UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
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| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
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This document is being made available by the Population Information
Network (POPIN) Gopher of the United Nations Population Division,
Department for Economic and Social Information and Policy Analysis,
in collaboration with the European Association for Population
Studies and the IUSSP. For further information please contact
Professor G.C. Blangiardo, Local Organizer, EAPS Conference, Milan,
University of Milan, Istituto di Statistica, V. Visconti di Modrone
21, Milan, Italy.
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EUROPEAN POPULATION CONFERENCE
CONGRES EUROPEEN DE DEMOGRAPHE
Milano, 4-8 settembre 1995
Plenary II
From state to market economy: the
population dimension
by Jerzy Z. Holzer
1. Introduction
The beginning of transformation from state or planned to free
market economy in Central and Eastern Europe has usually been set
at 1989 since the democracy and free enterprises spread rapidly
throughout the region in the subsequent years.
The beginning of regional socio-economic transformation
started in Poland in 1989, when new elites led by ®Solidarity¯
trade unions started the bloodless political and economic
revolution. The political changes developed quickly afterwards
country by country in Central and Eastern Europe.
Discussing the transformation process one has to remember that
the beginning of changes in the economy were not simultaneous all
over the region. In certain countries the economic reforms oriented
on some of the free market solutions started before 1989,
especially in Hungary and in Poland. Moreover there are several
kinds of differences in the cultural and political structures as
well as in the stages of economic development among countries,
especially in the field of the role of the state sector and
standard of living.
Therefore we will try to find the most important common
features only and present selected examples, more detailed for
Poland. The limitation for a wider and more in-depth analysis is
due to the lack of proper data, too short period of analysis (1990
onward) and a very high diversity of existing basic political,
economic and social conditions. The complex analysis of
transformation should be based on individual country case studies
which should take into consideration the wide spectrum of
determinants to avoid the possibility of jumping to wrong
conclusions. Lets hope this kind of research will be done soon.
It is worth emphasizing that some members of the previous
system's elite have joined the new order actively not only in
private business but also taking governmental posts, especially
after elections in the years 1993-1994. The basic reforms leading
to real democracy and to the creation of an efficient free market
economy, have been continuously going on in most of the countries
in the region. However it is necessary to remember that various
groups opposed to the transition process still exist, within some
of the countries concerned.
There are different kinds of aggregations of European
transition countries. The Unece (1994) document introduced the
following coverage: Eastern Europe - Albania, Bulgaria,
Bosnia-Hercegovina, Croatia, Czech Republic, Hungary, Poland,
Romania, Slovakia, Slovenia, the FYR of Macedonia, Yugoslavia (FR);
with sub-aggregates Central European countries with economies in
transition - Czech Republic, Hungary, Poland and Slovakia; South
European countries with economies in transition - Albania,
Bulgaria, Romania and the 5 Yugoslav successor states; Baltic
States - Estonia, Latvia, Lithuania; and 12 members of countries of
the Commonwealth of Independent States - Armenia, Azerbaijan,
Georgia, Kazahstan, Kyrgyzstan, Moldova, Russian Federation
(Russia), Tajikistan, Turkmrnistan, Ukraine and Uzbekistan.
Moreover UN document individualize ex-GDR Lander. According to our
assumptions the general discussion was meant to concern the
following group of countries: Belarus, Bulgaria, Czech Republic,
Estonia, Hungary, Latvia, Lihuania, Poland, Romania, Russian
Federation, Slovak Republic and Ukraine. Due to scarcity of
information on some countries, the more detailed examples or
comments have been presented for selected countries only. Moreover
some special comments have been added to signalize some very
interesting changes which have been taking place in the specific
conditions of ex-GDR after unification.
What were the basic common goals of reforms in the region? The
reforms had three central purposes: 1) to increase individual
freedom and to protect individual and especially human rights
(democratization process), 2) to introduce free market economy, 3)
to settle basis for a higher standard of living for all social
strata of the society.
To achieve these goals it was necessary first to abolish the
previous political system and then to make labor markets more
effective, including the increase of individual choice, extending
the role of private and reducing the state sector, to improve and
adjust education and training to new needs, to cope with
unemployment and poverty and to promote better health.
There were two ways to start the socio- economic transition:
by introducing reforms gradually or adopting shock therapy. Poland
was among those countries that followed the second way. There were
also other important elements in reaching success in reforms, i.e.,
willingness and determination of political and economic leadership
based on a wide support in the society.
Balcerowicz (1993) the author of the Polish reforms, argued
that the reform strategy within the transition period has three
components: stabilization, mainly through macroeconomic policy;
liberalization (for example of ownership options, prices and wages)
for an effective market mechanism; and institutional restructuring.
He characterizes the social and economic situation at the
beginning of transformation in Poland in 1989, distinguishing some
common features in former socialist states and some Polish specific
features.
Balcerowicz argues that Poland as well as other former
socialist states had a specific non-market system: based mainly on
the state sector, with a high concentration of organization,
deformed price system, without competition, with non convertible
currency. There was no independent central bank, there were no real
commercial banks, the Stock Exchange was not existing. The relation
of state budget expenditures to the level of Gross National Product
was very high. The social services were secured partly through
state budget and partly through state enterprises. There were two
ways of distributing income in Poland. Paying the salary to
employees and providing the provision to the so-called Public
Consumption Fund. This lead to the practice of levelling wages
which did not motivate people to work efficiently and moreover
created a possibility to provide privileges throughout Public
Consumption Fund to selected categories of workers.
