{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T03:36:43Z","timestamp":1778297803952,"version":"3.51.4"},"reference-count":43,"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 trends in life expectancy at birth and age and cause specific patterns of mortality in the former German Democratic Republic (GDR) and Poland during political transition and throughout the 1990s in both parts of Germany and in Poland.<\/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. Changes in life expectancy during transition by cause of death were examined using data for 1988\/89 and 1990\/91 for the former GDR and Poland; examination of life expectancy changes after transition were based on 1992\u201397 data for Germany and 1991\u201396 data for Poland.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In both the former GDR and Poland male life expectancy at birth declined by almost one year during transition, mainly attributable to rising death rates from external causes and circulatory diseases. Female life expectancy in Poland deteriorated by 0.3 years, largely attributable to increasing circulatory mortality among the old, while in East German female rising death rates in children and young adults were nearly outbalanced by declining circulatory mortality among those over 70. Between 1991\/92 and 1996\/97, male life expectancy at birth increased by 2.4 years in the former GDR, 1.2 years in old Federal Republic, and 2.0 years in Poland (women: 2.3, 0.9, and 1.2 years). In East Germany and Poland, the overall improvement was largely attributable to falling mortality among men aged 40\u201364, while those over 65 contributed the largest proportion to life expectancy gains in women. The change in deaths among men aged 15\u201339 accounted for 0.4 of a year to life expectancy at birth in East Germany and Poland, attributable largely to greater decreases from external causes. Among those over 40, absolute contributions to changing life expectancy were greater in the former GDR than in the other two entities in both sexes, largely attributable to circulatory diseases. A persisting East-west life expectancy gap in Germany of 2.1 years in men in 1997 was largely attributable to external causes, diseases of the digestive system and circulatory diseases. Higher death rates from circulatory diseases among the elderly largely explain the female life expectancy gap of approximately one year.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This study provides further insights into the health effects of political transition. Post-transition improvements in life expectancy and mortality have been much steeper in East Germany compared with Poland. Changes in dietary pattern and, in Germany, medical care may have been important factors in shaping post-transition mortality trends.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech.54.12.899","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:37:40Z","timestamp":1027751860000},"page":"899-906","source":"Crossref","is-referenced-by-count":66,"title":["Changing mortality patterns in East and West Germany and Poland. II: Short-term trends during transition and in the 1990s"],"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":"2025100304265976000_54.12.899.1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.3.272"},{"key":"2025100304265976000_54.12.899.2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.54.12.890"},{"key":"2025100304265976000_54.12.899.3","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1136\/jech.54.12.890","article-title":"Changing mortality patterns in east and West Germany and Poland. I: Long term trends (1960\u00e2\u0080\u00931997).","volume":"54","author":"Nolte","year":"2000","journal-title":"J Epidemiol Community Health"},{"key":"2025100304265976000_54.12.899.4","first-page":"257","article-title":"Todesursachen1990\/91 im vereinten Deutschland.","volume":"4","author":"Br\u00c3\u00bcckner","year":"1993","journal-title":"Wirtschaft und Statistik"},{"key":"2025100304265976000_54.12.899.5","doi-asserted-by":"crossref","first-page":"137","DOI":"10.2307\/2137633","article-title":"Demographic shocks after communism: Eastern Germany, 1989\u00e2\u0080\u009393.","volume":"20","author":"Eberstadt","year":"1994","journal-title":"Population Development