Health and mortality in Eastern Europe

Health is a necessary condition for social roles; people can have a complete activity in society when they feel themselves healthy and also society deems them healthy. With increasing age, the elder health could be at risk. At present, the elderly population has a rapid growth in different age groups and the greatest increase in the elderly population will occur in developing countries such as Iran in the near future.
The aim of this research is to study: how is the status of health of elderly people in Tehran? Elderly women have a better status than men in the four domains of health? In terms of health status, which elderly groups are better or worse? Do elderly married have better health than unmarried ones? The elderly, who are currently employed, experience better health in all aspects than elderly people who retired or elderly housewives.
The results indicate that the total elderly men have better health than older women in all areas of health. In all areas of health, elderly married people have better health than currently unmarried ones. Elderly people work or retirement experience more health than elderly housewives and disabled ones. Also, older women have the lowest level of health.

Key words: elderly, physical health, mental health, social health,
environmental health.

The health is an essential element for human to work. Improving health care contribute on quality of human capital in the future (Anand and Sen, 2000: 2038). Human capital is the value of learning and experience of someone at work who can improve productivity and income (Perkin, 2001: 206). Hence, the role of health is very important to improve the individual's income.
One of important aspect of health development is the maternal health. Indonesia has a relatively high maternal mortality ratio. Improve maternal health is 5th goal of the Millennium Development Goals (MDGs). One of its indicator is reduced by three quarters the maternal mortality ratio (MMR), between 1990 and 2015.
On the other hand, maternal health became an important factor in preparing for childbirth. Good Maternal health will also influence the birth of healthy babies. A healthy baby will determine the quality of human resources in the future (Wilhelmson and Gerdtham, 2006). Qualified human sources will also determine the quality of labor in promoting economic growth. This means that maternal health contributes to the quality of human capital, while the quality of human capital will determine the success of economic growth or growth of Gross Domestic Product .

We aim to explain regional disparities in mortality in Poland and their changes over the years 1991-2010 taking into account mortality from selected causes of death. The list of causes of death includes causes medically amenable and those dependent on behavioral factors (smoking-related, external causes and Ischemic Heart Disease), but also ill-defined causes. Regional inequalities in mortality are quantified with values of Mean Logarithmic Deviation estimated for regional life-expectancies and separately for gains in life-expectancies in the Polish regions resulting from elimination of selected causes of death. Changes in the value of these indeces are further decomposed to answer the question concerning the source of change in health inequality between Polish regions. Inequalities in life-expectancy between the regions are relatively small and stable over the study period, but the inequalities related to selected causes differ. With
the exception of medically amenable causes, this effect is stronger among males. In general, the largest negative effect characterizes medically-amenable causes of death and mortality from IHD. Effect of smoking-related and ill-defined causes is relatively small for the inequality in mortality between Polish voivodships.

The post communist transition brought along a significant decrease in mortality rates and improvement in health indicators in some Central European countries. That was the case of the Czech Republic and Poland, that witnessed sudden and systematic shift in life expectancy trends. Within two decades, from 1990 to 2009, life expectancies in both countries have increased considerably, by 5.8 years in the Czech Republic (reaching 77.3 for both sexes) and by 5.1 years in Poland (reaching 75.8). The aim of this paper is to present the most important tendencies in mortality by cause of death which allowed for this extension of life expectancies. We present a comparison to France where mortality rates remain at relatively low levels and that constitutes a good frame of reference. On the basis of the single cause-of-death time series restored for the period 1970-2009, it is possible to prove crucial importance of diseases of the circulatory system for the recent mortality developments in Czech Republic and Poland and to point at other specific health issues of the region.

In Turkey, mortality records are still inadequate for constructing representative life tables. In this study, life tables are constructed to compare life expectancy differences among different wealth groups for Turkey for males and females by using synthetic orphanhood method. This study is the first to compare life tables among different wealth groups in Turkey. The data sources that are used in the study are Turkish Demographic and Health Surveys 2003 and 2008.
The population is divided into five wealth groups. The results suggest that there are evident differences among wealth groups regarding life expectancy at birth. For females there are upto four years of difference in life expectancy at birth between females at lowest and highest wealth groups. For males the difference is about five years.

