3.1. Changes in mortality across all ages
During the period 1980-1996 life expectancy increased by 5.3 years for females and 3.1 years for males in East Germany, compared to 3.4 years for West German females and 3.9 years for males. Thus, the increase in life expectancy was most pronounced among East German females. When the period 1980 to 1996 is broken down into the three periods 1980-1987, 1987-1992, and 1992-1996, then it becomes obvious that the mortality changes were not synchronized for both sexes in the two former states. Most of the mortality decline for East German females occurred during the period 1992-1996 (see Figures 2a and 4a), while for West German females the period 1980-1987 was more important (see Figures 2b and 4b). The same is true for changes in male mortality. The period 1992-1996 was most important for the mortality decline among East German males (see Figures 3a and 5a), while the period 1980-1987 was most important for the mortality decline among their West German counterparts (see Figures 3b and 5b).
There are several interesting patterns with respect to mortality in early and middle adulthood. For both sexes and in both German states, the period around unification (1987-1992) was least efficient in reducing mortality in these adult ages. For example, for East German females aged 30-49 years, mortality actually increased during this period (see Figures 2a and 4a). This upward trend in mortality in the period around unification was even more emphasized among East German males, where mortality increased for all ages from 15 to 64 (see Figures 3a and 5a). Another distinctive pattern is that the period prior to unification (1980-1987) was most efficient in reducing West German female (Figures 2b and 4b) and male (Figures 3b and 5b) adult mortality when compared to the other two periods. This is in contrast to the pattern observed in East Germany, where the period after unification (1992-1996) was most efficient in reducing adult mortality for both females (Figures 2a and 4a) and males (Figures 3a and 5a).
An interesting picture emerged for a cohort of East and West German men who were born in the late-1920s and who were aged about 65-69 years in 1992-1996. Their mortality decline was less pronounced when compared to the adjacent cohorts (see Figures 3 and 5). These men were adolescents during the Second World War, and they may have acquired additional risks through the hardships of the war. Note that Horiuchi [Horiuchi 1983] documented elevated mortality at older ages among male cohorts in Germany who were adolescents during the First World War.
Infant and child mortality continued to decline gradually from 1980 to 1996. This was the case for both German states and for males and females (see Figures 2, 3, 4, 5). It seems that German reunification did not alter trends in infant and child mortality.
3.2. The contribution of older age groups (60 and over)
The older age groups contributed most to the increase in life expectancy at birth for females in East (Figure 2a) and West (Figure 2b). This is reflected in the period 1980-1996 as a whole, as well as when it is broken down into the periods 1980-87, 1987-92, and 1992-96. Life expectancy at birth for females in East Germany increased by 5.3 years. More than 71% of this increase came from ages 60 and above, and about 31% from ages 80 and above (see Figure 2a). Life expectancy at birth for females in West Germany increased by 3.4 years. Ages over 60 contributed 61% to this increase and ages over 80 contributed 22% (see Figure 2b). Thus, the contribution from the old ages to the increase in female life expectancy was quite substantial, particularly in East Germany.
The period after reunification (1992-1996) was characterized by a substantial reduction in female old age mortality in East Germany (Figures 2a and 4a), while the period 1980-1987 was the most important for the reduction among females in West Germany (Figures 2b and 4b). This is similar to the patterns observed in early and middle adulthood. In contrast to the patterns observed among younger women, reunification did not coincide with an increase in old age mortality. Quite the reverse was true: old age mortality decreased. Note that Figures 2a and 4a also suggest that female mortality in East Germany, in particular at old ages, started declining prior to reunification. However, it was during 1987-1992 and 1992-1996 that the pace of the mortality decline accelerated.
