BACKGROUND: Post-communist transition has had a huge impact on mortality in Eastern Europe. We examined how educational inequalities in mortality changed between 1990 and 2000 in Estonia, Lithuania, Poland and Hungary. METHODS: Cross-sectional data for the years around 1990 and 2000 were used. Age-standardized mortality rates and mortality rate ratios (for total mortality only) were calculated for men and women aged 35-64 in three educational categories, for five broad cause-of-death groups and for five (seven among women) specific causes of death. RESULTS: Educational inequalities in mortality increased in all four countries but in two completely different ways. In Poland and Hungary, mortality rates decreased or remained the same in all educational groups. In Estonia and Lithuania, mortality rates decreased among the highly educated, but increased among those of low education. In Estonia and Lithuania, for men and women combined, external causes and circulatory diseases contributed most to the increasing educational gap in total mortality. CONCLUSIONS: Different trends were observed between the two former Soviet republics and the two Central Eastern European countries. This divergence can be related to differences in socioeconomic development during the 1990s and in particular, to the spread of poverty, deprivation and marginalization. Alcohol and psychosocial stress may also have been important mediating factors.
BACKGROUND: Post-communist transition has had a huge impact on mortality in Eastern Europe. We examined how educational inequalities in mortality changed between 1990 and 2000 in Estonia, Lithuania, Poland and Hungary. METHODS: Cross-sectional data for the years around 1990 and 2000 were used. Age-standardized mortality rates and mortality rate ratios (for total mortality only) were calculated for men and women aged 35-64 in three educational categories, for five broad cause-of-death groups and for five (seven among women) specific causes of death. RESULTS: Educational inequalities in mortality increased in all four countries but in two completely different ways. In Poland and Hungary, mortality rates decreased or remained the same in all educational groups. In Estonia and Lithuania, mortality rates decreased among the highly educated, but increased among those of low education. In Estonia and Lithuania, for men and women combined, external causes and circulatory diseases contributed most to the increasing educational gap in total mortality. CONCLUSIONS: Different trends were observed between the two former Soviet republics and the two Central Eastern European countries. This divergence can be related to differences in socioeconomic development during the 1990s and in particular, to the spread of poverty, deprivation and marginalization. Alcohol and psychosocial stress may also have been important mediating factors.
Authors: J L Álvarez; A E Kunst; M Leinsalu; M Bopp; B H Strand; G Menvielle; O Lundberg; P Martikainen; P Deboosere; R Kalediene; B Artnik; J P Mackenbach; J H Richardus Journal: Int J Tuberc Lung Dis Date: 2011-11 Impact factor: 2.373
Authors: Johan P Mackenbach; José Rubio Valverde; Barbara Artnik; Matthias Bopp; Henrik Brønnum-Hansen; Patrick Deboosere; Ramune Kalediene; Katalin Kovács; Mall Leinsalu; Pekka Martikainen; Gwenn Menvielle; Enrique Regidor; Jitka Rychtaříková; Maica Rodriguez-Sanz; Paolo Vineis; Chris White; Bogdan Wojtyniak; Yannan Hu; Wilma J Nusselder Journal: Proc Natl Acad Sci U S A Date: 2018-06-04 Impact factor: 11.205
Authors: Alyson A van Raalte; Anton E Kunst; Olle Lundberg; Mall Leinsalu; Pekka Martikainen; Barbara Artnik; Patrick Deboosere; Irina Stirbu; Bogdan Wojtyniak; Johan P Mackenbach Journal: Popul Health Metr Date: 2012-02-16
Authors: Domantas Jasilionis; Giedre Smailyte; Ieva Vincerzevskiene; Vladimir M Shkolnikov Journal: Int J Public Health Date: 2015-10-01 Impact factor: 3.380
Authors: Olga Vikhireva; Hynek Pikhart; Andrzej Pajak; Ruzena Kubinova; Sofia Malyutina; Anne Peasey; Roman Topor-Madry; Yuri Nikitin; Michael Marmot; Martin Bobak Journal: Eur J Public Health Date: 2009-12-03 Impact factor: 3.367