Vogt Tobias, van Raalte Alyson, Grigoriev Pavel, Myrskylä Mikko
Max Planck Institute for Demographic Research, Konrad-Zuse-Str.1, 18057, Rostock, Germany.
London School of Economics and Political Science, London, UK.
Demography. 2017 Jun;54(3):1051-1071. doi: 10.1007/s13524-017-0577-z.
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.
在柏林墙倒塌之前，前东德的死亡率显著高于西德。德国统一后，这一差距迅速缩小。这种趋同现象在女性中尤为明显，以至于现在50至69岁的东德女性尽管收入较低且总体生活条件较差，但死亡率却更低。先前的研究表明，20世纪40年代和50年代出生的东德女性队列吸烟率较低是造成这种转变的主要原因。然而，1990年之后，吸烟行为发生了巨大变化，德国东部女性的吸烟强度更高。我们预测了这种不断变化的吸烟行为对东西方死亡率差异的影响，发现东德年轻队列中较高的吸烟率将扭转她们目前的死亡率优势。不考虑吸烟因素的死亡率预测方法可能会误导性地预测东德女性的死亡率优势将不断增加。其他国家的经验表明，严格的反吸烟政策可以有效降低吸烟率。相反，东德正成为一个警示案例，提醒人们注意反吸烟政策削弱和行为规范改变所带来的后果。
