German unification and the plasticity of mortality at older ages

German unification can be seen as a natural experiment that allows us to study the health effects of political and economic transition. This study examined old-age survival following German unification in cohorts born in 1895, 1900, 1905 and 1910. People born in these years were in their 80s and 90s at the time of unification in 1990. Before unification, mortality in these cohorts was considerably higher in East Germany than in the West. Following unification, mortality in the East declined toward prevailing levels in the West, particularly among women. This indicates that even the very-old East Germans were able to profit from the medical, social, and economic improvements associated with unification. Study results support the view that old-age mortality is plastic and amenable to intervention, and they attest to the importance of late-life events.