Another peculiarity of the Polish as well as other former
planned economies was the inadequate structure of the economy, with
a very high share of heavy industry. Moreover this production was
strongly bound with the former inefficient Ussr economy. This kind
of industry led moreover to serious environmental degradation.
The third peculiarity concerns the specific
structure of human
See file 2ndtab1.asc
See file 2ndtab2.asc
capital, which had no skilled persons connected with market
economy: marketing, banking, modern accounting system etc.
The specific Polish situation in 1980's was characterized
first of all by the drastic macroeconomic situation with very high
inflation rates, due to subsidies to food production, retail food
prices and rapid increase of wages provoked by political tensions
(strong movement of ®Solidarity¯ trade unions). General
macroeconomic disorder was noted in the second half of 1980-ties
due to the lack of basic macroeconomic discipline.
The very high foreign debt of 39 billion US $ (1030 US $ per
head) in Poland was yet another specific characteristic. Also the
decentralization of economic system was higher than in other
countries with planned economies. Moreover the liberalization of
the private sector and as well as of foreign trade started in
Poland as well as in Hungary much earlier than in other countries.
Finally it is worth mentioning that 76% of Polish agriculture
was in private hands. This situation was unusual in planned
economies. However the average size of a private farm was only 7.1
hectare versus huge state ineffective farms.
One can summarize that the basic concept of reforms introduced
in Poland at the beginning of 1990 by Prime Minister Balcerowicz
were to establish: macroeconomic stabilization (through strong
control of wages in state sector), private-market oriented economy
based on liberalized, free market price system (except price of
coal, petrol, electricity and rents), competitive economy oriented
on foreign trade, with elastic labor market. Moreover the principle
of free exchange of Polish zloty within the country was introduced.
2. Economic factors of system transformation
Unfortunately the immediate economic results of transformation
in the region were of disadvantageous character and may be
summarized as follows: deep economic depression, growing
unemployment and growing poverty. Some analysts say, that the
transition process appeared not only as an economic but also as a
social crisis.
The deep economic depression may be characterized by two
indicators (annual growth of GDP and annual inflation rate). The
rapid decrease of GDP was evident in most of the countries. The
Baltic states have experienced some of the most sever depressions.
Poland is the only country in the region which has noted positive
annual growth of GDP in consecutive years of the period 1992 - 1994
(see data in the tab. 1). Slight symptoms of recovery can be noted
in Romania (1993-1994) and in Czech Republic in 1994.
Most of the countries noted drastic increase of inflation
rates (indices of consumer prices, comparison: December to
December), just after price liberalization. In several countries
one may note hyperinflation also. The highest rates of inflations
had been noted in 1990 in Poland, in 1992 in Bielarus, Estonia,
Latvia, Lithuania, Russian Federation and in 1993 in Ukraine (the
highest noted level). Poland is the country which after the 1990
peak noted a steady decline of inflation rates due to shock
therapy. It is worth emphasizing that none of the transition
countries have annual rates established in single digits yet. Only
five countries out of 11 mentioned in the table 1 have reached two
digit rates at the end of 1993.
Transformation to market economy brought about, unknown in
previous 45 years of planned economy, open unemployment. The rates
of unemployment rose slowly from zero level in 1989 to few
percentages in 1990 and have risen sharply since 1991. The rate of
unemployment has reached the level of ca. 16% in Poland and
Bulgaria in 1993. It is worth emphasizing that there are some
estimates indicating that in transition countries the total number
of officially registered unemployed was equal to some 7.5 million
persons at the end of 1993. Polish ®input¯ represents ca. 39% and
Rumanians ca. 16%.
Keeping in mind the number of 2.8 million of officially
registered unemployed (16% of labor force) at the end of 1994 in
Poland and moreover an estimated additional 0.7 million of hidden
unemployed persons in Polish agriculture and 0.2 million outside
agriculture one can imagine how seriously the existing size of
unemployment and the increasing number of young persons must affect
the future socio-economic decisions. There are opinions that some
of the unemployed are active in shadow economy which has been
rapidly developing in the region in current years, but the
influence on the labor market of these events have no important
impact.
The Central Statistical Office of Poland published the
unemployment rates by age in 1993. The highest rate was reported in
the age group 18-24 36.0% and declining rates in the subsequent age
groups,(in the age group 25-34 28.1%, in 35-44 25.4%, in 45-54 9.5%
and in 55-59 1.9%). Preliminary reports of 1994 state that the age
group 18-24 is continuously the group of highest risk of
unemployment. Young age groups have been especially affected by
unemployment. On the other hand it is worth noting that there was
evidence of marked increase in participation in education and
training in recent years among persons aged 15-24 in Hungary and
Poland (European Commission, 1944). It is necessary to remember -in
this context - that effective human resources policies
contribute to both the political and the economic success of the
reforms. Ineffective policy may lead directly to social unrest.
The unequal distribution of unemployment in the country is
another important aspect. It is possible to distinguish three
groups of areas affected by high unemployment. The first,
represents areas which had been neglected to date in terms of
economic development, mainly agricultural areas. The heavily
industrialized regions but with outdated industries is the second
one. The last one may be represented by towns in which just one
industrial plant had dominated, upon which the majority of
inhabitants depended. The bankruptcy of such a plant, a situation
not rare, creates a dramatic situation on the local labor market.
