u00c3\u009cbersichten. Sonderreihe mit Beitr\u00c3\u00a4gen f\u00c3\u00bcr das Gebiet der ehemaligen DDR. Heft 27. (Statistisches Bundesamt, Wiesbaden)."},{"key":"2025100704551981000_54.12.890.14","doi-asserted-by":"publisher","DOI":"10.1007\/BF01796614"},{"key":"2025100704551981000_54.12.890.15","first-page":"123","article-title":"Health crisis in Russia.","volume":"8","author":"Shkolnikov","year":"1996","journal-title":"Population: an English selection"},{"key":"2025100704551981000_54.12.890.16","unstructured":"Chiang CL (1984) The life table and its applications. (Malabar, Florida)."},{"key":"2025100704551981000_54.12.890.17","first-page":"42","article-title":"Metod komponent v analize prodolzjitelnosti zhizni [The component method in analysis of life expectancy].","volume":"3","author":"Andreev","year":"1983","journal-title":"Vestnik Statistiki"},{"key":"2025100704551981000_54.12.890.18","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2307\/2061029","article-title":"Measuring and explaining the change in life expectancies.","volume":"21","author":"Arriaga","year":"1984","journal-title":"Demography"},{"key":"2025100704551981000_54.12.890.19","first-page":"766","article-title":"Contribution des \u00c3\u00a9carts de mortalit\u00c3\u00a9 par \u00c3\u00a2ge \u00c3\u00a0 la diff\u00c3\u00a9rence des vies moyennes.","volume":"40","author":"Pressat","year":"1985","journal-title":"Population"},{"key":"2025100704551981000_54.12.890.20","unstructured":"Microsoft Corporation. Microsoft Excel Version 97.."},{"key":"2025100704551981000_54.12.890.21","first-page":"464","article-title":"Imparit\u00c3\u00a4ten zwischen Ost und West\u00e2\u0080\u0094einige Besonderheiten der Mortalit\u00c3\u00a4tsentwicklung nach der Wiedervereinigung Deutschlands.","volume":"36","author":"Wiesner","year":"1993","journal-title":"Bundesgesundheitsblatt"},{"key":"2025100704551981000_54.12.890.22","first-page":"183","article-title":"Health transformations in Poland after 1988.","volume":"4","author":"Zato\u00c3\u00b1ski","year":"1996","journal-title":"J Epidemiol Biostat"},{"key":"2025100704551981000_54.12.890.23","first-page":"257","article-title":"Todesursachen1990\/91 im vereinten Deutschland.","volume":"4","author":"Br\u00c3\u00bcckner","year":"1993","journal-title":"Wirtschaft und Statistik"},{"key":"2025100704551981000_54.12.890.24","unstructured":"Casper W Wiesner G Bergmann KE , eds (1995) Mortalit\u00c3\u00a4t und Todesursachen in Deutschland. RKI-Heft 10\/1995. (Robert Koch-Institut, Berlin)."},{"key":"2025100704551981000_54.12.890.25","first-page":"429","article-title":"Influenza in the world: October 1971\u00e2\u0080\u0093September 1972.","volume":"47","year":"1972","journal-title":"Wkly Epidemiol Rec"},{"key":"2025100704551981000_54.12.890.26","first-page":"365","article-title":"Die Entwicklung von Lebenserwartung und Sterblichkeit in Ostdeutschland nach der Wende (1989\u00e2\u0080\u00931992).","volume":"57","author":"H\u00c3\u00a4ussler","year":"1995","journal-title":"Gesundheitswesen"},{"key":"2025100704551981000_54.12.890.27","first-page":"732","article-title":"Die innerdeutsche Wanderung und der Vereinigungsproze\u00ce\u00b2.","volume":"23","author":"Voigt","year":"1990","journal-title":"Deutschland-Archiv"},{"key":"2025100704551981000_54.12.890.28","first-page":"315","article-title":"Berechnung von Sterbetafeln und Trends der Lebensdauerma\u00ce\u00b2e f\u00c3\u00bcr die S\u00c3\u00a4chsische Bev\u00c3\u00b6lkerung im Zeitraum 1980 bis 1994.","volume":"59","author":"Rossa","year":"1997","journal-title":"Gesundheitswesen"},{"key":"2025100704551981000_54.12.890.29","first-page":"345","article-title":"Bericht 1996 \u00c3\u00bcber die demographische Lage in Deutschland.","volume":"21","author":"Gr\u00c3\u00bcnheid","year":"1996","journal-title":"Z Bev\u00c3\u00b6lkerungswissenschaft"},{"key":"2025100704551981000_54.12.890.30","first-page":"95","article-title":"Kohortensterbetafeln f\u00c3\u00bcr die Geburtsjahrg\u00c3\u00a4nge ab 1900 bis 1962 in den beiden Teilen Deutschlands.","volume":"18","author":"Dinkel","year":"1992","journal-title":"Z Bev\u00c3\u00b6lkerungswissenschaft"},{"key":"2025100704551981000_54.12.890.31","unstructured":"Henning A (1986) Mother and child care. in Political values and health care: the German experience. eds Light DW Schuller A (MIT Press, Cambridge, MA), pp 467\u00e2\u0080\u0093486."},{"key":"2025100704551981000_54.12.890.32","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/BF02956781","article-title":"Zur Validit\u00c3\u00a4t der Herz-Kreislauf-Mortalit\u00c3\u00a4ts-Statistik der ehemaligen DDR.","volume":"6","author":"Heinemann","year":"1998","journal-title":"Z Gesundheitswissenschaften"},{"key":"2025100704551981000_54.12.890.33","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2190\/BX3T-U5X7-GCEB-TPMQ","article-title":"Rising death rates among Polish men.","volume":"14","author":"Cooper","year":"1984","journal-title":"Int J Health Services"},{"key":"2025100704551981000_54.12.890.34","unstructured":"United Nations (1982) Demographic Yearbook 1980. Vol 32. (United Nations, New York)."