In the postwar period, the former GDR developed a comprehensive health care system that made steady advances in reducing infant mortality and extending life expectancy for both men and women. Early in the postwar period, life expectancy in some catego
ries was actually longer for East Germans than for West Germans, and infant mortality was lower until 1980. However, starting in the mid-1970s, West Germany began to register longer life expectancies in every age-group, and after 1980 the infant mortality
rate dropped below that of East Germany. In 1988 infant mortality in West Germany was 7.6 per 1,000 live births and 8.1 per 1,000 in East Germany.
The better health and longevity of West Germans probably stemmed from an increased interest in quality of life issues, personal health, and the environment. East Germans, in contrast, suffered the ill effects of the Soviet model of a traditional rust-
belt industrial economy, with minimal concern for workers' safety and health and wanton disregard of the need to protect the environment. Improving environmental conditions and a more health-conscious way of living should gradually reduce remaining health
differences among Germans. In mid-1995 unified Germany had an estimated mortality rate of about eleven per 1,000, and life expectancy was estimated at 76.6 years (73.5 years for males and 79.9 years for females). The major causes of death were the same a
s those of other advanced countries (see Current Health Care Issues and Outlook for the Future, ch. 4).
Population Distribution and Urbanization
Following unification, the Federal Republic encompassed 356,958 square kilometers and was one of the largest countries in Europe. With about 81.3 million people in mid-1995, it ranked second behind Russia in population among the countries of Europe. U
nification actually reduced the Federal Republic's population density, however, because East Germany, which had a large rural area, was more sparsely populated. With an average of 228 persons per square kilometer in late 1993, unified Germany ranked third
in population density among European countries. It ranked behind the Netherlands and Belgium, which had 363 and 329 persons per square kilometer, respectively.
Germany's population density varies greatly. The most densely populated Länder
are Berlin, Hamburg, and Bremen, with densities of 3,898, 2,236, and 1,697 persons per square kilometer, respectively, at the end of 1992 (see table 7, Appendix). The least densely populated are two new Länder
, Mecklenburg-Western Pomerania and Brandenburg, both mostly rural in character. They had population densities of eighty and eighty-six persons per square kilometer, respectively, at the end of 1992. Other Länder
are closer to the national average: the largest Land
, Bavaria, with 167 persons per square kilometer, is mostly rural, but its capital is the large city of Munich; Rhineland-Palatinate, with 196 persons per square kilometer, is also mostly rural but has numerous heavily populated areas along the Rhine; and
Saxony, with 252 persons per square kilometer, also has a number of heavily populated areas.
with the most population, one-fifth of the nation's total, is North Rhine-Westphalia. With a population density of 519 persons per square kilometer at the end of 1992, it is the most heavily settled of all Länder
, with the exception of the three city Länder
of Bremen, Hamburg, and Berlin. North Rhine-Westphalia's density is caused by its many cities; several dozen of these cities have populations above 100,000, including five with populations above 500,000. Many of these cities are located so close together
that they form one of Europe's largest urban agglomerations, the Ruhrstadt (Ruhr City), with a population of about 5 million.
The Federal Republic has few very large cities and many medium-sized ones, a reflection of the centuries when the name Germany
designated a geographical area consisting of many small and medium-sized states, each with its own capital (see table 8, Appendix). Berlin, by far the largest city, with a population of 3.5 million at the end of 1993, is certain to grow in population as
more of the government moves there in the second half of the 1990s and as businesses relocate their headquarters to the new capital. Some estimates predict that Greater Berlin will have a population of 8 million by early in the twenty-first century.
Berlin already dwarfs the only other cities having more than 1 million inhabitants: Hamburg with 1.7 million and Munich with 1.3 million. Ten cities have populations between 500,000 and 1 million, seventeen between 250,000 and 500,000, and fifty-four
between 100,000 and 250,000. In the early 1990s, about one-third of the population lived in cities with 100,000 residents or more, one-third in cities and towns with populations between 50,000 and 100,000, and one-third in villages and small towns.
Other densely populated areas are located in the southwest. They are Greater Stuttgart; the Rhine-Main area with its center of Frankfurt am Main; and the Rhine-Neckar region with its center in Mannheim. The greater Nuremberg and Hanover regions are al
so significant population centers. The new Länder
are thinly settled except for Berlin and the regions of Dresden-Leipzig and Chemnitz-Zwickau.
Urban areas in the east are more densely populated than those in the west because the GDR saw little of the suburbanization seen in West Germany. As a result, there is a greater contrast between urban and rural areas in the new Länder
than in the west. West Germany's suburbanization, however, is not nearly as extensive as that experienced by the United States after the end of World War II. Compared with cities in the United States, German cities are fairly compact, and their inhabitan
ts can quickly reach small villages and farmlands.
Germany's population growth has been slow since the late 1960s. Many regions have shown little or no growth, or have even declined in population. The greatest growth has been in the south, where the populations of Baden-Württemberg and Bavaria each in
creased by well over 1 million between 1970 and 1993. (Each had also grown by over 1 million in the 1960s.) North Rhine-Westphalia, which had grown by 1 million in the 1960s, added another 750,000 to its population between 1970 and 1993, a small increase,
given a total population of nearly 18 million at the end of 1993. Bremen, Hamburg, and the Saarland experienced some population loss between 1970 and 1993. With the exception of united Berlin, all the new Länder
lost population between the fall of the Berlin Wall and the end of 1993. In general, this development reflected long-term trends in East Germany, although the rate of decline has been higher since unification.
Data as of August 1995