In all these areas one may moreover observe the discrimination of
women on the labor market.
3. Social and psychological aspects of change
The real income per capita dropped down in all countries in
the region and one may note a serious rise in poverty. Real income
per capita has declined in several countries up to ca. 40% over the
period 1989-1993. At the same time there is a growing
differentiation of households according to well being, with rapid
growth of relatively small but very wealthy households.
The percentage of households below the poverty line (40% of
average wages) grew in Poland from 23% in 1989 to 36% in 1992.
However the estimates at the end of 1993 indicate the number of
poor households (below the red line), which need social support
have reached the level ca. 40%.(The Central Statistical Office
estimates). This level of poverty is also noted in Bulgaria and
Rumania.
On the other hand there was in Poland a rapid increase in the
number of TV sets per 100 of employee households from 50.7% in 1989
to 95.1% in 1993, video sets from 4.7% to 63.2% and cars from 30.7%
to 44.7% respectively. The number of registered personal cars
increased from 4.8 million in 1989 to 6.8 million in 1993, this
means an increase by 40% (December to December).
There exist another curiosity. The total number of old persons
(eligible to old age pensions) i.e., aged 60 and over females and
65 and over males had grown by 4.1%, from 4.9 million in 1990 to
5.1 million in 1992. On the other hand the number of retired and
disabled persons (receiving disability pensions) had grown by 20%,
from 7.1 million in 1990 to 8.5 million in 1992 and reached 9
million at the end of 1994. This is due to early retirements
schemes that were introduced in 1980's to avoid the then growing
unemployment. More than 86% of new male pensioners obtained in 1992
their benefits before reaching the age of 65 years and 78% of new
female pensioners before reaching the age of 60 years. In general
the average age of new pensioners is declining year by year and is
around 55 for males and 50 for females. Early retirement benefits
are treated in some circles as a remedy for unemployment which is
obviously not an accurate assumption.
However the possibility of obtaining early retirement benefits
is a push factor for persons being unemployed. The Central
Statistical Office of Poland estimates that ca. 0.9 million persons
(outside of agriculture) were pushed ®under compulsion¯to switch
into early retirement in the period 1990-1994. Simultaneously, in
both Hungary and Poland, substantial reduction in the participation
of men and women above retirement age are evident (European
Commission, 1994).
The economic situation of old age pensioners may be
characterized by the fact that in 1992 around 60% of them were
receiving pensions below the level of average pay in the economy.
The 1993 survey of households with at least one unemployed person
discovered that 64% of households are suffering from the lack of
money to cover basic needs (Kostrubiec, 1994).
The contemporary system of pensions in most of Central and
Eastern European countries consists of employer-only payroll
contribution and is based on the ®pay-as-you- go¯ principle. All
payments that cover social insurance risks (such as pensions, sick
pay, family allowances) in Poland come from two public agencies:
The General Social Insurance Fund (for the general population) and
the Social Insurance for Farmers. The sum of contributions to the
systems is below the level of expenditures and the State Budget has
to support the systems. Several proposals to change the system are
under discussion, however final decisions have permanently been
postponed. The most spectacular growth in pension expenditure,
independently of the demographic projections, will occur in
Poland between years 2005-2015 when the post-war baby-boom cohorts
will reach retirement age. There has been no time left to introduce
a new system that would be operational and self- sufficient before
numerous cohorts enter retirement age.
To summarize one can say that the last four years of
transformation led on one hand to democracy and created grounds for
reaching basic goals of reforms and on the other hand created an
atmosphere of uncertainty connected with unemployment and the
deterioration of family standard of living. Moreover there is a
growing number of poor people accompanied with an accelerated
concentration of wealth in fewer hands. In addition there appeared
a new category of ®working poor¯ whose income from work does not
provide the essential minimum. These changes are accompanied by
increasing alcoholism, as well as spreading of crime and homicide.
Most of changes mentioned have a direct or indirect impact on
demographic processes.
One more point should be stressed. The previous centrally
planned social security system created an attitude that the well
being of each household should depend mainly on the state budget or
subsidies from enterprises funds. The standard of living was
relatively low, but based on rather stable rules (till the
beginning of 1980's). Moreover there was an attitude that
population reproduction should be at the state's expense. The
transition to free market economy constrains this type of
expectations but time is needed to create a new way of thinking.
4. Expected influence of system transformation on population
processes
Evaluation of changes in demographic processes which have
taken place over the last four years in the context of system
transformation is not an easy task, since very often it is
difficult to estimate what kind of changes can be attributed to the
transformation and which can be treated as an effect of
continuation of previous trends. Therefore the paper describes
basic changes with comments which are supposed to explain basic
determinants and moreover try to formulate hypothesis of the most
probable expectations.
4.1. Nuptiality
In practically all countries in transition, crude marriage
rates have been falling during the 1980's, mostly at a relatively
slow pace. From the year 1990, the decline accelerated in most of
the countries in the region.
Having in mind the relatively numerous cohorts recently
entering marriageable age, especially in Poland and Romania, and
the reported falling marriage rates one may conclude that the young
generation is not enthusiastic to marry in existing difficult
socio-economic conditions. One may expect the postponement of
decisions. However the mean age of women at first marriage shows
stabilization (for example: Belarus, Bulgaria, Estonia, Hungary,
Romania) or a slightly increasing tendency in Poland. Age at first
marriage has been low and ranges between 20-22 years (higher in
Estonia and Lithuania). Marriage and first births are often linked
in Central and Eastern Europe with prenuptial conceptions. The
ongoing socio-economic transitional changes may increase the number
of births to single mothers since the intensity of contracting
marriages is rapidly dropping. There are also expectations that
cohabitation will be more common. However till now data on
cohabitation are scarce, not complete and from different type of
surveys, which makes them difficult to compare.
