This volume presents the procedings of an "Advanced Research Workshop," held under the auspices of the NATO International Scientific Exchange Programme, on the Environmental and Non-environmental Determinants of the East-West Life Expectancy Gap in Europe. The workshop brought together individuals from Eastern and Western Europe and North America who had a common interest in understanding the evolution of the relative declines in life expectancy in Central and Eastern Europe, compared to the West, over the past 30 years. Between 1989 and 1993, I carried out a series of investigations into the effects of environmental pollution on human health in Central and Eastern Europe, at first, under the auspices of the World Bank, and later, under a broader multilateral, multi-agency arrangement known as the "Environment for Europe" Process. These investigations provided unparalleled access to environmental health data from the region, and offered a glimpse of what the contribution of pollution to health status was, and what it was not. At the same time, the Program in Population Health of the Canadian Institute for Advanced Research (CIAR) and the International Centre for Health and Society (ICHS) at University College, London, were embarking upon multi-disciplinary inquiries into the broad determinants of health in modern societies. The work of the CIAR provided a framework for conceptualizing the East-West life expectancy gap and its potential determinants; the work of the ICHS provided specific insights into the relative contributions of these determinants.

Klappentext

During the last 25 years of the Cold War, life expectancy in Central and Eastern Europe fell behind that in the West, opening up a `life expectancy gap' between East and West. The decline was unprecedented, and the situation deteriorated even further immediately after 1989, the year of political liberalization. br/ The present book considers the determinants of health in its exploration of the life expectancy gap. It examines the contributions of environmental pollution, adverse lifestyle choices, inadequate health care services, and the stresses of the social and economic environment both before and after political liberalization. The picture that emerges is much more complex than has been conveyed in the media. The primary role of the social and economic environment is highlighted, but the subsidiary role of other health determinants is affirmed. Of interest to all concerned about how societies produce and undermine the health of their citizens.

Zusammenfassung
Proceedings of the NATO Advanced Research Workshop on Environmental and Non-Environmental Determinants of the East-West Life Expectancy Gap, Surrey, United Kingdom, March 20-22, 1995

Inhalt
I Overview of the East-West Life Expectancy Gap in Europe.- East West Life Expectancy Gap and Socio-Economic Change.- East-West Health Divide and Potential Explanations.- II Contribution of Differences in the Quality of Medical Care.- The East-West Life Expectancy Gap.- The Contribution of Differences in Mortality From Conditions Ammenable To Medical Intervention.- III Contribution of Environmental Pollution.- Environmental Pollution and Human Health in Central and Eastern Europe During the Soviet Period.- Air Pollution and Mortality in Central and Eastern Europe.- IV Contribution Of Lifestyle and Behaviour Differences.- Determinants of the East-West Life Expectancy Gap: Contribution of Lifestyle and Behaviour: Evidence From The Monica Study.- Contribution of Smoking.- V Contribution Of The Socioeconomic/Psychosocial Environment.- Evidence from Studies Within Central and Eastern Europe.- Biological, Maternal, and Life Style Interactions with the Psychosocial Environment: Primate Models.- Marriage and Mortality in Eastern Europe.- Differences in Mortality Between Lithuanian and Dutch Middle-Aged Men: Results from the Kaunas-Rotterdam Intervention Study (KRIS).- High Cost- Low Gain Conditions at Work as a Determinant of Cardiovascular Disease Morbidity and Mortality.- Different Patterns of Psychosocial Strain; etc.- Health and Civic Society in Eastern Europe Before 1989.- The Leading Hypothesis and Its Discontents: etc.- Policy Implications Of Our Understanding Of The East-West Life Expectancy Gap.