Publications

2024

1. PRPR

   Timing and Toll: Europe’s Excess Mortality in the First Three Years of COVID-19

   Ivan Marinković, and Marko Galjak

   Population Research and Policy Review Jun 2024

   Abs DOI

   This study examines excess mortality patterns in 32 European countries during the first three years of the pandemic, offering insights into the pandemic’s toll on each country. Using data from national statistical offices, we calculated monthly excess mortality for 2020–2022. Time series decomposition was employed for trend analysis, followed by clustering countries based on their mortality trends. Then we compared total excess mortality among different clusters. We found that neighboring countries with similar characteristics experienced comparable levels of excess mortality, regardless of the differences in their pandemic trajectories identified by cluster analysis. Other factors, such as healthcare infrastructure and pre-existing health risks, appear to have had a more significant impact on total excess mortality, with various pre-existing regional factors playing significant roles in shaping the pandemic’s final toll. While the timing of peak excess mortality may have been a factor, it was not the primary driver of the overall toll. This study highlights the critical need for comprehensive public health strategies that focus on reinforcing healthcare infrastructure and mitigating pre-existing health risks, essential for effective pandemic preparedness and response. These findings suggest the need for reevaluating current approaches and exploring alternative strategies for managing future health emergencies.

2. SPRINGER

   Serbia: Policy Response to Demographic Challenges

   Mirjana Rašević, and Marko Galjak

   Jun 2024

   Abs DOI

   Serbia, with its already aged population, is facing demographic challenges that are projected to result in even older population in the following 30 years. The main reasons of this frightening outlook are low fertility rates, emigration, and premature mortality. This chapter provides an in-depth overview of political response to these challenges. The chapter emphasizes the need for a comprehensive approach to addressing these issues, focusing on socioeconomic development, investment in health, education, and environmental programs, as well as closing the gender gap. It discusses the role of active aging, the importance of recognizing and addressing the needs of particularly vulnerable elderly individuals, and the necessity of implementing effective measures to promote childbirth. It also explores the potential benefits of managing migration as a tool for socioeconomic development and addressing premature mortality through primary and secondary prevention programs. The existing policy response to low fertility in Serbia, which involves offering direct cash benefits to encourage births, has been ineffective and comes with opportunity costs. Instead, the authors propose investing in the healthcare system as a more effective use of resources, given the substantial economic cost of premature mortality. Policy response especially in the near term should be on stopping the crippling emigration from Serbia. Authors suggest that better data collection, especially on emigration, would allow for more substantial research and enable evidence-based decision-making in future, ultimately leading to more targeted measures to address demographic challenges in Serbia.

3. Energy Policy

   Public perceptions of fossil and alternative energy in Serbia: Between NIMBYism and nationalism

   Marko Galjak, and Marina Budić

   Energy Policy Jul 2024

   Abs DOI

   Understanding public perceptions of energy sources is essential for successful policy formulation. Our study explores the Serbian public’s attitudes toward different types of energy, taking into account NIMBY (“Not In My Back Yard") sentiments, nationalist orientation, and pro-Russian attitudes. A correlational cross-sectional design utilized an online survey disseminated via social media platforms. The study examined public preferences for various energy types and their correlations with nationalist and pro-Russian tendencies. Poststratification weighting was applied to address sample representativeness. Our research revealed the public’s preference for renewable energy, particularly solar and wind. Surprisingly, nationalist views did not significantly align with fossil fuel preferences, differentiating Serbia from Western European trends. Geopolitical considerations, such as Serbia’s relationship with Russia, did not strongly influence public opinion. These findings underscore the importance of considering public preferences in shaping Serbia’s energy policy, emphasizing the need for investment in renewables. Based on the results we offer concrete policy recommendations. This study offers a methodological approach adaptable to other countries undergoing similar energy transition.

2023

1. AE

   Discrepancies Between Preliminary and Final COVID-19 Mortality Data – the Case of Serbia

   Marko Galjak, and Ivan Marinković

   Annals of Epidemiology Jul 2024

   Abs DOI

   Since the start of the COVID-19 pandemic, countries have scrambled to set up data collection and dissemination pipelines. These data end up in various online datasets. While it has been evident from the beginning that these preliminary data produced by some countries are not very reliable, the mortality data from Serbia seemed particularly problematic. These data are included in all major COVID-19 databases and utilized for research purposes worldwide. Discrepancies were identified between the preliminary mortality data reported through the emergency necessitated system and the final mortality data generated by the regular vital statistics pipeline. The number of deaths due to COVID-19 in Serbia, as reported preliminarily, does not align with the final death toll, which is more than three times higher. To evaluate the impact of the problematic data on research, we identified databases that include these data and reviewed the articles that utilized them. Our literature review identified at least 86 studies that were impacted by these problematic data. We strongly advise researchers to disregard the preliminary COVID-19 mortality data from Serbia. If all-cause mortality data is available, any preliminary data should be validated using excess mortality.