Poland reported in 1993, for the first time in the post war
history an excess of dissolved marriages (by death of spouse or by
divorce) over the number of contracted ones. Therefore the total
number of existing marriages, after taking into account the net
international migration of married persons, has slightly decreased
in the country (1994 Statistical Yearbook of Demography).
The FFS Country Summary Report of Poland, 1991 (J. Z. Holzer,
I. Kowalska, 1994) states that marriage and family is the
prevailing basic socio-economic unit of society and that until now
cohabitation has not been widespread in Poland. 97% of all females
and males entered into first marriage without cohabitation. Besides
the differences in the intensity of prevailing moral (religious)
values existing in Poland and other countries, the difficult
economic conditions and especially the scarcity of housing
constitute the principal obstacles to cohabitation becoming more
common. The cohort analysis based on Polish FFS biographical data
relating to birth cohorts 1967-1971 and 1942-1946 show that
contemporary cohorts are much more and longer dependent on their
parents than previous ones. This situation may be aggravated in
current years of transformation period. However it is worth
emphasizing also that survey results confirm that contemporary
cohorts start their sexual life earlier than previous ones. The
median age at sexual initiation dropped down when comparing the two
mentioned Polish birth cohorts of women: 17.9 years among younger
cohort and 21.0 years among older one.
It is worth noting the different trends concerning divorce
rates. Practically in all countries of the region, the 1970's and
1980's were characterized by a stabilization or slight growing
tendency of the divorce rates, with a different intensity. From
1989 onwards one may observe a growing tendency of divorce rates in
all countries of former Ussr and an evident declining tendency in
all remaining Central and Eastern European countries. It is
extremely difficult to find a clear explanation of this phenomenon.
Finally it is worth adding that the described changes in
nuptiality patterns have an influence on the structure of
households. Especially one may find increasing numbers of
single-parent families and single-person households. For example
the last census in Poland reported an increase in the number of
single-persons households, up to 2.2 million compared with 1.9
million in 1978. The 1988 census revealed also that there was in
Poland 1.4 million single-mothers with children and 0.2 million
single-fathers with children. These two kinds of families require
special support through social policy programs.
4.2. Fertility
Changes in fertility can be discussed on the basis of TFRs,
since they describe trends that are not affected by age structure
differences. Practically in all Central and Eastern European
countries fertility has been falling for a long time, with
temporary ups and downs. From the middle of 1980's one may note the
definite downward trend in TFRs. But demographic response to
unemployment, poverty and political instability may be easily
illustrated by the significant and in some cases rapid drop in the
level of TFRs since 1990. The lowest rate was reported in 1993
(except the Eastern part of Germany) in Slovenia (1.31), Russian
Federation (1.35), Romania and Estonia (1.44), Bulgaria (1.45) and
the highest in Poland (1.85).
However the most spectacular drop in TFR was noted in Eastern
Germany (former GDR). The total number of live births fell by ca.
60% in the period 1989-1993. The TFR dropped down from the
relatively low level of 1.57 in 1989 to 0.81 in 1993.
Such an abrupt and precipitous drop in fertility is
unprecedented for an industrialized society during peacetime. In
the past, human populations have on occasion experienced sudden and
dramatic reductions of childbearing of comparable proportion, but
only during times of catastrophe, desperate privation, and
widespread loss of life.
Eastern Germany's adults appear to have come as close to a
temporary suspension of childbearing as any such population in the
human experience (N. Eberstadt, 1994, p. 138-139).
It is worth emphasizing that the recent 1994 report on the
demographic situation in Germany (J. Dorbritz, 1994) states the
hypothesis that:
... at least for the time being, the first phase of
demographic change and of the reunification to marriage, birth and
divorce of the socio-economic transformation shock seems to have
come to an end.
The following analyses show that behavioral patterns adopted
in the social situation of the GDR are relatively persistent and
will make the differences in the demographic situation of East and
West continue. This is due to the fact that in the new federal
states so far there has been no individualization process.
The impact of political and socio-economic transition on
demographic processes in former GDR and FRG call for special in-
depth studies since it is the only case in Europe when two parts of
one nation have been united, after 44 years of functioning in
completely different political and socio- economic systems.
The highest level of specific fertility rates have been in
recent years in the age group 20-24 followed by the next age group
in all the countries of the Central and Eastern Europe. The
expected postponement of age at first marriage and at the first
birth will probably change the existing pattern of fertility moving
the peak of fertility to the age group 25-29.
The 1991 Polish FFS results show that the mean number of
children planned at first marriage was to 2.10 among women and 2.13
among men. The respondents age had no significant impact on the
level of calculated mean; it ranged from 2.01 among the youngest
women to 2.19 in the group of women aged 30-34 and from 2.01 and
2.20 in respective age groups of men. The results confirm the
opinion that fertility plans of young generations of Polish women
and men at the beginning of their marriage are rather modest and
moreover they are not fulfilled in real life, especially not in the
current transition time. The Polish FFS confirmed also that the
wanted number of children is negatively correlated with the
education level.
