Designing One Nation

BackgroundHealth and social conditions vary between West and East Germany.MethodsWe analyzed annual mortality data of all recorded deaths caused by lung, colorectal, breast and prostate cancer in Germany as they are published by the Federal Bureau of Statistics (FBS) encompassing the period 1980–2014 for former West Germany (WG) and 1990–2014 for former East Germany (EG). To compare East and West Germany we computed the ratio of the mortality rates in both parts (mortality rate ratio, MRR, <1 indicates a lower mortality in EG). Forecasting methods of time series analyses were applied (model selection based on the Box/Jenkins approach) to predict 5-year trends until 2019.ResultsLung cancer: In women mortality rose in both regions (WG: +2.8%, 1991–2014, EG: +2.2%, 1990–2014). In men mortality in WG declined between −2.1% and −1.2%, and by −2.7% (1993–2009) in EG which was followed by a plateau. Colorectal cancer: A decline was found in both WG (−3.1%, 1993–2014) and EG women (−3.8%, 1993–2008 and −2.0%, 2008–2014). A decline in EG men since 1992 (−0.9%, 1992–1997 and −2.3%, 1997–2014) mirrors the development in WG (−2.6%, 1995–2014). Breast cancer: Constant mortality decline in WG after 1996. In EG a decline (−2.4%, 1992–2007) was followed by a plateau with an MRR <1 (1990–2014). Prostate cancer: In WG a decline (−3.4%) came to a hold after 2007, while there was a constant decline of 1.5% in EG. The forecast indicated that mortality of colorectal/lung cancer in men and breast cancer reaches a plateau in future years.ConclusionCourses of mortality were similar between East and West, while existing differences are likely to remain in the near future.

A substantial amount of literature dealing with conceptualisations of the nation has neglected the importance that gender and the politics of reproduction play in the construction of national identities. Analysing images of political campaigns and activists as well as public discourses on motherhood, abortion and childcare, I will illustrate the importance that gender and sexuality assumed in German nation-building projects before and after its unification in 1990. After 1949, East and West German ideas of nationhood were premised on opposing ideas of gender roles, in that politicians within these two German nations mobilised distinct gender identities to assert their respective political system as superior and progressive. While in East Germany, the progressiveness of the socialist project was measured along the lines of women’s integration into the labour force; in West Germany, the idea that a woman’s identity was primarily rooted in motherhood played an influential role in nationalist discourses. Once East and West Germany reunified in 1990, these opposing ideas of gender roles clashed. This became particularly visible in the context of political debates around abortion and childcare. An analysis of these debates suggests that the “new” unified German nation was premised upon a story in which the West German idea of the housewife-breadwinner model prevailed. This was diametrically opposed to what was framed as the East German “woman-worker” who had free access to abortion, and was abjected as immoral and backward. Analysing how such a national story was constructed is highly valuable, as it elucidates the ways in which gender has become a constitutive and structural element in the nation-building process of unified Germany to the present day.

The annual number of persons killed in road-traffic accidents in Germany declined by 36% from 2001 to 2008, yet official traffic statistics still reveal a marked difference in fatalities between the federal states of the former East and West Germany twenty years after German reunification. We retrospectively analyzed data from the Trauma Registry of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie; TR-DGU). Patients receiving primary treatment that had an Injury Severity Score (ISS) of 9 or above were analyzed separately depending on whether they were treated in the former East Germany or the former West Germany. Data were obtained from a total of 26 866 road-accident trauma cases. With Berlin excluded, 2597 cases (10.2%) were from the former East Germany (EG), and 22 966 (89.9%) were from the former West Germany (WG). The percentage of the population living in these two parts of the country is 16.7% and 83.3%, respectively. The two groups did not differ significantly in either the mortality of injuries (EG 15.8%, WG 15.7%) or in the standardized mortality rate (0.89 [EG] vs. 0.88 [WG]). Over the years 2002-2008, the mean time to arrival of the emergency medical services on the scene was 19 minutes (EG) vs. 17 minutes (WG), and the mean time to arrival in hospital was 76 minutes (EG) vs. 69 minutes (WG). Among the hospitals whose cases are included in the TR-DGU, there is no significant difference between the former East and West Germany with respect to mortality or any other clinically relevant variable. Hypothetically, the higher rate of death from road-traffic accidents in the former East Germany, as revealed by national traffic statistics, might be attributable to a difference in the quality of care received by trauma patients, but no such difference was found. Other potential reasons for it might be poorer road conditions, more initially fatal accidents, and lower accessibility of medical care in less densely populated areas.