2. EJPH

   Assessing the availability and quality of COVID-19 mortality data in Europe: a comparative analysis

   Ivan Marinković, Ana Tramošljanin, and Marko Galjak

   European Journal of Public Health Jul 2024

   Abs DOI

   Researching mortality during the COVID-19 pandemic has been challenging due to methodological inconsistencies and the limited availability of vital statistics data. At the beginning of the pandemic, the World Health Organization recommended daily data publication to inform policy response, but these data were often poor. Final data on COVID-19 deaths in many countries are not yet available, especially for 2021. This report shows that many countries have significant inconsistencies between the preliminary number of deaths and what vital statistics and excess mortality indicate. The inconsistencies in the mortality data raise concerns about the reliability of analyses and public health recommendations.

3. DEM

   Assessing premature mortality in Serbia: Insights from the Median Age of Years of Life Lost

   Marko Galjak

   Demografija Jul 2023

   Abs DOI

   Premature mortality, defined as death occurring before a predetermined chronological age, is a significant public health challenge in Serbia, compounded by an aging population, high rates of non-communicable diseases, and healthcare system challenges. This study introduces a novel indicator, the Median Age of Years of Life Lost (MeAYPLL), to assess the age distribution of premature mortality in Serbia and selected European Union (EU) countries during the pre-pandemic period (2000-2019). The findings reveal that Serbia is among the European countries with the highest rates of premature mortality, similar to other former socialist countries. However, the age distribution of premature deaths varies considerably across countries, influenced by factors such as the cause of death and population age structure. The results show that Serbia, in the period between 2017 and 2019, lost 539,591.3 years of potential life annually with Serbian MeAYPLL being 57.62 years in this period. The study underscores the importance of considering multiple dimensions of premature mortality, including its intensity, age structure, and geographical variations, for designing effective public health interventions. It also highlights the limitations of the MeAYPLL indicator, recommending its use in conjunction with other measures of premature mortality intensity for a comprehensive assessment.

2022

1. SPRINGER

   Demographic Challenges in Serbia

   Mirjana Rašević, and Marko Galjak

   Jul 2022

   Abs DOI

   The present chapter focuses on fertility and mortality problems as the two big demographic challenges facing Serbia. The trend of the average number of live births to women who were past the reproductive age in 2011, considered by age cohorts, indicates an early below-replacement fertility and a long period in which the number of live births per woman was stable at the value of 1.8. Although younger cohorts have yet to age beyond their reproductive years, markedly lower average number of live births by women aged between 36 and 40 compared to women aged 41 and over in 2011 will probably deepen due to completed fertility declining below the 1.8 mark. At the same time, Serbia is struggling with high premature mortality. Premature deaths of middle-aged people, but also younger, reproductively capable people, have effect on the economy, childbearing, and depopulation. In Serbia, men are dying more prematurely than women. About half of all deaths of men younger than 75 in 2015 could have been avoided by either prevention or adequate and timely healthcare. Big urban centres are much better off in this regard, unlike more remote regions which often lack good healthcare services.

2021

1. TEME

   Effects of the COVID-19 Pandemic on Mortality in Serbia in 2020

   Ivan Marinković, and Marko Galjak

   TEME Jul 2021

   Abs DOI

   The coronavirus SARS-CoV-2 causes the systemic disease COVID-19, which killed more people in a few months than all infectious diseases together in this century. COVID-19 was one of the leading causes of death in 2020 in many countries (according to the preliminary data).By applying the demographic method to final mortality data for 2020, we can give an overview of the situation in Serbia through population mortality indicators.The effect of COVID-19 on mortality in Serbia in 2020 was higher than anticipated. The surplus of mortality that occurred in 2020 (compared to the three-year average of 2017-2019) is 14,657, an increase in mortality of about 14%. Deaths from COVID-19, according to vital statistics, make up 71% of excess mortality. This increase is also reflected in life expectancy at birth which dropped by 1.55 years. The male population observed higher mortality rates from COVID-19 and a more significant life expectancy drop. Around 4% of those who died from COVID-19 are younger than 50. A person who is 85 or older was almost 100 times more likely to die from the consequences of COVID-19 than a person who is 34 or younger. COVID-19 was the second leading cause of death in Serbia in 2020. One of the few positive things about this pandemic is that violent deaths plummeted.