The percentage of persons planned to remain childless was
rather low (1.6% of women and 1.7% of men). When comparing the last
FFS results with the data obtained in 70's and 80's one may
conclude that the wish to remain childless is a new and expanding
phenomenon in the country. The Polish 1991 FFS results reveal that
83% of all respondents agreed to the statement: if a woman wants to
have a child as a single parent, and she does not want to have a
stable relationship with a man, she should be able to have a child.
Only 5.4% didn't agree with the statement and 11.6% were undecided.
Cohabitation is probably not widely spread in Central and
Eastern Europe. Information on this phenomenon is very scarce,
which makes it difficult to estimate the influence of cohabitation
on fertility. However some guesses concerning cohabitation may be
closely linked with extra-marital births. It is worth emphasizing
that the percentage of births to unmarried mothers is growing
substantially all over the time, especially after 1989. The highest
percentage reported in 1993 was in Bulgaria (22.2%), Hungary
(17.4%) and Russian Federation (17.1% in 1992). The percentage has
doubled or increased by 50% or more for most of countries over the
last 4 years. This information could be treated as an sign of
modest diffusion of cohabitation in the region under discussion.
The significant fertility changes took place in the 1990's
independently from the fact that there still exists the lack of
modern family planning services in most of former countries with
centrally planned economies. The most popular methods of birth
control have been: 1) periodic abstinence, rhythm method and
withdrawal, 2) condom, 3) IUD, 4) pill. Traditional and not modern
methods and measures of family planning have been used most
frequently in most countries of the Central and Eastern Europe. The
Polish 1991 FFS married women respondents who were fecund, not
pregnant and had regular intercourse during the last four weeks
before the survey took place, used most frequently (31%) periodic
abstinence as contraceptive method, (23.5%) withdrawal and (11.5%)
condom. The frequency of IUD and pill use was rather low, 6.4% and
2.5% respectively.
The foundation of more open societies will affect the
reproductive behavior of couples as they introduce more careful
timing and spacing of their births on the basis of modern
contraceptive methods use. The new socio-economic situation has
also introduced the free market of different contraceptive means
which have already been on sale. However, problems of their
accessibility exist due to relatively high prices and a growing
share of poor families in the societies concern.
Since not effective family planning methods have as yet been
used, the level of abortions has been rather high in some of these
countries. Abortion rates (per 100 live births) higher than 100
were reported in 1993 in Bulgaria (127), Romania (234), Russian
Federation (217) and Ukraine (154). The lowest level was reported
in Poland (2.3 in 1992) since from 1991 abortions have been
strictly prohibited in the country, except for narrowly defined
medical reasons and in the case of incest or rape. It is
interesting that the introduction of the restrictive abortion law
in Poland had no evident influence on the number of life births
which one could expect to occur.
Until now most of the countries under consideration do not
belong to the group which have experienced a considerable
postponement of first marriage and first birth. Only women with
higher education have given birth to their first child remarkably
later than the less educated women. The shortening of intervals
between subsequent births has been typical for younger cohorts. One
may expect that these kind of changes will follow in the near
future as a result of transformation to free market economy.
The general direction of changes in fertility in the last
years has been the same, independently whether there was a shock or
gradual therapy i.e., downward trend. This trend will continue
until the current economic, social and political crises will be
overcome and new optimistic prospects will be visible. However the
small family size will most probably be predominant.
Moreover it should be noted that there have been no political
decision taken yet, whether the demographic goals concerning
reproductive aspects should be included into the general strategy
of socio-economic development of the Central and Eastern European
countries. Therefore till now only economic goals are predominant
in strategic program. Social aspects are evidently neglected.
4.3. Mortality and health status
Health care has become one of the major preoccupation of
modern societies and moreover it tends to be treated as a common
and universal right. In spite of the fact, that more and more
research is going on health and health care policies the
contemporary assessment of society's health level is rather based
on mortality measures than on new measures of health level. This
applies especially to countries of Central and Eastern Europe where
detailed statistical information in this field is seriously
limited.
There exists a widely accepted observation, that from the end
of the Second World War until the mid-late 1960's, health
conditions in Central and Eastern Europe have been improving
rapidly. Improvements in health conditions were particularly
visible when comparing infant mortality rates and young children
age specific death rates as well as in adult and old age groups.
This improvement was brought about by gradual economic recovery,
egalitarian social policy approach and expansion of basic and free
of charge or low-cost, highly effective health services, especially
maternal and child ones.
Unfortunately, health conditions and mortality trends except
infant and child mortality deteriorated sharply between the
mid-1960's and the late 1980's in all countries of the Central and
Eastern Europe. The life expectancy dropped down in most of the
countries of Central and Eastern Europe, especially for male
population aged 30-60 years. In Poland for example the life
expectancy fell between 1965/1966 and 1985/1986 by 2.2 years for 30
years old men and by 1.9 years for 45 years old men. The life
expectancy of females started to fall from the middle of 1970's and
was not so much pronounced as among males.
It is possible to generalize that from the middle of 1960's
the deterioration of health conditions affected most of Central and
Eastern Europe, particularly male population in 30-60 age brackets.
Among different causes of growing mortality, which will be
discussed later, the deterioration of health system operation
should also be mentioned. In Hungary in the 1990's, it has been
estimated that about one fifth of the deaths among males 50-54,
could be avoided by adequate medical intervention (Josan, 1993).
