Due to the division of Germany during the Cold War, former East and West Germany have provided demographers with a ‘natural experiment’, especially when studying mortality. Research by Michael Mühlichen used this idea to carry out a study on how mortality rates have developed in two German states, Mecklenburg-Vorpommern (former East Germany) and Schleswig-Holstein (former West Germany), since reunification with specific focus on premature mortality. Using official population and cause-of death statistics for Germany, Mühlichen found that premature mortality has decreased rapidly since reunification, especially in the east. This decline is closely connected with a decrease in causes of death that can be considered avoidable. However, certain differences among the observed groups persisted: The rural areas in the east still showed higher rates of avoidable mortality than in the west, particularly among men. Conversely, the urban areas of both states have converged, with eastern German women even showing the lowest rates of avoidable mortality. This means that the long-standing east-west divide has become limited to the rural areas and is more connected with men than women. Therefore, this research highlights the need for improved accessibility and quality of medical care in rural areas in eastern Germany, as well as a need for effective health policies that focus on primary prevention (e.g. smoking and alcohol abuse). This could help reduce avoidable mortality, specifically among men in the (rural) east, but also among women in the (urban) west.