This doctoral thesis examines the trends and patterns of premature mortality in the German Baltic Sea region in past and present. Based on demographic methods, it shows that the crucial determinants have changed over the course of the epidemiologic transition. Nutrition and sanitation were decisive factors in the 19th century, which led to significant variations in infant mortality by social class. Today, the access to adequate health care and risk-relevant behavior play a more important role in the region. In particular, the rural areas in the east still have room for improvement here.