These changes have continued in the early 1990's. The age
specific death rates for males aged 20-39 increased in the period
1989-1993 in Bulgaria (by 12%), Romania (by 3%), Russian Federation
(by 69%) and Ukrain (by 28%). In Poland the increase in death rates
recorded between 1989 and 1991 was followed by a return in 1993 to
the better condition than in 1989. The population in age group
40-59 was following the same pattern of changes. The highest
increase was noted in the Russian Federation (by 54%) and a slight
drop in Poland (by 9%). The changes of females age specific death
rates were at a much lower scale.
Unicef report (1994) makes an interesting and to the point
observation:
The escalation in mortality until 1993 (and the fall in life
expectancy at birth [ more important changes were noted for 30-60
age brackets, JZH]) in the countries of Eastern Europe seems to
have followed three fairly consistent patterns. First, while
mortality edged upward during the initial phase of the reforms in
all the economies in transition, this blip was fully and swiftly
reabsorbed in the Czech Republic and Slovakia in subsequent years
and in Poland from 1993. The second, in those countries where the
overall increase in crude death rate was relatively contained, such
as Hungary, the recorded increases for 1990-1991 were essentially
stabilized in the following years. Third, and in contrast, the
increase in death rates accelerated, rather than stabilized, in the
second and third years of the transition in those nations,
including Bulgaria, Russia, Ukraine and Rumania, which registered
the steepest overall upswings in mortality between 1989 and 1993.
Romania, however, seems to have been able to stabilize mortality in
the second part of 1993.
The greatest relative increase in mortality has occurred among
men in 20-59 age group, however specific age groups of highest
increase differed from country to country. The mortality in infancy
and childhood presented a declining tendency in Poland and Hungary,
and stagnation or slight growth in remaining countries. In
conjunction with changes in mortality of the population aged 60 and
over the Unicef report (1994) states:®Without doubt, one of the
most surprising findings of this report is that there has been only
limited growth or even decline (as in Bulgaria and Hungary [and in
Poland, JZH]) in the death rates for several groups within the
over-60 age bracket during the past few years - a finding which
distinctly clashes with the widespread notion that the elderly have
suffered the most from the transition changes.¯ It seems to me that
one may look for an explanation of this situation in the premature
mortality of adult groups (especially males) which retains stronger
survivors.
In spite of the declining tendency in infant mortality in the
region it is necessary to mention the growing number of premature
births and an increasing share of infants weighting less than 2500
grams at birth. This is an evidence of the deteriorating health
conditions of mothers. Over the period 1985-1993, the low birth
weight incidence showed an increase or a stagnation at a relatively
high level, around 8%. In Poland for example the share of infants
born with weight below 2500 grams grew from 7.6% in 1985 to 8.6% in
1993.
The proximate causes and risk factors of the rise in adult
mortality in the period 1960's - 1980's and early 1990's was
attributed to the three basic causes of deaths: 1) diseases of
cardio-circulatory system, 2) cancer and 3) external causes of
injury and poisoning (accidents, poisoning, suicides and
homicides).
The spectacular rise of mortality in the region, over last
20-30 years, due to heart and circulatory system diseases has no
complete explanation. The death rates due to these causes were in
1993 at a very high level of 623 deaths per 100 000 population in
Bulgaria, 760 in Russian Federation and 507 in Poland. The increase
of incidence of deaths due to heart and circulatory diseases was
equal to 60% in Bulgaria, 44% in Russian Federation and 3% in
Poland over the period 1989-1993.
Usually high mortality due to heart and circulatory diseases
are attributed to improper nutrition, tobacco smoking, alcoholism,
environmental contamination and stress creating situations. However
the results of Polish investigation, published in 1992 (Hanke and
Szadkowska-Staczyk, 1992) revealed that complication in family life
(insufficient income, unemployment, family conflicts, living alone)
or a neglect of own health received priority before such acclaimed
factors as hypertension, tobacco smoking or improper nutrition.
Therefore the new unstable economic situation in the region
increases stress among population which may lead to the increase of
mortality due to heart and circulatory diseases. However, medical
doctors argue that the impact of stress, on the health condition of
population, connected with all bad consequences of the transition
period will be especially visible after 5-6 years of time lag.
Improper nutrition in the region results from high consumption
of cholesterol-rich products (mainly animal fat) and very low
consumption of vegetables, fruits and vegetable oil. Free market
and proper propaganda are supposed to change consumption habits.
Recent medical research (Zatoski, 1994) has established that
90% of deaths due to male lung cancer should be attributed in
Poland to cigarette smoking habits. In spite of health campaigns to
discourage smoking, introduced in some countries, one may observe
rising numbers of cigarettes smoked per person. This trend may be
correlated with a very aggressive campaign to smoke cigarettes
introduced by big tobacco companies which entered the Central and
Eastern European markets recently. On the other hand it is worth
noting that the growing cigarette consumption is based on
cigarettes with lower nicotine content than cigarettes locally
produced earlier in the region. The campaign against smoking habits
has to be continued in spite of the fact that country budgets
derive considerable revenue from sales taxes.
A very high alcohol consumption is reported in the region. It
is necessary to emphasize that hard liquor represents here ca.
60-70% of total alcohol consumption. Moreover there exists a custom
of extensive drinking which leads very often to loss of
consciousness which has a direct influence on the deterioration of
the health condition among drinkers. Alcohol drinking in
correlation with the rapid growth in the number of cars may be
treated also as one of the most important factors influencing
spectacular increase in the number of deaths due to car accidents
after 1989. For example the number of persons killed on spot due to
car accidents, grew in Poland within the period 1988-1992 by 67% in
the age group 15-24, by 41% and 45% in age groups 25-39 and 40-59
respectively.