2. DEM

   The Effects of COVID-19 Pandemic on the Premature Mortality in Serbia in 2020

   Marko Galjak

   Demografija Nov 2021

   Abs DOI

   Serbia is experiencing a massive number of deaths due to COVID-19. One way to express this mortality is by measuring the years of potential life lost to this disease. This paper looks at the cost of the pandemic in 2020 to premature deaths in Serbia. The final data on mortality in 2020 in Serbia provided by the Statistical Office of the Republic of Serbia is used to measure this loss. Premature mortality is examined through geographical, age, and sex dimensions. In total, 64.620 years of potential life were lost directly by COVID-19, i.e., 1019.14 years of potential life per 100 000 people younger than 75. Men lost 2.5 as many potential years of life than women did. Moreover, the region of eastern and Southern Serbia fared much worse than any other region. There is no clear pattern regarding the rural/urban divide, as some of the hardest-hit municipalities were rural and urban. The analysis was expanded to include the estimate of the economic cost of premature mortality due to the COVID-19. In 2020 more than \0.34 billion was lost to premature deaths, and by the end of 2021, this number will likely be well over \1 billion when the pandemic ends. The direct cost of premature deaths on future birth rates will not be pronounced as very few women younger than 50 died to affect future birth rates significantly.

3. BMC Med Ethics

   What drives public attitudes towards moral bioenhancement and why it matters: an exploratory study

   Marina Budić, Marko Galjak, and Vojin Rakić

   BMC Medical Ethics Dec 2021

   Abs DOI

   The paper represents an empirical study of public attitudes towards moral bioenhancement. Moral bioenhancement implies the improvement of moral dispositions, i.e. an increase in the moral value of the actions or character of a moral agent. The views of bioethicists and scientists on this topic are present in the ongoing debate, but not the view of the public in general. In order to bridge the gap between the philosophical debate and the view of the public, we have examined attitudes towards moral bioenhancement. The participants were people from Serbia older than 15, who voluntarily completed an online questionnaire. The questionnaire consisted of a brief introduction to moral bioenhancement, seven general questions, 25 statements about participants’ attitudes towards moral bioenhancement, and five examples of moral dilemmas. The questionnaire also included questions which were used to reveal their preference of either deontology, or utilitarianism. Participants were asked to what degree they agree or disagree with the statements. The results showed that the means used to achieve moral enhancement, the level of education, and preference for deontology or utilitarianism do have an impact on public attitudes. Using exploratory factor analysis, we isolated four factors that appear to drive the respondents’ attitudes toward moral bioenhancement, we named: general—closeness, fear of change, security, and voluntariness. Each factor in relationship to other variables offers new insights that can inform policies and give us a deeper understanding of the public attitudes. We argue that looking into different facets of attitudes towards moral bioenhancement improves the debate, and expands it.

4. STNV

   Excess mortality in Europe and Serbia during the COVID-19 pandemic in 2020

   Ivan Marinković, and Marko Galjak

   Stanovništvo Jun 2021

   Abs DOI

   The 2020 pandemic came at a huge demographic cost, particularly regarding the increase in mortality. In this paper we examine excess deaths in Serbia and 34 other European countries in 2020. Methodological inconsistencies and big differences in how COVID-19 deaths were recorded across different countries make it difficult to make any cross-country comparisons, even with the scope limited only to Europe. Since the number of total deaths is a methodologically solid indicator, we looked at the differences between the total number of deaths in 2020 and compared that to deaths in 2019. The lowest increase in mortality – below 5% – occurred in countries in the north of Europe (Norway, Denmark, Finland, Latvia), while the highest increase – over 18% – was recorded in the southern and central parts of the continent (Albania, Northern Macedonia, Spain, Belgium, Poland, Slovenia, Russia). There is no clear geographical regularity. In 2020, Serbia had 12.6% more deaths compared to 2019, which was close to the European average. Within Serbia, statistical differences between regions were not large. Measuring the contribution of COVID-19 deaths to excess mortality is much more problematic. The excess death ratio is more helpful for understanding methodological and data-gathering issues than finding evidence about composition and divergence in mortality. According to this indicator (based on preliminary data), only 25% of excess deaths in Serbia in 2020 were caused by COVID-19, while the European average was 54%. However, in many (primarily Eastern European) countries in 2020, the indirect consequences of COVID-19 on the health of the population were more significant than the direct ones. It is precisely the ratio of COVID-19 diagnoses that led to death in total mortality that shows this. The final results may confirm this statement or indicate potential data manipulation. While this paper focuses only on the year 2020, as of Q1 of 2021, the pandemic is not nearing its end. Based on preliminary data published daily, Serbia had more COVID-19 deaths in the first four months of 2021 than for the whole of 2020. This indicates that the consequences of the pandemic for Serbia will be dire in 2021, regardless of the course the pandemic takes.

