Mortality in Eastern Europe during the 20th century: the marks of political history
Résumé
During the twentieth century, the history of Eastern Europe was marked by political upheavals that severely impacted health and mortality trends. Following the First World War, the health transition accelerated in several new states built on the ruins of the Austro-Hungarian and Russian Empires, while in the newly formed USSR the Stalinist dictatorship was responsible for the most deadly famine of the century in Europe.
After the Second World War, with its staggering death toll and the political division of Europe, Eastern and Central European countries experienced dramatic health progress thanks to a successful fight against infectious diseases. But in the 1970s, they were unable to enter the cardiovascular revolution, the second stage of the health transition, and life expectancy stopped improving and even, in some cases, started to decrease. Rigid centralized health systems could not adapt to the new sanitary deal.
With the fall of Berlin Wall and the break-up of the Soviet Union, progress resumed in Central Europe, while countries of the former USSR went through a major health crisis due to the brutal change to the market economy. Only in the early twenty-first century did notable improvement in those countries finally occur.
Despite fragmentary vital statistics, it has been possible to assess life expectancy trends in most of the region’s countries between the two World Wars and to provide estimates of the number of victims of the Great Famine. Regarding the second half of the twentieth century, Soviet archives provided original data on deaths by cause in the different republics of the former USSR, which has allowed the main features of their difficult health transition to be highlighted.
The proposed paper will trace the history of mortality in these countries and emphasize the main challenges they will have to face in the near future.