Population trends, employment levels, economic performance, and income evolution in East and West Germany since unification

Culture from the Slums opens with an overview of punk and a detailed explanation of the divided German context. In the process, it makes three main claims. First, that punk has substantially influenced politics, society, and culture in divided Germany during the 1970s and 1980s and helps explain the success of democracy in West Germany and the failure of socialism in East Germany. Second, that alternative culture and authenticity are crucial for understanding the subculture and these decades, and explains why and how they drove the cultural experimentation that defines this era. And third, there were considerable similarities between East and West Germany in popular music production and consumption, parallels suggesting a certain subcultural convergence across the Iron Curtain in the last decades of the Cold War. Along with discussions of methodology and definitions, the introduction outlines the study’s historiographical interventions and punk’s importance for understanding postwar German history.

Using data from the German Socio-Economic Panel (SOEP), we show that single women in East Germany are significantly more likely to give birth to a child than single women in West Germany. This applies to both planned and unplanned births. Our analysis provides no evidence that the difference between East and West Germany can be explained by economic factors or the higher availability of child care in East Germany. This suggests that the difference in out-of-partnership births is rather driven by behavioral and cultural differences. However, these behavioral and cultural differences do not only reflect different gender role models that evolved under the former communist regime in East Germany and the democratic one in West Germany. Partly, they also reflect a long historical divide that predates the 1945 separation of Germany.

So far, comparisons of self-rated health (SRH) between East and West Germans have mostly referred to current residence, neglecting where people lived before the fall of the inner German Wall. This article considers the place of residence before 1990 to explain health differences, thereby accounting for socio-political socialization and differing socioeconomic starting points. It examines whether differences in self-rated health persisted 20 and 30 years after reunification between those who had lived in East or West Germany before 1990.We are using survey data from GEDA 2009-12 (30,883 women, 24,959 men) and 2021 (2,203 women, 1,917 men) to estimate age-adjusted prevalence of good self-rated health by pre-1990 and current residence, for women and men. Multiple logistic regression adjusts for education, income, and migration history. Interaction effects between cohorts and residence pre- and post-reunification are specified. Predicted probabilities display East-West differences by cohort. Analyses are performed separately by sex and for birth cohorts based on established generation definitions.Germans living pre-1990 and currently in East Germany were less likely to report good SRH in 2009-2012 (women OR: 0.727, CI 0.67-0.79; men OR: 0.767, CI 0.70-0.84) than individuals living pre-1990 and currently in West Germany. These differences were absent in 2021. At both time points, older generations were less likely to report good SRH than younger ones, especially East Germans who were still living in East Germany. The analysis by generation shows that good SRH was less likely among East German women and men compared to West Germans in the three oldest cohorts (born before 1960).East-West differences by generation indicate that the East German background is an important determinant of self-rated health for specific cohorts. Explanations include selective migration, higher pre-1990 health burdens, and challenges during East Germany's transformation. Comparisons over time suggest that East-West health disparities may fade as generations who lived in East Germany before 1990 pass.

The Double German Transformation: Changing Male Employment Patterns in East and West Germany

Unionization in Germany has declined considerably during the last two decades. We estimate the impact of socioeconomic and workplace-related variables on union membership by means of Chamberlain-Mundlak correlated random effects probit models, using data from the German Socio-Economic Panel. Drawing on the estimates, we project net union densities (NUD) and analyze the differences between East and West Germany, as well as the corresponding changes in NUD over time. Nonlinear Blinder-Oaxaca-type decompositions show that changes in the composition of the work force have only played a minor role for the deunionization trends in West and East Germany. In West-East comparison, differences in the characteristics of the work force reflect a lower quality of membership matches in East Germany right after German unification.

In this paper studies on current contraceptive use and attitudes toward various contraceptive methods in Germany are reviewed. Both the former West and East Germany are considered. On the basis of the existing studies it is difficult to have a clear impression of which methods are currently used in both countries and how contraceptive practice developed over time, due to methodological differences between studies. Nevertheless, it can be concluded that use of reliable contraceptive methods is widespread in both East and West Germany. In this respect East Germany differs considerably from other previously communistic countries. Attitudes were mainly assessed in West Germany, and with respect to oral contraceptives and IUDs great concern appeared to exist regarding the safety of both methods. As far as oral contraceptives are concerned, selective mass media attention toward possible side-effects of oral contraceptives may have contributed to this situation.

Since reunification in 1990, the link between acts of violence against foreigners, especially in east Germany, and the previously different political systems of former East and West Germany has come under scrutiny. At issue is whether the population in the east has on average a more ethnocentric orientation because of its different political socialization. Some observers have argued in addition that, as a consequence of the political structure of the former GDR, east Germans exhibit a higher level of authoritarian attitudes (e.g. Hopf et al., 1999; Lederer and Schmidt, 1995). This issue will be addressed here and will be refined by an empirical comparison between east and west Germany. The study will focus particularly on the relationship between authoritarian and ethnocentric attitudes, which will be analyzed in the ALLBUS data of 1996.KeywordsLatent ConstructResidual CorrelationSocial Identity TheoryNational PrideEqual ParameterThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

