The health situation in Russia has often been characterized as a long‐running crisis. From the 1960s until the beginning of the 2000s, the declining life expectancy trend was substantially interrupted only twice: once in the mid‐1980s as a result of Gorbachev's anti‐alcohol campaign, and again at the end of the 1990s as a result of the “rebound” effect following the dramatic rise in mortality associated with the acute socioeconomic crisis. In both cases, the progress made proved to be short‐lived. A third mortality decline in Russia began in 2003 and is still ongoing. We investigate the components and driving forces of this new development, in particular the role played by cardiovascular diseases. Using cause‐specific mortality data, we identify the main features of the recent improvements and compare these features with those observed in selected European countries, specifically France, Poland, and Estonia. Our aim is to gauge whether the features of the improvements in these countries are similar to those of the recent advancements made in Russia. Although the recent improvements in Russia have features in common with initial stages of prior mortality declines in other countries and may support optimism about the future, a return to mortality stagnation cannot be ruled out.

The papers in this special collection were presented at the seminar "Determinants of Diverging Trends in Mortality", held at MPIDR, Rostock on 19-21 of June, 2002. The seminar was organized by the Max Planck Institute for Demographic Research and the Committee on Emerging Health Threats of the International Union for the Scientific Study of Population.

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The well-known Oeppen-Vaupel straight line of maximum female life expectancies showed that the highest life expectancy observed in a given year increased linearly from 1840 to 2000. Their analysis fueled major controversy, especially when used to extrapolate future improvements in life expectancy at the same pace. We improve on the empirical analysis by enriching the dataset, expanding the period to 1750-2005, and considering both maximum life expectancy at birth and lowest age-specific survival rates. It clearly appears that the original Oeppen-Vaupel straight line must be divided into several segments characterized by different slopes and that each segment corresponds to a major advance in the health transition. There is room to push life expectancy higher, but unless some new breakthrough increases the human "life span", progress will very likely decelerate as mortality reduction affects individuals at older and older ages. The main key to the future lies not in knowing whether the observed straight line can be extrapolated but in anticipating the next major health improvement that will lead to an additional increase in life expectancy. Copyright (c) 2009 The Population Council, Inc..

From 1965 to 1995, average European male life expectancy -with the European part of the former USSR included among European countries -barely increased. In fact, if one looks at western, northern and southern Europe, life expectancy gained six years, whereas it gained only one year in the countries of central Europe and actually lost six years in the former Soviet Union… France M ESLÉ and Jacques V ALLIN describe in detail the agespecific, sex-specific and cause-specific mortality trends over these 30 years, during which the former Soviet Union and eastern Europe went through many political upheavals. In the nonformerly Communist countries, life expectancy gains were mostly due to the decline of infant mortality (an area where further gains will hereafter be limited) and of the mortality of adults aged 30 to 59 and especially over 60 (half of the gains). In the former USSR, losses affected all ages above 15, among both males and females, and the main culprits are cardiovascular diseases and violent deaths.* Institut national d'études démographiques (INED), Paris.

During the 1990s, the sex ratio at birth increased considerably and simultaneously in the three independent Caucasian countries, Armenia, Azerbaijan, and Georgia. At the end of the first decade of the twenty‐first century, levels remain abnormally high in Armenia and Azerbaijan (above 114 male births per 100 female births) and show erratic trends in Georgia. Analyzing data from demographic surveys carried out around 2005, we confirm the persistence of high sex ratios in these three countries and document significant differences in fertility intentions and behavior according to the sex of the previous child or children that constitute evidence of the practice of sex‐selective abortion. These countries combine societal features and medical systems that make this phenomenon possible: son preference in a context of low fertility and the possibility of prenatal sex selection given easy access to ultrasound screening and induced abortion. Why high sex ratios are observed only in these three countries of the sub‐region remains, however, an open question.

In the most advanced countries, child mortality and adult mortality under age 65 years have fallen so low that further improvement in life expectancy relies almost completely on the decline of mortality at older ages. This phenomenon is particularly pronounced among women, who are far ahead of men in survival rates. Thus, to project the future of life expectancy, this study focuses on trends in female life expectancy at ages 65 and older. Four countries are selected for this analysis: the United States, Netherlands, France, and Japan. It is particularly interesting to understand why American and Dutch trends in female old-age mortality have been diverging from those in France and Japan for two decades. It is shown here that most of the divergence derives from the fact that decline in cardiovascular mortality is more and more offset by increases in other causes of death in the United States and the Netherlands, while the other two countries are more successful in reducing mortality from all causes at increasingly older ages. This latter phenomenon could represent a new stage of the health transition. Copyright 2006 The Population Council, Inc..

Until the end of the 1990s, mortality patterns and trends in Estonia, Latvia and Lithuania were remarkably similar. However, from the year 2000 onwards, life expectancy trends in the three countries started to diverge. In particular, sustainable progress in Estonia over the period 2000-2007 contrasts with stagnation in Latvia, and even worsening trends in Lithuania. These contradictory changes seem to be mainly explained by contrasting dynamics in mortality from cardiovascular diseases, external causes of death and digestive system diseases. Whereas cardiovascular and external-cause mortality declined in Estonia and Latvia, worsening or stagnation of mortality from these causes of death was observed in Lithuania. The negative mortality changes in Lithuania were also reinforced by a striking increase in mortality from alcohol-related digestive system diseases. The findings suggest that the divergence in health trends between the three countries may be attributable to their varying degrees of success in implementing structural health care reforms and specific health policy measures. By contrast, the very recent improvement (since 2008) is parallel in the three countries and is largely because of the introduction of rather similar anti-alcohol measures.