Background: Trends in external causes of deaths in the Baltic States--Estonia, Latvia and Lithuania--were analysed against the background of turbulent political, social and economic changes. The reliability of mortality statistics concerning external causes of death in these countries is considered to be good.
Method: This study is based on data published by the statistical offices of the three Baltic States and on data obtained through interviews with personnel employed at the national statistical offices. The study period was divided, by socio-political and economic factors, into a period of stagnation (1970-1984) and a period of reforms (1985-1997).
Results: During 1970-1984 a stable slightly upward trend of external causes of death rates was observed. The curve became S-shaped in the reform period: between 1984 and 1988 a marked decrease occurred followed by a rapid increase of rates until 1994, and then by 1997 a fall to the approximate level of 1984. The male to female ratio of external causes of death was between 3.4:1 and 4.2:1. External deaths accounted for 10% to 14% of all deaths before 1984. During the period 1984-1988 the proportion of external deaths was under 10% and peaked in 1994 at 16%. Fluctuations in the trends of external death were more pronounced among males than females in all Baltic countries.
Conclusion: Trends in external causes of death were similar in Baltic States. High proportions of violent death decreased life-expectancy for both sexes, but markedly for males. Social stresses and alcohol consumption could be considered as factors influencing the mortality rates and specific fluctuations in trends of external death, especially among males.