2020

1. ERNOP

   Philanthropy in the Western Balkans: A Network Analysis Report on Giving in the Region

   Marko Galjak

   In Philanthropy in the Spotlight? Resources, Reputation and Achievements Jun 2020

   Abs DOI

   Cross-country philanthropy research is problematic because of cultural, economic and political differences. The paper proposes an alternative approach of cross-country comparison by looking at the networks formed by donors and beneficiaries. Data on giving from local sources in Serbia, Croatia, Bosnia and Herzegovina, Albania, Macedonia, Kosovo and Montenegro gathered from media sources in the period between 2015 and 2019 was used to construct philanthropy networks. The analysis revealed unique features of each country’s philanthropy ecosystem: Croatia’s network is centralized and Serbia’s distributed. Montenegro’s network seems to be the most stable, while Albania’s network is the most unstable and Kosovo’s the most fractured. Network analysis can provide a unique macro perspective on a philanthropy landscape but also provide us with the micro-level knowledge, helping us ascertain positions of specific actors in the network. Growing data availability means that we could employ similar analysis more widely in the future.

2018

1. STNV

   East-west demographic divide in the EU: A regional overview

   Marko Galjak

   Stanovnistvo Jun 2018

   Abs DOI

   The goal was to examine demographic differences between former communist regions and other regions of the EU. Besides providing a regional overview of EU’s demographic differences, we question whether the subnational approach offers any new insights into the East-West divide. This cross-sectional study was conducted on 1,155 EU’s NUTS3 regions from 2014. These regions are grouped in two groups: regions that were part of a communist country, and other regions. Mortality, fertility and age structure indicators were tested between the two groups of regions. GDP/c was used to control for differences in economic development by segmenting the regions into tree brackets: low, medium, and high. The differences were then tested for each indicator. Regional variation within countries for each indicator was also assessed. The gaps exist at regional level and are the widest with mortality and fertility schedule, regardless of GDP/c. Former communist regions on average tend to be slightly younger. Analysis of regional variation showed that subnational approach was warranted when studying East-West demographic disparities, especially when it comes to fertility schedule.

2. ZMSDN

   Fight against the early mortality in Serbia: Finland as an example of good practice

   Marko Galjak

   Zbornik Matice srpske za drustvene nauke Jun 2018

   Abs DOI

   Serbia is faced with many demographic challenges, and one of them is a relatively high mortality, especially the avoidable mortality. The clearest example of successful interventions to lower the mortality is the one which took place in a province of Finland called North Karelia between 1972 and 1977. A big campaign, with goal to lower the cardiovascular disease risk factors, mobilized not only the healthcare system, but also different multiple agents such as: schools, supermarkets, agriculture, civil society organizations, etc. Campaign proved to be very successful and was quickly expanded to include the entire country. The mortality by ischemic heart disease of those younger than 65 years in North Karelia was lowered by 73% between 1972 and 1995. Which parallels can be drawn from the mortality situations of Serbia today and Finland then? This paper identifies the causes of death that can be avoided where mortality rates are still very high in Serbia and identifies possible directions of measures geared toward lowering mortality.

2016

1. JGI JC SASA

   Ageing map of the Balkan Peninsula

   Ivana Magdalenic, and Marko Galjak

   Journal of the Geographical Institute Jovan Cvijic, SASA Jun 2016

   Abs DOI

   Age structure of a population, representing the final result of all the demographic processes, tells a unique story which incorporates not only the main demographic components, but also its history, cultural and political characteristics of the population. Through its history the Balkan Peninsula has been alluring to all kinds of demographic research. The process of aging, which is intensifying in all developed countries, will increasingly be the main focus of future demographic research. Although there is undeniable general shift in the age structure, there are many regional differences in the Balkan Peninsula. Thus, for the purpose of this paper we created a choropleth map of the Balkans showing the age structure at NUTS 3 regional level. For the purposes of this paper borders of the Balkan Peninsula are defined by Jovan Cvijić in his homonymous work. Toward a more complete understanding of the ageing phenomena in the Balkans we conducted an analysis of regionalization of ageing, to serve as a backbone for the analysis of age structure at the national level. We compare ageing borders with ethnic, religious and political borders in the peninsula.

2014

1. DEM

   Amenable Mortality in Serbia and European Union – Comparative Analysis

   Marko Galjak

   Demografija Jun 2014

   Abs

   State of mortality differs across members of the European Union. That state of mortality can be represented using a couple of different measures. The most widely used measures for comparing mortality across countries are standardized mortality rate and life expectancy. The state of mortality across the EU and Serbia is compared using standardized amenable mortality rate. The results show that Serbia and the other excommunist countries have higher amenable mortality rate that the other countries in EU. Correlation between amenable mortality rate and health expenditure has also been established. Countries that spend more than \2000 per capita on healthcare get diminishing returns. The ex-communist countries spend less than \2000 on healthcare per capita, with the exception of Slovenia. Serbia spends about \550 per capita for healthcare, and with its current annual GDP growth it would take more than 50 years for Serbia to get to the \2000 threshold.