SPECIAL REGIONAL CONSIDERATIONS - BULGARIA
GENERAL HEALTH ISSUES OF THE POPULATION 6, 7
Bulgaria is ranked as a moderately urbanized European country, with 70% of the population living in urban areas. In 2005 the population was 7.7 million, of whom 51.6% were women. In 2001 Bulgarians accounted for 83.9% of the total population, Turks 9.4%, Roma 4.7% and others 2%. Bulgaria's population is aging. The share of the population below 15 years of age decreased and accounted for 13.8% of the total population in 2005, whereas the share of those over 65 increased to 16.8% of the total population. As in many central and eastern European countries, in Bulgaria the aging of the population is more significant for rural areas, where 25% of the population in 2005 was aged over 65 and the average age for the rural population was 41.2 years old.
Bulgaria is now undergoing one of the most severe peacetime population declines in history. Since 1997 Bulgaria has registered the world's lowest level of fertility: its total fertility rate plummeted from an average of 2.2 births in 1975- 1980 to an average of just 1.09 births in 1997-2004. Birth rates have been dropping steadily since 1990, and Bulgaria has one of the lowest crude birth rates in Europe. The birth rate in 2003 was 8.02 per 1,000 population in 2003 compared to 16.0 per 1,000 in 1970 and 14.5 per 1,000 in 1980. In addition to low birth and high mortality rates, the population is decreasing owing to migration. This includes migration of the ethnic Turkish community as well as the fact that many young people are leaving the country to seek better opportunities for education and jobs abroad.
6 Georgieva L, Salchev P, Dimitrova S, Dimova A, Avdeeva O. Bulgaria: Health system review. Health Systems in Transition, 2007; 9(1): 1-156.
7 UNICEF, Bulgaria background, http://www.unicef.org/infobycountry/bulgaria_background.html