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East Europe: Stress Contributes To High Mortality Rate

  • Stuart Parrott

London, 9 December 1997 (RFE/RL) -- The World Health Organization (WHO) reports that stress, often related to poverty or the fear of unemployment, is playing a significant part in shortened life expectancy in the Central and East European countries and the newly independent states of the former Soviet Union.

A new WHO report says that known risk factors, like smoking and poor diet, can only partly explain "a dramatic deterioration" in health across the eastern region where life expectancy, particularly among males, is far lower than in the EU countries.

The report says that fear of unemployment and the insecurity that accompanies it are important predictors of ill health. It also says there is evidence that those at the margins of society and in relative poverty -- divorced men, for example -- are the most adversely affected, and that stress is causing people to die early.

The report says high mortality rates in the CEE and NIS nations reflect "economic decline and widening income differentials." It says the theory that social position and socioeconomic factors are a major factor in mortality rates is supported by a long-running British study which found that death rates among government officials were higher among those in junior positions than in senior ones.

The report cites statistics comparing life expectancy in western and eastern countries. In the EU, average male life expectancy at birth is now 73.8 years (females 80.6). In the CEE countries, the figure for males is 67.3 years (females 75.3). In the NIS countries, life expectancy has fallen to 60.6 years (females 71.9).

However, the picture is a mixed one. The Czech Republic and Poland have seen recent reversals of long-term downward trends in life expectancy while Hungary has not. Moreover, life expectancy is mostly greater in CEE and NIS countries located in southern regions (Some areas of the Caucasus have very long life expectancy).

The report says that accidents, homicide and suicide (the third most important cause of death after cardiovascular disease and cancer) are a major contributor to the gap in life expectancy at birth between eastern and western Europe.

The report says that accidents, homicide and suicide have "risen dramatically" in the NIS countries, partly due to increasing casual violence and growing psychological stress which, in turn, contributes to increasing levels of alcohol consumption.

The report says cirrhosis of the liver, accidents and violence -- all strongly related to alcohol consumption -- are a major cause of death in the European republics of the NIS and in Hungary.

But they are a less important factor in, for example, Poland, where a campaign against alcohol consumption in the early 1980s halted a previously increasing trend in alcohol-related diseases.

Death rates from lung cancer outstrips those in west European countries. The report says: "As there is an interval of many years between starting smoking and developing lung cancer, the very high rates of smoking in these regions suggest the health services of the 21st century will face an enormous burden from this disease."

This is particularly true of countries like Russia, Latvia, Lithuania, Estonia, Croatia, Bulgaria, Romania and Albania which have among the highest smoking rates in the world. The report says that "aggressive marketing by tobacco companies in the CEE countries and the NIS will have major health consequences..."

The report notes that diet is an extremely important factor in preventing disease -- particularly cancer. It says that the better life expectancy in Poland reflects the decreasing consumption of animal fats and an increasing consumption of fruit and vegetables.

The report says the "generally low levels of nutrition in the CEE countries and the NIS" are a key factor in mortality rates.

In conclusion, it notes that health status is largely determined by the interaction of four linked factors: genetic susceptibility, behavior and lifestyle, socioeconomic status and environmental factors. Its message is a familiar one: stop smoking, cut down on alcohol, and eat more fruit and vegetables and less animal fat.