The Czech Republic and Slovakia have the distinction of being the only former socialist countries to have reversed the downturn in life expectancy. Beginning in the mid-1960s, longevity declined among males in the former Czechoslovakia—as in most of the Soviet bloc—only to turn upward in the mid-1980s. Consequently, the Czech and Slovak experience contains important clues about reversing rising mortality in the region. The reasons for this turnaround are the focus of this chapter. I begin with an examination of the relationship between health and social change in Czechoslovakia over the past century until 1993 when the Czech Republic and Slovakia separated. At that point, each country and its social determinants of life expectancy are discussed independently.
The current Czech Republic is composed of Bohemia and Moravia, along with part of Silesia. This territory existed as either one state or a confederation of states as early as the Middle Ages. Slovakia, on its part, belonged to the Kingdom of Hungary from around 1000 to 1918. When most of Hungary was occupied by the Turks in the sixteenth and seven-
This chapter was written with the assistance of Hana Janečková, Ph.D., School of Public Health, Postgraduate Medical School, Prague, Czech Republic.