87
THE DEMOGRAPHIC SITUATION:
PROBLEMS AND TRENDS
demic typhus. During the past ten years,
cardio-vascular diseases have become the
main causes of death in the country.
Throughout the past ten-year period they
have accounted for more than 60 per cent
of the lethal cases. Among them the share
of deaths resulting from diseases of the
brain vessels and from ischaemia has been
the highest. The causes of death next in
importance have been malignant tumours,
traumas and intoxications and the diseases
of the respiratory system.
The death rate among men is higher
than that among women with cases of all
socially significant diseases. This difference
is more than three times in the death rate
ensuing from traumas and intoxications and
more than two
times from diseases of the
digestive system. Like in most of the Euro-
pean countries, in Bulgaria, too, men are
more susceptible to the main causes of
death. The ensuing result is an increase in
the difference in the life expectancy of men
and women.
The types of settlement also exert an
influence on the total death rate and on
the deaths resulting from the main causes
of death. In 1994, the death rate in the vil-
lages was 19.2 per thousand, or nearly twice
as high as that in the urban centres, where
it was 10.4 per thousand. In Bulgarian con-
ditions, the death rate of all basic socially
significant diseases is also higher in the vil-
lages than in the towns. This difference is
particularly clear-cut in the diseases of the
respiratory system, as well as in the car-
diovascular diseases. These differences are
influenced both by living conditions in the
towns and villages, and by the higher health
care standards and better health care se-
curity in the towns than in the villages. It
should also be borne in mind that the rural
population is considerably older than the
urban. The death rate is the highest in the
regions of Montana and Lovech. To some
extent the high rate of death in these re-
gions is due to the population that is well
advanced in years.
The problem of the death rate is also
topical from the point of view of attaining
a certain average future longevity. After the
end of the Second World War and up to
the mid-1970s, Bulgaria had an increase
by 20 years of the average future longev-
ity. This has been beyond any doubt a suc-
cess of public health, particularly in the
treatment of infectious diseases, the dis-
eases of the
respiratory system and in the
drastic reduction of infant mortality. The
opening of public health establishments, the
increase in the number of medical person-
nel, the introduction of new medicines, the
raising of the peoples educational stan-
dards as well as the introduction of free
medical aid have played a positive role in
the reduction of the death rate and in pro-
longing the life of the people. After the
expiry of that period, however, there has
been though slight decrease of the average
future longevity of men and of women. In
1994, the average longevity of future life
was 67.2 years for men and 74.8 years for
women. From among the member-coun-
tries of the Council of Europe, it is only in
Bulgaria, Hungary and Poland, that there
has been a trend towards the stabilization
of the average future longevity. In the 1980s
and particularly in the early 1990s, even a
slight drop in that indicator has been noted
in these countries. In the other European
Relative share of deaths due to basic socially significant
diseases (1985-1994, in %)
Causes
1985
1989
1994
Total number of deaths
100.0
100.0
100.0
Cardiovascular diseases
60.1
61.2
62.2
Neoplasia
13.7
14.4
14.5
Diseases of the respiratory
system
7.7
6.3
4.9
Traumas and intoxications
5.3
5.3
5.2
Diseases of the digestive
system
3.1
3.2
3.2
Others
10.1
9.6
10.0
Table 7.2.
HUMAN DEVELOPMENT REPORT ! BULGARIA 1996
88
countries there is not only an increase, but
in individual cases (the Scandinavian coun-
tries and Switzerland) there is future lon-
gevity by 5-6 years higher than that in Bul-
garia.
The negative trends in the develop-
ment of the death rate and the average fu-
ture longevity observed during the past few
decades, have been exerting a grave im-
pact on the formation of the living and
labour potential of the nation. The causes
of the high death
rate are multifaceted in
their nature. In the period of transition, the
drop in the living standards and the dete-
rioration of nutrition, particularly in low-
income strata has had an adverse effect.
Damage to the environment, as well as the
distancing of the working environment
from the optimum working conditions,
which do not harm mans health also exert
their influence. The social environment is
also adverse, full of a great number of prob-
lems: from unemployment and poor living
conditions to the continuous violation of
mans psychological comfort by situations
of stress, typical of the crisis period. No
positive assessment can be given to the sys-
tem of public health, which has not out-
grown the red tape and suffers from im-
proper provision of the required material
base and medications.
7.2. Migration and emigration
The intensity of the internal migration,
particularly high in the 1956-1965 period
(18 per cent of the average annual popula-
tion), gradually dropped to 2.3 per cent in
1994.
The data point to changes in the basic
flows of migration. From the middle of the
1980s, resettlement from one town to an-
other occupy a leading place in the flows
of migration amounting to 38.9 per cent of
the migrants in 1994. For the first time,
resettlements from town to village ranked
second. This
comes to show that the pro-
cess of leaving the urban centres which
started in the country in the 1970s is al-
ready underway and encompasses 24.3 per
cent of the
migrant population within the
country. The
migration flow from the vil-
lages to the towns, which was basic for the
entire period up to the mid-1970s, already
ranks third, encompassing 23.9 per cent of
the migrant population. The last place is
occupied by the migration flow between
villages (from one village to another),
which included 13% of the migrant popu-
lation over the past decade.
The share of the urban population
from the total number of population in
Bulgaria was comparatively stable up to the
middle of the 1930s. Up untill that time
about one-fifth of the population lived in
towns. During the subsequent censuses
taken, the relative share of the urban popu-
lation steadily grew reaching 67.8 per cent
by the end of 1994.
Since the bulk of Bulgarias popula-
tion lives in towns and cities, its develop-
ment in terms of size is of special interest.
At the end of 1994, the city of Sofia had a
population of 1 164 000 people, showing
an annual negative natural growth of about
3 000 people for that year. But the capital
city has population, which is still, though
insignificantly, growing, owing to the posi-
tive migration balance which is 5,800
people.
From among the big cities with popu-
lation exceeding 100 000 people, the fol-
lowing cities have positive natural growth
and positive migration balance: Plovdiv,
Sliven, Stara Zagora and Bourgas. The cit-
Table 7.3.
Migration flows (in %)
Directions of
periods
migration
1966-1975
1976-1985
1986-1992
1994
Total
100.0
100.0
100.0
100.0
From town to town
30.2
38.3
44.7
38.9
From town to village
9.9
13.3
17.7
24.2
From village to town
42.7
34.3
22.6
23.9
From village to village
17.2
14.1
13.0
13.0