Health difference in eastern Europe: preliminary findings from the Nowa Huta study

This paper reports the findings of a retrospective study of differential mortality trends among men in a cohort of steelworks employees during the period 1974-1993, a period which encompassed the rise of Solidarity, martial law, and the transition to democracy in Poland. The Nowa Huta study traced vital status for 34,141 individuals and found few systematic differences in death rates among the social groupings it compared. However, there was a significant temporary increase in mortality differentials between skilled and unskilled manual workers, as well as between men of manual worker and peasant farmer origin, in 1981. In addition, differences between manual and non-manual workers opened up after 1991 and reached statistical significance in 1993. This paper considers the extent to which employment at the Nowa Huta steelworks, experienced within a specific and changing political context, may have contributed to the pattern of findings revealed by the study. The paper argues that an adequate account of the East-West health divide should include explicit consideration of qualitative differences in the structuring the social distribution of health.