The current statistical data show a growing trend of suicides
and homicides. The suicides among males aged 20-59 grew over the
period 1989-1993 by 53% in Russian Federation, by 50% in Rumania
and by 33% in Poland. Also all remaining countries registered an
increase in the number of suicides but not this sharp. It is worth
noting that in Poland in 1992, four reported suicides were
committed due to Aids. The increase of homicides has been more
pronounced than the increase of suicides. The absolute number of
homicides among males 20-59 increased within the period 1989-1993
in Russian Federation by 137%, in Bulgaria by 188%, in Hungary and
Poland over the period 1989-1992 the numbers increased by 56% and
62% respectively.
The homicides are concentrated in big agglomerations. In
Poland for example in 1993 the homicides per 100,000 inhabitants
were equal to 6.2 in capital city of Warsaw against 2.8 in the
country as a whole. The homicides connected with robbery were three
times higher in Warsaw than in the rest of the country.
Unfortunately the rapid increase of suicides and homicides may
be attributed to the current transformation period.
5. Migrations
The transition period brought about an evident decline in both
the intensity and the level (in absolute terms) of internal
movement of population in all countries in the region, except
Germany. The basic direction of internal migrations in Poland for
example, have been rural to urban movements. The total net internal
migration in urban areas in Poland reached in 1989 the level of 140
thousand migrants and in 1993 only 60 thousand migrants. The
economic recession and especially stagnation in housing
construction, unemployment in all parts of the country have been
the main causes of rapid decline in internal migrations. It is
difficult to expect radical changes in the existing situation as
long as there is no economic growth leading to new job
opportunities.
The international migrations in Central and Eastern Europe
present a very complex picture. The opening of the borders as a
result of political transformation brought about significant
migration movements. The most important were noted within Germany.
The Council of Europe (1992) reported that: The main destination of
the new east-west migration was the Federal Republic of Germany.
Throughout the 1980's the ethnic Germans - mainly from Poland and
Romania, but, since 1987, increasingly from the Soviet Union too -
had been admitted. In 1989, some 1.2 million people may have come
to Western Europe from Central and Eastern Europe, including
720,000 ethnic Germans. In 1990 the FRG (in its old borders) again
admitted over one million immigrants, including 658,000 ethnic
Germans and 380,000 people moving from the former GDR. In 1991, the
number of ethnic German immigrations fell off to 200,000.
The basic kind of international migration may be specified as
follows: 1) family reunification, return of ethnic, linguistic and
religious minorities (especially to Germany and Hungary), 2) labor
migration outside of the region and especially seeking of jobs in
Central European countries by citizens of the former Soviet Union
and Romania, 3) refugees from different countries where political
and military events have recently been taking place.
The migration based on family reunification was not widely
spread in the Central and Eastern Europe (except Germany). This
kind of migration is usually connected with previous single male-
only labor migration. A new wave of family reunification movement
may be expected when one considers the high wave of legal and
illegal tourist trips that were undertaken with the intention to
prolong the stay in the receiving country, that took place during
the last 15 years. This depends however on the receiving country
policy concerning the acceptance for settlement. Ok½lski (1994)
made an estimate of the ®invisible¯ emigration from Poland during
the period 1.04.1981-31.08.1988. The ®invisible¯ out migrant has
been defined by Ok½lski as a permanent resident of Poland, who went
away to one of the non-socialist countries for a ®temporary stay¯
and for professional reasons i.e. for broadly conceived tourist
reasons and stayed abroad at least three months. According to this
estimate 667 thousand persons left Poland and did not come back
till 6.12.1988 (census day), among them 82% in the age group 18-64
and 14% in age group 0-17 years. The total number of single man-
only migration has not been estimated. The years 1989-1994 were
characterized also by further migration of this kind.
Labor migration in the region will depend mainly on the
economic requirements of European Community countries from outside.
It is worth emphasizing that the Central and Eastern European
countries have a population age structure, especially within the
young labor age cohorts, which can be treated as complementary to
the age structures in countries of European Community. Since the EC
citizens can enter other EC countries for work without formalities,
the inclusion of some Central European countries to the EC may
create a better possibility for migration.
Contemporarily in Central and Eastern European countries one
may note a growing illegal labor migration from former Ussr and
Romania. These migrants take up jobs in the spreading shadow
economy. The scale of this migrations has not yet been evaluated.
The very important dilemma is created by brain drain in the
region. Deep differences in the standard of living between this
region and rest of the World, and practically open borders in
Europe as a whole, create conditions for this type of events. It
has been estimated that within the period 1981-1991, 10% of highly
qualified persons engaged in the institutions of science and
university education left Poland. Additional 1.5% left Poland in
the period 1992-1993. Also the existence of internal brain drain
has been reported. This is created by differences in earnings
offered by science and education, and by free enterprises,
especially international companies.
The most important causes for scientists emigration from
Eastern and Central Europe have been: low salaries, lack of
possibilities of professional development, lack of jobs in the
country due to limited funds in science. It is obvious that
emigration of persons employed in science has been an
disadvantageous phenomenon for the respective country of origin.