Review"},{"key":"2025100304265976000_54.12.899.6","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":"2025100304265976000_54.12.899.7","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":"2025100304265976000_54.12.899.8","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":"2025100304265976000_54.12.899.9","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":"2025100304265976000_54.12.899.10","first-page":"130","article-title":"Akuter Herzinfarkt\u00e2\u0080\u0094dramatischer Sterblichkeitsanstieg in den neuen Bundesl\u00c3\u00a4ndern?","volume":"36","author":"Hoffmeister","year":"1993","journal-title":"Bundesgesundheitsblatt"},{"key":"2025100304265976000_54.12.899.11","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1136\/bmj.316.7137.1047","article-title":"Ecological study of reasons for the sharp decline in mortality from ischaemic heart disease in Poland since 1991.","volume":"316","author":"Zatonski","year":"1998","journal-title":"BMJ"},{"key":"2025100304265976000_54.12.899.12","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":"2025100304265976000_54.12.899.13","first-page":"338","article-title":"Validity of the official cardiovascular mortality statistics.","volume":"159","author":"Heinemann","year":"1994","journal-title":"Acta Cardiol"},{"key":"2025100304265976000_54.12.899.14","unstructured":"UNICEF. Crisis in mortality, health and nutrition. Florence: UNICEF International Child Development Centre Regional Monitoring Report No 2, 1994.."},{"key":"2025100304265976000_54.12.899.15","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1136\/bmj.318.7199.1647","article-title":"The carnage wrought by major economic change: ecological study of traffic related mortality and the reunification of Germany.","volume":"318","author":"Winston","year":"1999","journal-title":"BMJ"},{"key":"2025100304265976000_54.12.899.16","unstructured":"Edwards G Anderson P Babor T (1994) Alcohol policy and the public good. (Oxford University Press, Oxford)."},{"key":"2025100304265976000_54.12.899.17","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/BF02956782","article-title":"Entwicklung der Herz-Kreislauf-Morbidit\u00c3\u00a4t und -Mortalit\u00c3\u00a4t in Ostdeutschland nach der politisch-\u00c3\u00b6konomischen Wende.","volume":"6","author":"Barth","year":"1998","journal-title":"Z Gesundheitswissenschaften"},{"key":"2025100304265976000_54.12.899.18","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1080\/14631379308427772","article-title":"Health and the fate of communist states.","volume":"5","author":"Eberstadt","year":"1993","journal-title":"Communist Economies and Economic Transformation"},{"key":"2025100304265976000_54.12.899.19","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1159\/000177956","article-title":"Trends in food intake in adults from the city of Erfurt before and after the German reunification.","volume":"41","author":"Winkler","year":"1997","journal-title":"Ann Nutr Metab"},{"key":"2025100304265976000_54.12.899.20","doi-asserted-by":"crossref","first-page":"S61","DOI":"10.1017\/S0007114599000914","article-title":"Dietary recommendations and prevailing food and nutrient intakes in Germany.","volume":"81 (suppl 2)","author":"Hermann-Kunz","year":"1999","journal-title":"Br J Nutr"},{"key":"2025100304265976000_54.12.899.21","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/26.1.1"},{"key":"2025100304265976000_54.12.899.22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ije\/26.1.1","article-title":"Fruit and vegetables, and cardiovascular disease: a review.","volume":"26","author":"Ness","year":"1997","journal-title":"Int J Epidemiol"},{"key":"2025100304265976000_54.12.899.23","first-page":"S46","article-title":"WHO MONICA Project: Risk factors.","volume":"18 (suppl 1)","year":"1989","journal-title":"Int J Epidemiol"},{"key":"2025100304265976000_54.12.899.24","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)00179-T"},{"key":"2025100304265976000_54.12.899.25","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/0895-4356(94)00179-T","article-title":"Trend of cardiovascular risk factors in the east German population 1968\u00e2\u0080\u00931992.","volume":"48","author":"Heinemann","year":"1995","journal-title":"J Clin Epidemiol"},{"key":"2025100304265976000_54.12.899.26","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/BF02956091","article-title":"Analyse nationaler Trends kardiovaskul\u00c3\u00a4rer Risikofaktoren f\u00c3\u00bcr die Bundesrepublik Deutschland von 1984 bis 1991.","volume":"7","author":"Helmert","year":"1999","journal-title":"Z Gesundheitswissenschaften"},{"key":"2025100304265976000_54.12.899.27","doi-asserted-by":"crossref","unstructured":"Capewell