East-West Life Expectancy Gap in Europe: Environmental and Non-Environmental Determinants

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.