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Recent Life Expectancy Divergence in Baltic Countries

Récentes divergences d’espérance de vie dans les pays Baltes

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Abstract

Until the end of the 1990s, mortality patterns and trends in Estonia, Latvia and Lithuania were remarkably similar. However, from the year 2000 onwards, life expectancy trends in the three countries started to diverge. In particular, sustainable progress in Estonia over the period 2000–2007 contrasts with stagnation in Latvia, and even worsening trends in Lithuania. These contradictory changes seem to be mainly explained by contrasting dynamics in mortality from cardiovascular diseases, external causes of death and digestive system diseases. Whereas cardiovascular and external-cause mortality declined in Estonia and Latvia, worsening or stagnation of mortality from these causes of death was observed in Lithuania. The negative mortality changes in Lithuania were also reinforced by a striking increase in mortality from alcohol-related digestive system diseases. The findings suggest that the divergence in health trends between the three countries may be attributable to their varying degrees of success in implementing structural health care reforms and specific health policy measures. By contrast, the very recent improvement (since 2008) is parallel in the three countries and is largely because of the introduction of rather similar anti-alcohol measures.

Résumé

Jusqu’à la fin des années 1990, les évolutions et structures de mortalité en Estonie, Lettonie et Lituanie étaient remarquablement similaires. Cependant, à partir de l’année 2000, les tendances de l’espérance de vie ont commencé à se différencier. Plus particulièrement, les progrès soutenus en Estonie au cours de la période 2000–2007 contrastent avec la stagnation en Lettonie et la détérioration en Lituanie. Des dynamiques différentes de la mortalité par maladies cardio-vasculaires et du système digestif et par morts violentes semblent être les principales causes de ces évolutions divergentes. Alors que la mortalité cardiovasculaire et par morts violentes diminuait en Estonie et en Lettonie, une aggravation ou une stagnation de ces causes de décès étaient observées en Lituanie. Ces changements négatifs de mortalité en Lituanie ont été renforcés par une importante augmentation de la mortalité par maladies du système digestif liées à l’alcool. Ces résultats suggèrent que les divergences de mortalité entre les trois pays peuvent être attribuées à des degrés variables de succès dans la mise en place de réformes structurelles des systèmes de soins de santé et de mesures spécifiques de santé publique. A l’opposé, la très récente amélioration (depuis 2008) est similaire dans les trois pays et repose largement sur l’introduction de mesures contre l’alcool assez semblables.

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Notes

  1. Age- and cause-specific contributions to life expectancy changes were calculated according to Andreev’s method (Andreev et al. 2002).

  2. −0.38 Years for ischaemic heart diseases and −0.26 for other heart diseases (Table 3).

  3. For simplicity, we call ‘Liver cirrhoses’ the group including ICD-10 items K70 (Alcoholic liver disease) and K74 (Fibrosis and cirrhosis of liver), which includes mainly alcohol-related cirrhoses, even if they are not specified as such.

  4. The list of 33 causes of death amenable to health care was taken from Nolte and McKee (2004) (see Table 10).

  5. At least for Estonia and Lithuania since data for 2009 are not yet available for Latvia.

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Acknowledgments

The authors would like to thank Statistics Estonia, Central Statistical Bureau of Latvia and Statistics Lithuania for providing data on population and death counts. The authors also thank two anonymous reviewers for their helpful comments. The research was partially funded by the ANR-DFG EDICCOD grant.

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Authors and Affiliations

  1. Max Planck Institute for Demographic Research, Konrad Zuse Str. 1, 18057, Rostock, Germany

    Domantas Jasilionis & Vladimir M. Shkolnikov

  2. Institut National d’études Démographiques (INED), 133 bd. Davout, 75020, Paris, France

    France Meslé & Jacques Vallin

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  1. Domantas Jasilionis
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  2. France Meslé
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  3. Vladimir M. Shkolnikov
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  4. Jacques Vallin
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Correspondence to Domantas Jasilionis.

Appendix

Appendix

See Figs. 8, 9 and Tables 2, 3 and 4.

Fig. 8
figure 8

Age- and cause-specific components of the total change in life expectancy at birth in Estonia, Latvia and Lithuania from 2000 to 2007. Data source As in Fig. 2

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Fig. 9
figure 9

Age- and cause-specific components of the total change in life expectancy at birth in Estonia, Latvia and Lithuania from 2007 to 2009. Data source As in Fig. 2

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Table 2 Groups of causes used for the decomposition of life expectancy changes and calculations of standardised death rates
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Table 3 Cause-of-death components of changes in male and female life expectancy at birth in Estonia, Latvia and Lithuania, from 2000 to 2007
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Table 4 Cause-of-death components of changes in male and female life expectancy at birth in Estonia, Latvia and Lithuania, from 2007 to 2009
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Jasilionis, D., Meslé, F., Shkolnikov, V.M. et al. Recent Life Expectancy Divergence in Baltic Countries. Eur J Population 27, 403–431 (2011). https://doi.org/10.1007/s10680-011-9243-0

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