},{"key":"2025100704551981000_54.12.890.35","first-page":"205","article-title":"Reflections of the health policy of the former German Democratic Republic.","volume":"3","author":"Niehoff","year":"1992","journal-title":"Int J Health Sciences"},{"key":"2025100704551981000_54.12.890.36","unstructured":"Knox RA (1993) Germany: One nation with health care for all. (Faulkner and Gray, New York)."},{"key":"2025100704551981000_54.12.890.37","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0140-6736(05)63557-X","article-title":"Decline in mortality from testicular cancer in West Germany after reunification.","volume":"350","author":"Becker","year":"1997","journal-title":"Lancet"},{"key":"2025100704551981000_54.12.890.38","unstructured":"Bundesminister f\u00c3\u00bcr Gesundheit (1993) Indikatoren zum Gesundheitszustand der Bev\u00c3\u00b6lkerung in der ehemaligen DDR. (Nomos-Verlagsgesellschaft, Baden-Baden)."},{"key":"2025100704551981000_54.12.890.39","first-page":"S90","article-title":"Blood pressure, hypertension, and other risk factors in East and West Germany.","volume":"3 (suppl)","author":"Heinemann","year":"1993","journal-title":"Ann Epidemiol"},{"key":"2025100704551981000_54.12.890.40","first-page":"95","article-title":"H\u00c3\u00a4ufigkeit und Prognose von Schlaganfallerkrankungen in der Bev\u00c3\u00b6lkerung Ostdeutschlands. Ergebnisse von Schlaganfallregistern in den Jahren 1985\u00e2\u0080\u00931988.","volume":"65","author":"Eisenbl\u00c3\u00a4tter","year":"1994","journal-title":"Nervenarzt"},{"key":"2025100704551981000_54.12.890.41","unstructured":"Statistisches Bundesamt (1998) Gesundheitsbericht f\u00c3\u00bcr Deutschland 1998. (Metzler-Poeschel, Stuttgart)."},{"key":"2025100704551981000_54.12.890.42","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1006\/pmed.1994.1027","article-title":"National trends in risk factors for cardiovascular disease in Germany.","volume":"23","author":"Hoffmeister","year":"1994","journal-title":"Prev Med"},{"key":"2025100704551981000_54.12.890.43","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/BF02956070","article-title":"Behandlung und Kontrolle prim\u00c3\u00a4rer kardiovaskul\u00c3\u00a4rer Risikofaktoren in den alten Bundesl\u00c3\u00a4ndern. Ergebnisse des bev\u00c3\u00b6lkerungsmedizinischen Monitoring durch die Nationalen Gesundheitssurveys der DHP 1984\/85\u00e2\u0080\u00931988\u00e2\u0080\u00931990\/91.","volume":"1","author":"Laaser","year":"1993","journal-title":"Z Gesundheitswissenschaften"},{"key":"2025100704551981000_54.12.890.44","doi-asserted-by":"publisher","DOI":"10.1097\/00043798-199606000-00002"},{"key":"2025100704551981000_54.12.890.45","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/00043798-199606000-00002","article-title":"Decline of coronary heart disease mortality in The Netherlands from 1978 to 1985: contribution of medical care and changes over time in presence of major cardiovascular risk factors.","volume":"3","author":"Bots","year":"1996","journal-title":"J Cardiovasc Risk"},{"key":"2025100704551981000_54.12.890.46","doi-asserted-by":"publisher","DOI":"10.1136\/jech.54.2.84"},{"key":"2025100704551981000_54.12.890.47","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91327-0"},{"key":"2025100704551981000_54.12.890.48","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8510(98)00048-7"},{"key":"2025100704551981000_54.12.890.49","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.2.167"},{"key":"2025100704551981000_54.12.890.50","first-page":"167","article-title":"Alcohol related mortality in Poland and Hungary: differences and similarities.","volume":"51","author":"Varasovszky","year":"1997","journal-title":"J Epidemiol Community Health"},{"key":"2025100704551981000_54.12.890.51","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/26.1.75"},{"key":"2025100704551981000_54.12.890.52","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/ije\/26.1.75","article-title":"The east-west life expectancy gap: Differences in mortality from conditions amenable to medical intervention.","volume":"26","author":"Velkova","year":"1997","journal-title":"Int J Epidemiol"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech.54.12.890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T11:55:35Z","timestamp":1759838135000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech.54.12.890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12,1]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2000,12,1]]},"published-print":{"date-parts":[[2000,12,1]]}},"alternative-id":["10.1136\/jech.54.12.890"],"URL":"https:\/\/doi.org\/10.1136\/jech.54.12.890","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,12,1]]}}}