To document the effects of sudden economic change on death rates for occupants of cars in the former German Democratic Republic (East Germany).
Ecological time series study of East Germany in comparison with the former Federal Republic of Germany (West Germany) before and after reunification in 1990.
East and West Germany from 1985 to 1996.
Populations of East and West Germany between 1985 and 1996.
Main outcome measures
Death rates for occupants of cars.
After the reunification of Germany, East Germany experienced a sudden, temporary affluence and a concomitant fourfold increase in death rates for car occupants between 1989 and 1991. Although death rates increased in all age groups, young adults (aged 18-24) were most affected. The death rate per 100000 population for those aged 18-20 years increased 11-fold between 1989 and 1991; for those aged 21-24 years the increase was eightfold.
A tragic consequence of the reunification of Germany was a dramatic increase in the death rate for car occupants. Sudden economic change and availability of cars resulted in both a rise in vehicle ownership and an increase in the number of inexperienced drivers on roads that were ill prepared for the increased traffic. The lesson learnt from Germany is that during times of economic change and modernisation, measures to prevent the predictable injury deaths that will result need to be considered.
- German reunification was associated with a fourfold increase in death rates for car occupants in former East Germany between 1989 and 1991, young adults having an 11-fold increase
- Access to previously unobtainable cars and the youth and inexperience of drivers contributed to the increased traffic accidents in East Germany after reunification
- Although modernisation of underdeveloped nations and their economies is ultimately beneficial, it can prove fatal without appropriate injury prevention measures
- Public health and medical communities must take the lead in ensuring that economic change does not adversely affect the health and safety of the public