The formerly socialist countries of Eastern Europe and the former Soviet Union have
experienced a remarkable demographic transformation in the past twenty years. On
many dimensions of fertility and family formation, much of the region now looks like
Western Europe—below-replacement fertility rates, rising age at first marriage and first
birth, and high and increasing out-of-wedlock birthrates, characterize many countries
formerly distinguished by replacement-level fertility and early, near-universal marriage
and childbearing. The other facet of this demographic transformation is nearly
unprecedented changes in adult mortality rates. An upsurge of cardiovascular and
external cause mortality caused a massive premature loss of life among working-age
men in the former Soviet Union in the 1990s. In contrast, cardiovascular mortality has
fallen at a rapid rate across Eastern Europe since 1989. This study discusses the
dimensions and most likely causes of these demographic changes and assesses the
possible consequences of the changing fertility and mortality patterns. Much remains
unknown about the underlying reasons for the demographic transformation of the
region; directions for future research in this area are discussed.