Vogt Tobias C, Missov Trifon I
Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.
Population Research Centre, University of Groningen, PO Box 800, 9700 AV, Groningen, The Netherlands.
Popul Health Metr. 2017 Sep 19;15(1):33. doi: 10.1186/s12963-017-0151-3.
Before German reunification, old-age mortality was considerably higher in East Germany than West Germany but converged quickly afterward. Previous studies attributed this rapid catch-up to improved living conditions. We add to this discussion by quantifying for the first time the impact of mortality selection.
We use a gamma-Gompertz mortality model to estimate the contribution of selection to the East-West German mortality convergence before and after reunification.
We find that, compared to the West, frailer East Germans died earlier due to deteriorating mortality conditions leading to converging mortality rates for women and men already over age 70 before 1990. After 1990, the selection of frailer individuals played only a minor role in closing the East-west German mortality gap. However, our study suggests that, after reunification, old-age mortality improved quickly because the more robust population in the East benefitted greatly from ameliorating external factors such as health care and better living standards.
Our results from a natural experiment show that selection of frail individuals plays an important role in population-level mortality dynamics. In the case of the German reunification, East German old-age mortality already converged before 1990 because of stronger selection pressure.
在德国统一之前，东德的老年死亡率远高于西德，但此后迅速趋同。此前的研究将这种快速追赶归因于生活条件的改善。我们首次通过量化死亡率选择的影响来加入这一讨论。
我们使用伽马-冈珀茨死亡率模型来估计统一前后选择对东西德死亡率趋同的贡献。
我们发现，与西德相比，身体较弱的东德人由于死亡率状况恶化而更早死亡，这导致在1990年之前70岁以上的男性和女性死亡率趋于一致。1990年之后，身体较弱个体的选择在缩小东西德死亡率差距方面只起到了很小的作用。然而，我们的研究表明，统一后，老年死亡率迅速改善，因为东部更强健的人口从改善医疗保健和提高生活水平等外部因素中受益匪浅。
我们从一项自然实验得出的结果表明，身体虚弱个体的选择在人口层面的死亡率动态中起着重要作用。就德国统一而言，由于更强的选择压力，东德的老年死亡率在1990年之前就已经趋同。
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