or females. This was a 35-percent increase
over pre-World War II figures. Although Bulgarians have had a reputation
for longevity, which has been attributed to their diet, a high infant
mortality rate and a high incidence of morbidity had combined until the
mid-1950s to keep the life expectancy relatively low. Those who survived
to middle age tended to become octogenarians or older; but they were in
a minority. Proportionately, however, there were more older people in
Bulgaria than in most other countries in the world.

The increase in life expectancy since World War II has been brought
about by a drop in the death rate from 12.2 per 1,000 in 1939 to seven
per 1,000 in 1970 for the urban population and from 13.7 per 1,000 in
1939 to 11.4 per 1,000 in 1970 for the rural population. During the same
period, infant mortality dropped from 139 per 1,000 live births to
twenty-seven per 1,000 live births. In the late 1960s the incidence of
infant mortality was 39 percent higher among rural infants than among
urban ones. More than one-half of the deaths of children under one year
of age were the result of pneumonia. The second major cause of infant
mortality was birth trauma, despite the fact that 98 percent of the
births took place in a public health facility under medical supervision.

The three major causes of death in 1970 were diseases of the heart and
circulatory system, which accounted for 252 per 1,000 deaths;
cerebrovascular diseases, which accounted for 206 per 1,000 deaths; and
cancer, which accounted for 146 per 1,000 deaths. A program of
systematic treatment and prevention of infectious diseases, which were
once widespread, has either brought them under control or eradicated
them completely. The law requires that all cases of contagious diseases
be registered with the public health service. In 1971 the greatest
incidence was reported for influenza, mumps, chicken pox, dysentery,
infectious hepatitis, and measles.

The Public Health Service

The public health service, modeled after that of the Soviet Union, is
based on the premise that the state has the responsibility to provide
free health care for the population and that such care should be uniform
and readily available. The health service is financed by the state,
supervised by the Ministry of Public Health, and administered by the
public health departments of the district people's councils. Free health
care is available to all citizens; medicine required for