Following World War II, the peoples of Eastern Europe not only had increased access to affordable, hygienic housing, they also had improved access to health care. Still, like the new housing opportunities, the new health care offerings were limited in quantity and quality, and other everyday life changes conspired to test their efficacy. In the first years of Communist rule, the health of East Europeans significantly improved. The development of new medicines and improved housing led to the containment of the diseases that had been deadliest prior to the war, including tuberculosis, syphilis, and pneumonia. Increased birth rates and life expectancy resulted from this progress, but only for a short time. By the 1960s, however, the health of East Europeans showed signs of deterioration not due to the return of the old diseases but, instead, due to the rise of so-called "lifestyle" diseases. Lifestyle diseases, sometimes also known as "civilization diseases", include heart, vascular, liver and lung diseases, diabetes, and cancer. They result from changes in lifestyle associated with industrialization and urbanization in mass consumer societies. These changes can include diets that are richer in animal products, sugar, and fats, and increased consumption of alcohol, cigarettes, and recreational drugs.
Práce was the newspaper of the Revolutionary Trade Union, the only trade union allowed in Communist Czechoslovakia and an important arm of the Communist Party.
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"Unsatisfactory State of Health Deplored," September 7, 1988, PRACE, trans. Foreign Broadcast Information Service (FBIS).
[Excerpts] . . . The situation of our state of health is nothing to boast about. [. . .] In the world table of cardiovascular diseases listed as the cause of death, we, for example, occupy second to sixth place. Cardiovascular diseases have long been the number one cause of death in our country. . . .
Statistical tables show that, as recently as the mid-sixties, our population's state of health was fully comparable with that of the most advanced industrial countries. We have, however, lost this standing. The decline in the infant mortality rate is slow (from 19.2 per thousand in 1970 to 12.3 per thousand in 1985, compared with less than 10 per thousand in advanced countries).
The average longevity of both men and women is stagnating. Middle-aged men, in particular, are dying more and more often. The stronger sex has an average life expectancy of 67.3 years in our country, while the fair sex has an average life expectancy of 73.9 years. This is between 4 and 7 years less than the average life expectancy in other industrially advanced countries.
(In this connection it is not uninteresting to take a look at the increments in average life expectancy between 1960 and 1985: Average life expectancy in the CSSR increased by 0.1 to 70.5 years; in the FRG by 5.3 to 75.0 years; in France by 4.8 to 75.9 years; in the United States by 4.4 and 74.7 years; and in Hungary by 2.3 to 69.7 years. The fact is that [of all these countries] the CSSR has experienced the lowest increase in average longevity. We have managed to drop to 25th place among the 28 European countries studied. We have been overtaken by some 20 developing countries and rank approximately 50th in the world "league" table.)
The illness rate of women has increased. One in three pregnancies can be designated as high-risk pregnancies.
The sickness rate and work disability on account of diseases of the digestive, motor, and nervous systems is growing.
Finally, there is an unfavorable trend in cardiovascular and oncological diseases. One in two Czechoslovaks dies of cardiovascular diseases and one in four of malignant tumors. . . .
There are several causes for this unsatisfactory state of health—the steadily deteriorating state of the environment, the very often unsuitable working environment, the poor composition and often also poor quality of food, lack of movement, which applies virtually to all age groups, and, last but not least, our own inadequate care of our health.
To this we must add the not exactly world-class endowment of our health care system and our hospitals with top technology: problems with pharmaceuticals and medical supplies; the great amount of paperwork that distracts physicians from their work; the feminization of health care with all the consequences that this involves; and the lower percentage of gross national income spent on health care compared to industrially advanced countries. . . .
Every year, 28 billion cigarettes are consumed in our country. Each person drinks and average of 140.1 liters of beer, 15.5 liters of wine, and 8.2 liters of spirits and distillates. We are also big eaters. Our energy consumption has climbed to 12,900 kilojoules, which far exceeds the recommended intake. . . . Moreover, fats account for much too large a percentage of our diet. . . .
Those who have read the above lines may ask: What things can I influence, and what is beyond my power? Some experts contend that we can influence virtually everything. [passage omitted] True, some things, such as improving the environment, will take time. . . . However, even now we must honestly strive of such an improvement. It is also necessary that the new laws provide for greater responsibility of individuals, as well as production organizations, for the health of employees. One cannot put employees' health at risk ad infinitum in the pursuit of momentary economic advantages. . . . It is in the working people's interest that they work in an environment that does not endanger their health, that they avoid last-minute rush work, and that they do not have to spend Saturdays and Sundays making up for arrears caused by bad labor organization.
In connection with the required change of diet, it is necessary that shops provide enough good-quality food and that they offer the correct food from the standpoint of healthy nutrition. . . .
People in the housing estates and in city centers must be provided with more opportunities to engage in sports and to spend their free time actively and outdoors. In short, it is necessary not to content oneself with the proclamation of slogans but rather to start creating conditions for a healthy way of life. This is the only way to catch up. These are tasks which, for objective reasons, cannot be mastered by individuals but only by society in its entirety. . . .