Shorter life expectancies in eastern versus western EuropeBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2067 (Published 03 April 2013) Cite this as: BMJ 2013;346:f2067
The gap in life expectancy between eastern and western Europe is 12 years for men and eight years for women, and it is greater today for men than it was four decades ago. Whereas life expectancy has continuously improved in the west over that time, patterns have been inconsistent in the east⇑.
The rise in the west is thought to be linked with economic growth and improvements in healthcare and policy. Success was seen in relation to perinatal and maternal health, immunisations, detection and treatment of hypertension, screening for cancer, and more effective treatment of many diseases. Policies such as tobacco control, road traffic safety, and reductions in air pollution have also contributed to better health, although success has varied between countries.
In the east—in this study, central and eastern Europe as well as the whole of the former Soviet Union—economic problems coupled with the lack of effective health policies have led to poorer health. Before the fall of the Berlin Wall, tobacco and alcohol control were almost non-existent in large parts of the region, as was awareness of the role of nutrition in prevention of chronic diseases. Smoking rates are still high, especially in young women. In some countries surrogate alcohols—sold as aftershaves and medicinal tinctures and containing 70-90% ethanol—are consumed widely. Control of infectious diseases broke down in some countries, with re-emergence of diphtheria and tuberculosis.
Care may have improved in central and eastern Europe since the fall of communism, but it has worsened in the former Soviet Union, where the newly introduced formal and informal payments now mean many people don’t get the care they need.
Also of concern are rising health inequalities within countries, and common challenges remain in both eastern and western Europe, such as policies on food and alcohol.
This is the first time the Lancet has published a series of papers on health in Europe (www.thelancet.com/series/health-in-europe).
Cite this as: BMJ 2013;346:f2067