The pattern for males (Figures 3a and 3b) was somewhat different from that of females. The contribution of old and oldest ages was less prominent for males than for females in both East and West Germany. During 1980-1996 male life expectancy at birth increased by 3.1 years in East Germany. 62% of this increase came from ages 60 and over, and 17% from ages 80 and over. In West Germany male life expectancy increased by 3.9 years from 1980 to 1996. Ages over 60 contributed 60% and ages over 80 contributed 9%. Although the pace of mortality decline at the oldest old ages was slower for males than for females, it is obvious that there was also a considerable decline in old age mortality among men in both East and West Germany.
To summarize, Figures 2a, 2b, 3a, and 3b indicate that most of the increases in life expectancy came as a result of decreasing mortality at older ages (ages over 60). This pattern was observed for males and for females, in East Germany as well as in West Germany. The pattern was more pronounced for females than for males, and it was more obvious in East than in West Germany.
3.3. Changes in oldest old mortality (80 and over)
A fair amount of the mortality decline in both East and West Germany can be attributed to the oldest old (ages 80+). A detailed observation of mortality changes at these ages is shown in Figure 6, where central death rates are plotted, separately for East and West Germany as well as for males and females. The period covered is 1955-1996.
An examination of these historical trends indicates that oldest old mortality decline in East Germany was present as of the late 1980s. The decline accelerated in the 1990s, particularly among females. A closer look at the female map for East Germany suggests that around reunification there was an acceleration of the mortality decline for almost all oldest old ages (80+). This explains the high contribution of ages over 80 to changes of life expectancy at birth during 1987-92, as shown in Figure 2a.
A different picture is portrayed in West Germany. Female mortality at the oldest ages started to decrease in the early 1970s. Here the mortality decline was gradual and it affected all ages 80 and over. For males the mortality decline started later, around 1980. Similar to females, the decline was gradual during the remaining period. A distinctive feature for females in both East and West Germany is that we see a mortality decline even at the very old ages over 95.
Figure 7 shows the ratios of the central death rates in East and West Germany for both males and females. The color red indicates lower death rates in East Germany; the color blue signifies lower death rates in West Germany. The scale on the right shows the ratio of East/West German central death rates. For example, a ratio of 1.1 indicates that mortality in East Germany is 10% higher than in West Germany.
The Lexis maps for both sexes indicate that East and West Germany had similar levels of oldest old mortality (ratios close to 1.0) until about 1970. The female advantage of West Germany started in the 1970s, while the male advantage started in the 1980s. For females the gap diverged further in the 1980s. Female oldest old mortality in East Germany was sometimes 30% higher than in West Germany. The male map shows that the divergence in the 1980s was not as pronounced as it was for females. Male mortality among the oldest old in East Germany was sometimes 20% higher than in West Germany.
There appears to be a time lag of about five to ten years between female and male changes, with mortality changes for females preceding changes for males. This lag was observed in West Germany when female mortality started declining in the 1970s while male mortality followed this decline in the 1980s (see Figures 6 and 7). Similarly, in East Germany the rapid decline of female mortality at the end of the 1980s and in the early 1990s is now being experienced by males in the last years of 1990s (see Figure 6).
For both sexes the East-West German gap was wider in the late 1980s and it seems to be closing in the 1990s. Interestingly, the disappearance of the large West German advantage is most salient for the very old ages (ages over 90). It is even more emphasized among centenarians. Table 1 lists the absolute number and the proportion of centenarians (ages 100 and over) in 1990 and 1996, separately for East and West Germany as well as for women and men. During this period there was a rapid increase in the number of centenarians in both parts of Germany. However, the increase was more pronounced in East Germany. During 1990-1996 the number of female centenarians in East Germany increased by a factor of 2.51 (184 centenarians in 1990 versus 461 centenarians in 1996). The number of female centenarians in West Germany in that same period increased only by a factor of 1.88. Similarly, the increase in the number of male centenarians was more pronounced in East Germany (factor 1.49) than it was in the West (factor 1.13).
Old-Age Mortality in Germany prior to and after Reunification
Arjan Gjonça, Hilke Brockmann, Heiner Maier
© 2000 Max-Planck-Gesellschaft ISSN 1435-9871