Mortality transition in Albania, 1950-1990

Albania was noteworthy, not just for the isolationist policy of its government, or its domestic rigid policies applied to Europe's poorest country, but because of its high life expectancy at birth. At the end of the eighties, life expectancy at birth passed the boundary of seventy, although the country's GDP per capita was {dollar}2500 in 1990, the lowest in Europe (Madison 1995).This puzzled scholars, who either doubted the success of Albania, or because of the lack of firm information, speculated with different explanations (Watson, 1995). This research was initiated by this controversy in trying to first, estimate the scale of Albania's success in improving life expectancy and document the mortality transition in Albania during the period 1950-1990. It also looks at the social, economic and political factors behind the success of improving life expectancy at birth from 51 to 71 years in a relatively short period of 40 years. The research attempts to explain why the Albanian pattern of mortality, with very high infant and child mortality and very low adult mortality, is so different from that of other East European countries, which had the same social and economic backgrounds. The analysis concludes that the life style factors are the most likely factors in explaining the controversial mortality pattern of Albania. The research uses a new set of complete data, obtained from formerly-closed Albanian State Archives, which were made available only after 1994. It is the first time that the cause specific data are used to analyse the mortality transition in Albania. The research starts with a description of country's cultural and historical background. It continues with the political, social and economic transition during the communist rule 1945-1990, which are of particular importance in understanding the demographic regime in general, and the mortality transition in particular (Caldwell, 1986). The research continues with a detailed analysis of the availability and quality of mortality data. The analysis of mortality trends and patterns during this period confirms the success of Albania in achieving high life expectancy at birth by the end of eighties. It also shows that this was achieved by very low adult mortality, and relatively high infant and child mortality. The later analysis shows that this finding is related to the cause specific pattern of mortality, as well as regional differences within the country. The research ends with an international comparison of mortality trends and patterns in Albania, in the context of whether the Albanian success was part of the experience of countries that had "a good health at low cost" (Caldwell, 1986), or if the Albanian way is another route to low mortality