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The German East-West Mortality Difference: Two Crossovers Driven by Smoking

Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50–69 now have lower mortality despite l...

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Autores principales: Vogt, Tobias, van Raalte, Alyson, Grigoriev, Pavel, Myrskylä, Mikko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486873/
https://www.ncbi.nlm.nih.gov/pubmed/28493101
http://dx.doi.org/10.1007/s13524-017-0577-z
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author Vogt, Tobias
van Raalte, Alyson
Grigoriev, Pavel
Myrskylä, Mikko
author_facet Vogt, Tobias
van Raalte, Alyson
Grigoriev, Pavel
Myrskylä, Mikko
author_sort Vogt, Tobias
collection PubMed
description Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50–69 now have lower mortality despite lower incomes and worse overall living conditions. Prior research has shown that lower smoking rates among East German female cohorts born in the 1940s and 1950s were a major contributor to this crossover. However, after 1990, smoking behavior changed dramatically, with higher smoking intensity observed among women in the eastern part of Germany. We forecast the impact of this changing smoking behavior on East-West mortality differences and find that the higher smoking rates among younger East German cohorts will reverse their contemporary mortality advantage. Mortality forecasting methods that do not account for smoking would, perhaps misleadingly, forecast a growing mortality advantage for East German women. Experience from other countries shows that smoking can be effectively reduced by strict anti-smoking policies. Instead, East Germany is becoming an example warning of the consequences of weakening anti-smoking policies and changing behavioral norms.
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spelling pubmed-54868732017-07-17 The German East-West Mortality Difference: Two Crossovers Driven by Smoking Vogt, Tobias van Raalte, Alyson Grigoriev, Pavel Myrskylä, Mikko Demography Article Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50–69 now have lower mortality despite lower incomes and worse overall living conditions. Prior research has shown that lower smoking rates among East German female cohorts born in the 1940s and 1950s were a major contributor to this crossover. However, after 1990, smoking behavior changed dramatically, with higher smoking intensity observed among women in the eastern part of Germany. We forecast the impact of this changing smoking behavior on East-West mortality differences and find that the higher smoking rates among younger East German cohorts will reverse their contemporary mortality advantage. Mortality forecasting methods that do not account for smoking would, perhaps misleadingly, forecast a growing mortality advantage for East German women. Experience from other countries shows that smoking can be effectively reduced by strict anti-smoking policies. Instead, East Germany is becoming an example warning of the consequences of weakening anti-smoking policies and changing behavioral norms. Springer US 2017-05-10 2017-06 /pmc/articles/PMC5486873/ /pubmed/28493101 http://dx.doi.org/10.1007/s13524-017-0577-z Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Article
Vogt, Tobias
van Raalte, Alyson
Grigoriev, Pavel
Myrskylä, Mikko
The German East-West Mortality Difference: Two Crossovers Driven by Smoking
title The German East-West Mortality Difference: Two Crossovers Driven by Smoking
title_full The German East-West Mortality Difference: Two Crossovers Driven by Smoking
title_fullStr The German East-West Mortality Difference: Two Crossovers Driven by Smoking
title_full_unstemmed The German East-West Mortality Difference: Two Crossovers Driven by Smoking
title_short The German East-West Mortality Difference: Two Crossovers Driven by Smoking
title_sort german east-west mortality difference: two crossovers driven by smoking
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486873/
https://www.ncbi.nlm.nih.gov/pubmed/28493101
http://dx.doi.org/10.1007/s13524-017-0577-z
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