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Carlson P. (1998). Self-perceived health in East and West Europe: another European health divide. Social Science and Medicine 46, 1355–1366.

There is a great, and possibly also a growing, difference in public health between the central/eastern (CEE) and western European countries. Several suggestions have been put forward as explanations for this health divide. A broader framework than one focusing on medical care systems or behavioural patterns is necessary to examine this difference. It will be more fruitful to try to identify social and economic factors at large, as well as specific explanatory factors. The aim of this study is to find out to what extent “The East–West Mortality Divide” was apparent in people's perception of their own health in 1990–1991, as a division in self-perceived health across Europe. If there were indeed differences, the aim is to examine whether or not they can be explained by specific economic and social conditions present in the early 1990s. Data from “World Values Survey 1990” reveal a striking east–west divide in self-perceived health among people in the age group 35–64 yr, one of greater size than the gender gap in self-perceived health. The importance of a number of circumstances for people's self-perceived health in the 25 European countries was estimated. The assumption was that any resulting difference between eastern and western European countries could help to explain the health divide. An attempt was made to estimate how much the east-west health divide would be reduced if some of these circumstances were similar in CEE to those in the west. The results indicate that people's participation in civic activities has a positive effect on their health. This effect is recognised especially on a societal level. This supports theories about civic activities and community performance. In western Europe the tradition of the active citizen is more developed than in eastern Europe. People's life control was important for their self-perceived health in almost every European country, both in the west and the east. In the former communist countries, however, people did not feel that they had the same control over their lives as did people in the west. People's economic satisfaction was the most powerful predictor of self-perceived health, both in the eastern and western parts of Europe. The average level of economic satisfaction in 1990–1991 was considerably lower in CEE. If people's influence and economic resources were the same in the former communist countries as in the west, the health divide, according to my estimations, would decrease by something between 10–30%.


Carlson, Per

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