IntroductionChanges in risk factors and the introduction of mammography screening in 2005 have led to dramatic changes in the breast cancer-associated burden of disease in Germany. This study aimed to investigate long-term disease-related incidence and mortality trends in women from East and West Germany since the reunification of Germany.MethodsTotal and stage-specific incidence rates were evaluated based on data obtained from selected cancer registries. Sufficiently complete data going back to 1995 were available for 4 East German and 3 West German regions. The figures were weighted for population size, and rates were calculated for the whole of Germany based on the rates for East and West Germany. The study particularly focused on 3 different age groups: women eligible for mammography screening (50 – 69 years), younger women (30 – 49 years) and older women (70+ years). All rates were standardised for age. The mortality rates obtained from the official statistics on cause of death since 1990 were processed accordingly.ResultsIncidence rates in the observation period increased, as they were affected by the increasing number of cases with early-stage cancers being diagnosed in the screening age group. The total incidence for this group, which included the incidence of non-invasive breast cancers, increased by 14.5% between 2005 and 2016. Early-stage cancers (UICC stages 0 and I) increased by 48.1% while late-stage diagnoses (UICC stages III and IV) decreased by 31.6%. Qualitatively similar changes were noted for the other age groups, although they were less pronounced. The decrease in breast cancer mortality observed since the mid-1990s ended around 2008 for the group of younger women but continued in the screening age group. After 2008, an increase in mortality was observed in the group of older women. The differences in disease burden between East and West Germany (in favour of East Germany) decreased in younger women during the observation period but tended to increase in the group of older women.ConclusionThe analysis suggests that the introduction of mammography screening contributed to a decrease in the incidence of advanced-stage breast cancers and in breast cancer-related mortality rates but also resulted in a substantial number of overdiagnoses. The relatively unfavourable incidence trend in the group of younger women, particularly in East Germany, should be interpreted in the context of lifestyle changes. The slight increase in mortality observed in the group of older women after 2008 requires further analysis.

Background: Early childhood influences are important for the development of the allergic phenotype. In East Germany, tremendous lifestyle changes took place after 1990 and it can be hypothesized that the allergic phenotypes in mothers and their children are less similar than in West Germany. This was investigated in our study done in mothers and their 6-year-old children from East and West Germany in the year 2000. Methods: 1,393 mother-child pairs participated. A subgroup of 774 pairs gave blood for the determination of specific IgE. Regional differences in mother-child correlations and in prevalence of mother-child combinations with respect to allergic sensitization and disease were examined by logistic regression analysis. Results: The adjusted association in positive allergic sensitization between mothers and their children was not significant in East Germany (OR 1.23, 95% CI: 0.68–2.24) but highly significant in West Germany (OR 2.89, 95% CI: 1.73–4.80). The probability for the combination of ‘negative’ mother and ‘positive’ child was significantly higher in East than in West Germany. Conclusions: Mother-child transmission of atopy predisposition can even be cancelled by environmental changes.

Using a DNA-based polygenic index, we explored geographical and historical differences in polygenic associations with educational attainment in East and West Germany around the time of reunification. This index was derived from a prior genome-wide association study on educational attainment in democratic countries. In 1,930 individuals aged 25 to 85 years from the SOEP-G[ene] cohort, the magnitude of polygenic associations with educational attainment did not differ between East and West Germany before reunification but increased in East Germany thereafter. This gene–environment interaction remained robust when we probed for variance dispersion. A control analysis using a polygenic index of height suggests that this interaction is unlikely to reflect a general trend toward greater genetic associations in East Germany after reunification. The observed amplification of education-genetic associations aligns with theories suggesting heightened genetic influences on educational attainment during periods of greater social and educational opportunity. We emphasize the need for replication in larger German genetic data sets.

Until the mid-1980s, labour markets in Germany were characterized by a high level of employment stability. Employment biographies of men were dominated by full-time employment in both East and West Germany and were hence quite similar in this respect, despite the two regions’ enormously different institutional settings. Since that time however, important changes have occurred. Labour markets have become more flexible, as have employment biographies. However, the process towards de-standardization and increased discontinuity in employment biographies began in East Germany later than it did in the West. East German change started namely in 1990, when the German Democratic Republic was incorporated into the Federal Republic of Germany. This study uses the German Socio-Economic Panel (SOEP) to analyse how men’s employment patterns in Germany have changed over three different birth cohorts. Through the use of sequence analysis the authors not only observe an increase of non-standard episodes in such biographies, such as unemployment and part-time work, but also investigate whether employment biographies have on the whole become more discontinuous in nature. In addition, the authors analyse the main differences in trends observed in East as opposed to West Germany as a result of differing societal and economic changes. The results of this analysis show evidence of de-standardization in employment in both regions. However, this trend follows a separate path in each region, with the process being faster in East Germany than in the West.