Married live longer and their advantage tends to increase with time. Whether marital benefits result from selection or protection is still lively discussed. But while the marital advantage increases, the share of the married in the population decreases. We explored the dynamics of marital status mortality differentials in the Czech Republic since 1961. Unlinked death counts and census marital structures were used. The differentials were measured by life expectancy at age 30; its differences and changes were decomposed by the step-wise replacement algorithm. Mortality differences by marital status have considerably increased between 1961 and 1991 due to the worsening survival of the unmarried adults. Since 1991 the differentials rose only slightly and shifted to older age groups. Never-married lag the most, with 9.58 years shorter life expectancy compared to married men (7.70 years for women) in 2010. The decline of marriage and further increase of divorciality resulted in a loss of 0.89 years of the overall male life expectancy. Individuals lacking spousal support were particularly vulnerable before the transition. In spite of their mortality recovery after 1991, they are still far behind the married ones. A plausible explanation is that the marital benefits are now available to more positively selected population.

This paper assessed whether a north-south gradient in the health of the Albania population remained following the transition to a market economy in the 1990s. Data from the 2002 Albanian Living Standards Measurement Survey was analysed for two dependent variables - chronic illness and acute illness. Multilevel logistic variance components models were fitted by stepwise model selection. The results showed that regional disparities exist for both chronic and acute illness. The traditional pattern of regional disparities in health remains for acute illness. The coastal region, however, appears to have the highest levels of self-reported chronic illness. It is argued that the higher levels in the coastal region are not likely to be due to a fundamental change in the regional patterns of health status in Albania at present but due to the huge north-south internal migration that occurred during the 1990s.

Mortality analysis seen from the cohort perspective is in demography often associated with purer and more adequate way of study of mortality changes and mortality development. Cohort mortality is more stable in time and reflects the mortality conditions during the whole life of the generation. Unfortunately, traditionally the complete cohort life tables could be calculated only for cohorts which are already extinct. In this paper a simple method of mortality estimation is applied for cohorts which are not yet extinct. This method was developed in previous research steps of the author. Through application of this estimation method the intensity of mortality of adults will be calculated and then analyzed in connection to the concept of rectangularization of the survival curve or compression of mortality. According to the assumptions, the verification of this concept could be taken as a proof of the existence of a limit of the human life span. Analysis of this process is applied to the empirical as well as modeled cohort data from several selected European countries. The differences between post-communist and other European countries will be traced and described with the aim of finding some more general patterns and regularities usable for example in population forecasting.

It has been shown that there are meaningful similarities between causes of death responsible for the East-West mortality divide in Europe and cause-specific pattern of the socioeconomic mortality differences in England & Wales. It has been suggested that such remarkable similarities point to common threads that underlie the two types of disparities. These threads may be caused by contemporary behaviors and conditions, but also by early life conditions and risks accumulated over the life course. The present study provides a detailed look at mortality differences between Finland and Lithuania and compares mortality inequality between countries with mortality inequality within Finland. We examine similarities and differences in age- and cause-specific patterns of mortality inequality between total Finnish and Lithuanian populations and manual and non-manual occupation groups in Finland.

Over the last forty-five years, Moldova failed to progress in life expectancy at birth. Disregarding the wide fluctuations linked to the 1985 anti-alcohol campaign and the social and economic crisis of the 1990s, the general trend in life expectancy is stagnating among males and slightly improving among females. Interpreting recent mortality changes in the light of long-term trends provides an insight into the reasons of the health crisis affected Moldova like other former USSR republics from the mid-1960s. However, the periodic changes in classification of causes of death break the continuity of death time series. To assure their consistency we used a special reconstruction method (Meslé and Vallin, INED). Moreover, unlike other European countries of the former USSR, the quality of death registration in Moldova in infancy and at older ages for the 1960s and 1970s is rather questionable. The analysis of cause-specific mortality trends will be produced here after corrections for under-registration. After a long period of deterioration mixed with large fluctuations as in other former USSR countries, the recent favorable trends give hope but not yet the proof of a start of sustainable positive trajectory.