Health Consequences of the German unification as reflected by mortality patterns in Mecklenburg-Vorpommern

Eva UB Kibele, Max Planck Institute for Demographic Research
Rembrandt Scholz, Max Planck Institute for Demographic Research
Vladimir Shkolnikov, Max Planck Institute for Demographic Research

Mecklenburg-Vorpommern (MV) is situated in the nothern part of East Germany on the Baltic Sea. This region is somewhat backward economically and has the country's lowest population density. The Unification resulted in a rapid change of the whole socio-economic context and instant replacement of the medical system by the West German one. It also caused high unemployment in MV and increasing inequality. Since the early 1990s, the population of Mecklenburg-Vorpommern gained 5 years of life expectancy and largely diminished the gap from the German average in life expectancy. Decreasing mortality from cardiovascular diseases and other avoidable causes constituted a core part of this convergence. Mortality from causes related to behaviors including alcohol-related conditions substantially determines the remaining difference from Germany. Total mortality decline has uneven territorial components. Mortality variation within MV shows certain "urban advantages". Determinants of the latter are investigated by means of ecological analysis.