S Morrison CE McMurrey JJ (1999) Contribution of modern cardiovascular treatment and risk factor changes to the decline in coronary heart disease mortality in Scotland between 1975 and 1994. Heart, ,81:380\u00e2\u0080\u00936..","DOI":"10.1136\/hrt.81.4.380"},{"key":"2025100304265976000_54.12.899.28","doi-asserted-by":"crossref","unstructured":"Gjon\u00c3\u00a7a A Brockmann H Maier H (1999) Old-age mortality in Germany prior to and after unification. MPIDR Working Paper WP 1999\u00e2\u0080\u0093011. (Max Planck Institute for Demographic Research, Rostock).","DOI":"10.4054\/DemRes.2000.3.1"},{"key":"2025100304265976000_54.12.899.29","unstructured":"Cockerham WC , ed (1999) Health and social change in Russia and eastern Europe. (Routledge, London)."},{"key":"2025100304265976000_54.12.899.30","unstructured":"European Observatory on Health Care Systems (1999) Health care systems in transition: Poland. (European Observatory on Health Care Systems, Copenhagen)."},{"key":"2025100304265976000_54.12.899.31","doi-asserted-by":"publisher","DOI":"10.1136\/jech.54.2.84"},{"key":"2025100304265976000_54.12.899.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8510(98)00048-7"},{"key":"2025100304265976000_54.12.899.33","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0168-8510(98)00048-7","article-title":"Neonatal mortality in the Czech Republic during the transition.","volume":"46","author":"Koupilov\u00c3\u00a1","year":"1998","journal-title":"Health Policy"},{"key":"2025100304265976000_54.12.899.34","first-page":"65","article-title":"Zur Situation alter Menschen in Ostdeutschland.","volume":"31","author":"Schmidt","year":"1998","journal-title":"Deutschland-Archiv"},{"key":"2025100304265976000_54.12.899.35","unstructured":"Br\u00c3\u00bcckner G (1998) Health expectancy in Germany: What do we learn from the reunification process? (Nihon University Population Research Institute, Tokyo)."},{"key":"2025100304265976000_54.12.899.36","doi-asserted-by":"crossref","first-page":"21","DOI":"10.2307\/2955359","article-title":"Self-rated health and mortality: a review of twenty-seven community studies.","volume":"38","author":"Idler","year":"1997","journal-title":"J Health Soc Behav"},{"key":"2025100304265976000_54.12.899.37","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/BF03042797","article-title":"Nichtnat\u00c3\u00bcrliche Todesf\u00c3\u00a4lle und Verletzungen im Rahmen von Mortalit\u00c3\u00a4t und Morbidit\u00c3\u00a4t.","volume":"41","author":"Casper","year":"1998","journal-title":"Bundesgesundheitsblatt"},{"key":"2025100304265976000_54.12.899.38","unstructured":"ECOHOST (1998) Childhood injuries: a priority area for the transition countries of Central and Eastern Europe and the newly independent states. (LSH&TM, London)."},{"key":"2025100304265976000_54.12.899.39","unstructured":"Statistisches Bundesamt (1998) Gesundheitsbericht f\u00c3\u00bcr Deutschland 1998. (Metzler-Poeschel, Stuttgart)."},{"key":"2025100304265976000_54.12.899.40","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1600521"},{"key":"2025100304265976000_54.12.899.41","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/sj.ejcn.1600521","article-title":"Dietary intake of middle-aged men from an East and a West German city after the German reunification: do differences still exist?","volume":"52","author":"Winkler","year":"1998","journal-title":"Eur J Clin Nutr"},{"key":"2025100304265976000_54.12.899.42","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1093\/ije\/28.3.437","article-title":"An ecological analysis of determinants of coronary heart disease rates: a comparison of Czech, Bavarian and Israeli men.","volume":"25","author":"Bobak","year":"1999","journal-title":"Int J Epidemiol"},{"key":"2025100304265976000_54.12.899.43","unstructured":"Waterhouse JAH Muir CS Correa P , eds (1976) Cancer incidence in five continents. (International Agency for Research on Cancer, Lyon)."}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech.54.12.899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:27:14Z","timestamp":1759490834000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech.54.12.899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12,1]]},"references-count":43,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2000,12,1]]},"published-print":{"date-parts":[[2000,12,1]]}},"alternative-id":["10.1136\/jech.54.12.899"],"URL":"https:\/\/doi.org\/10.1136\/jech.54.12.899","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]]}}}