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When the Berlin Wall fell on this day twenty years ago, its effect on health probably wasn’t the on the minds of the inhabitants anywhere in Germany. But for epidemiologists the joining of these two countries provided a natural experiment of how fundamental political change can affect health. And within just a couple of years reunification was already affecting the levels of disease in both the former East Germany (the GDR) and West Germany - and it wasn’t all good news.

Claudia Hammond talks to Ellen Nolte, a public health specialist from the Cambridge think-tank the Rand Group, who since 1990 has tracked patterns of disease and life expectancy in the former east and west Germany.