Trends in life expectancy in Bulgaria before and after the socio-economic transition

Background: Countries of Central and Eastern Europe differ by the pattern of life expectancy (LE) changes experienced after the initiation of political transition. Bulgaria is among the few countries with a longer period of stagnation and decline of LE.
Objective: To examine changes in life expectancy in Bulgaria before and after the transition.
Methods: Population numbers and mortality data were extracted from the WHO Mortality database for a period of 25 years (1980-2004).  A list of 40 causes of death considered to be amenable by medical care was used. The effect of four major cause-of-death groups was studied as well. Standard life table technique and the Arriaga’s method were used to calculate and decompose LE changes by age and cause of death for 5 periods: 1980-1984, 1985-1989, 1990-1994, 1995-1999, 2000-2004.
Results: LE in the periods before the transition showed a slight decline of 0.22 years in men and an increase of 0.39 in women. Male population experienced further decline in LE during the first decade of socio-economic transition and a loss of 1.04 years. LE for women decreased by 0.39 years for the same period. The most successful period with rapid positive change in LE for both sexes was the period 2000-2004 with gains of about 1.5 years. The major contribution to the decline of LE after transition was due to increased infant mortality for both sexes and mortality in the age groups 45-64 for men and in women aged over 65. Significant raise of cardiovascular mortality was registered in the period 1995-1999, especially in the year 1997 considered to be the critical year of the transition. The recovery observed in 2000-2004 was caused by a reduction of infant mortality and cardiovascular deaths in middle aged. Amenable mortality contributed more to the improved LE in women than in men.