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19-21 June 2002, Max Planck Institute for Demographic Research (MPIDR), Rostock, Germany
Call for Papers
Our understanding of major trends in mortality and health is largely based on the classic works of the 1970s by Omran, Preston and McKeown. These key studies have created a well-justified system of views on the nature of mortality transition observed in the 20th century and its major determinants. In general, they have created a notion of continuous reduction of premature death with economic development through a progressive sequence of mortality structures, defined in terms of ages and causes of death. This "grand theory" of mortality transition is still valued today because it continues to explain a core part of changes and international differences observed in mortality.
However, some of the positive changes predicted in the 1970s on the basis of the historical experience of Europe and North America have not been seen over the last decades. In the 1970s it was expected that less developed countries would follow the historical pathway of the West and that this would result in a global mortality convergence. In fact, during the last three decades many countries and population groups within national populations experienced diverging trends, substantially deviating from the major route of mortality transition.
Most remarkably, countries of the former Soviet union and Eastern Europe experienced long term stagnation and even significant decreases in life expectancy due to rising adult-age mortality. The extremely high present levels of mortality from cardiovascular diseases and violence in the countries of former Soviet union could not be predicted in the 1960s or the 1970s.
Infectious diseases, which seemed to be under firm control at least in developed countries and were rapidly declining in developing countries in the 1970s, have re-emerged since the early 1980s when the first outbreak of AIDS occurred. Many African countries, especially in the Sub-Saharan zone, are experiencing dramatic increases in mortality due to HIV/AIDS and other communicable diseases. In Africa AIDS has the potential to reduce life expectancy from its present level of 50-60 years to about 30 years.
Increasing levels of trade, people’s growing spatial mobility, continued ecological change and contacts with unusual environments can be also considered as actual and (even more so) growing dangers for the world’s health.
There is good empirical evidence that long-term reduction of mortality differentials between social classes and population groups has slowed down or even reversed in many countries in the last two decades. Over this period the mortality decline tended to be steeper among better-off population groups than among the worse-off groups. Some poor urban areas in the Americas, Africa and India experience extreme levels of mortality due to violence, poverty, bad nutrition and sanitation, the spread of alcohol and drug abuse, and environmental contamination.
Collective and inter-individual violence has been increasing in many parts of the world during the last three decades as a result of totalitarian attitudes in societies and individuals, purposeful actions or bad management by governments, growing unemployment and poverty, spread of fire arms, and (at least in some cases) resource scarcity combined with high population pressure.
A complex system of links between economic development and mortality has not been fully understood by now. It is now clear that mortality could increase in a paradoxical coincidence with improvements in income and consumption. In some cases mortality does not change significantly after major economic crises, whereas in other cases these are associated with dramatic mortality explosions. Some relatively poor countries have unexpectedly low mortality, while some of the wealthier nations experience significantly higher levels of premature death.
Mortality and health trends in the modern world are determined by multiple socio-economic, cultural, behavioural factors, and probably by the progress in medicine. Overall, it appears that the progress in health and mortality is not an inevitable consequence of a general "development" and that a sustainable improvement in a population’s health can not be expected to occur on its own. This important fact calls for a deeper understanding.
The first CEHT Seminar in Rostock will be focused on emerging mortality trends and patterns. It will provide an opportunity for presenting the results of comprehensive analyses on particularly unfavourable and/or unexpected mortality phenomena and to re-visit, on this basis, the concept of mortality transition.
The seminar will include the following sessions:
Session 1. Pathways of health transition in a changing world
Session 2. Determinants of long-term unfavourable mortality trends in Central and Eastern Europe
Session 3. Mortality trends after the fall of communism: country case-studies
Session 4. Health policies: adequacy of response to health crises
Session 5. Diverging trends in health transition in the South: country and regional case-studies
Session 6. Increasing socio-economic inequalities in mortality within countries - 1
Session 7. Increasing socio-economic inequalities in mortality within countries - 2
Session 8. Diverging regional trends in mortality within countries
Session 9. Loci of high mortality in metropolitan areas: contextual and socio-economic factors
Session 10. Trends in mortality inequalities at old age
Final session. Summary note by the Chair of the CEHT and round table discussion
Contributions to the Seminar, in the form of extended abstracts or full-length papers, and a one page CV should be sent via e-mail to Vladimir Shkolnikov or Edelgard Katke before 15 February 2002.