Agnieszka Fihel

Migration as an Asset? Polish Returnees at the Time of the Crisis

In the second half of the 1990s, the European Union (EU) witnessed two important processes shaping many areas of its socio-economic reality. First, two enlargement rounds initiated in May 2004 have led to a significant change in the internal structure of the EU in terms of income structures, welfare, social conditions, etc. Second, similarly to other parts of the global economy, many member states are suffering from a severe economic crisis. These two effects are supposed to impact migration processes, both in internal and international terms. Against this background, Poland presents an interesting case study, largely due to its massive involvement in the post-enlargement migration.

Role of smoking in regional variation in mortality in Poland

AIMS We assess the effect of smoking on regional disparities in mortality in Poland and its contribution to the change in regional disparities during the last two decades. DESIGN, SETTING AND PARTICIPANTS We used population-level mortality data from the population registry for 379 Nomenclature of Territorial Units for Statistics (NUTS)-4 Polish regions for 1991-93 and 2008-10. MEASUREMENTS The importance of smoking was assessed by smoking-attributable mortality (SAM) derived using a simplified indirect Peto-Lopez method. Regional differences in age-standardized all-cause, smoking- and non-smoking-attributable mortality (NSAM) rates at ages 35 years and over were mapped, and spatial clustering (Morans I) and coefficients of variation (CV) were estimated. The contribution of SAM to variation in all-cause mortality was assessed by variance decomposition and compared over time. FINDINGS In 2008-10, all-cause and SAM rates were characterized by a similar pattern of spatial clustering (Morans I > 0.44, P < 0.0001). For NSAM, a more random pattern with less regional clustering showed (Morans I = 0.34, P < 0.0001). The contribution of smoking to regional variation was substantial [54%, 95% confidence interval (CI) = 44.9, 62.5 among men; 24.9%, 95% CI = 20.9, 29.1 among women], and compared with 1991-93, 27.5 percentage points lower for men and 6.3 percentage points higher for women. Smoking contributed to the divergence between the regions in all-cause mortality between 1991-93 and 2008-10 for men [increase in CV of SAM by 2% (0, 4%)], but not for women [decrease in CV of SAM by 15% (22, 10%)]. CONCLUSIONS Differences in past smoking behaviour may largely explain the regional differences in all-cause mortality existing in 2008-10 in Poland, and its trends since 1991-1993.