Among scientists that emigrated from Poland they were mainly:
biologists, mathematicians, physicists, informaticians and
chemists. Recent estimates reveled that the number of scientists
leaving Poland has been slightly greater in the years 1992-1993 as
compared to the period 1989-1991. USA, Canada and Germany were the
main receiving countries of Polish scientists during the last years
(J. Hryniewicz, B. Jaowiecki, A. Mync, 1991, 1992 and 1994).
As long as political and military unrest take place in Europe
(former Yugoslavia) and Russian Federation (especially Chechen
Republic) the problem of asylum seekers and illegal migrants will
be open in Europe. Assuming that democracy will be widely accepted
in practice throughout the region, there should be no refugees and
asylum seekers, coming from Central and Eastern Europe, in coming
years.
There is no doubt that in Central and Eastern Europe further
controlled international migration will be depending mainly on
successful development of market economy in all transition
countries. However great labor force resources existing in the
region, without internal economic growth and international
cooperation may be treated, in the near future, as an potential
factor creating danger of uncontrolled migration. It is worth
repeating that the age structure, especially in productive age
groups, is complementary to that existing in Western Europe.
6. Conclusions
The population dimension of the transformation from planned to
market economy should be summarized at least in the following
areas:
1. consequences of existing age structure changes,
2. determinants and consequences of population processes,
3. relations between population and socio- economic strategic
goals.
The existing age structures in most of the Central and Eastern
European countries will produce very similar problems for
respective governments. They are connected with the fluctuating
numbers of children and youth in school age groups due to previous
baby ®booms¯ and ®busts¯. As an example one may find that there are
clearly defined serious increases in the numbers of youth in
secondary and university education age in Poland until the end of
this century. The same cohorts will be entering also marriageable
age and labor force age, creating very serious economic tasks which
have to be solved. The age group 19-24 will grow gradually year by
year to reach the level higher by 31% in 2005 comparing with 1990.
It is worth noting that investments in human capital have been
designated as first priority goals in strategic transition program
of development in Poland.
Secondly the coming years will be characterized by serious
increases in the number of population in labor force age (18-59
females/ 18-64 males). Demographic changes in age structure will
produce, for example, in Poland increases in the number of
population in this group by ca. 1 million persons in each
quinqennial period till 2005. This change will create a very
serious burden for the introduction of a smooth socio-economic
program of further reconstruction of the economy. It is also
necessary to remember that in Poland in 1994 the registered
unemployment reached 16% of labor force. Moreover there exist ca.
0.7 million persons of covered unemployment in agriculture.
The rapid increase in the number of old population will start
at the beginning of the next century in most of Central and Eastern
European Countries. In Poland it will start between 2005 and 2010,
when the cohorts of 1950's ®baby boom¯ will be crossing the lower
boundary of retirement age. The existing system of social security
and especially pension system needs fundamental and immediate
reconstruction to be operational on time.
Among demographic processes the most important questions one
may enumerate as follows.
1. The improvement of health conditions of population in all
countries under consideration should be treated as a first priority
question. It requires special attention and priority in the socio-
economic programs of transition, to stop further deterioration and
to reach declining mortality, especially among males in productive
age, in all groups of social strata. The solution of this question
depends largely on economic growth, since it includes action: to
limit poverty in the society, to limit unemployment, to introduce
healthy diets, to improve health services, etc.
2. To create conditions for young cohorts to set families. The
solution to this question depends also largely on economic growth.
In most of Central and Eastern European countries the family is
treated as the basic social unit but the small family size, with
two or one child became the predominant type of family. Moreover
the basic social and moral values have been changing. Even in
catholic Poland one may observe a declining number of marriages and
the growing share of births to unmarried mothers. Cohabitation may
therefore start to expand in this part of Europe. At least one may
expect postponement of decisions to marry and as a consequence
postponement of decision to have a child, especially the first one.
The increasing age at first marriage will be probably the evident
sign of this change. Therefore one may expect that due to
socio-economic transformation a process will start that will lead
to the same age at first marriage that exists already in Western
Europe.
Women in Central and Eastern Europe have been relatively
highly involved in the economic activity. High unemployment on one
hand may push women to stay home with pro-family attitudes but the
growing poverty may on the other hand push women to look for jobs
and have no children or postpone decisions to have them. There is
no ready reply as to which option will succeed.
3. Internal migrations have been radically limited since they
depend entirely on economic growth. Therefore it is extremely
difficult to make predictions. High officially registered
unemployment exists in Poland and moreover hidden unemployment.
Therefore it is proposed to support programs of small investments
in rural areas to create jobs for local people. If this idea will
be financially supported and applied, the internal migrations could
be even further limited.
4. International migrations may depend on: a) political or social
instability, especially among the member states of the former
Soviet Union, b) recovery and prosperous economic growth in some
countries only. The first situation may be created by rapid
deterioration of social and economic situation, evoking
uncontrolled migration movements with several undesirable
consequences. International cooperation is needed to avoid this
hypothetical situation. The prosperous economic growth in some
countries will provoke international migrations, but proper legal
barriers (push factors) or special incentives (pull factors) may
and have to keep migratory movements under control.
Finally it is necessary to state that according to our
knowledge none of the country programs have officially and clearly
specified demographic strategic goals. Usually only short term
expected consequences of age structure dynamics are mentioned, but
there is no proper understanding of the complexity of reproduction
process in long term perspective. However the basic dilemma
concerns the question whether and how to secure desirable future
age structure, rather than the total number of population. Should
we still discuss demographic problems within existing state
boundaries or should we look for global European point of view?
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