Study objective-To compare the health status and factors influencing the health of populations that had previously lived under diVerent political systems. Design-Cross sectional health and social survey using postal interviews. The relation between self reported health and psychosocial factors (stressful life events, social support, education, health promoting life style and health endangering behaviour) was investigated. To determine EastWest diVerences a logistic regression model including interaction terms was fitted. Setting-East and West Berlin shortly after reunification 1991. Participants-Representative sample of 4430 Berlin residents aged 18 years and over (response rate 63%).Results-Of all respondents, 15.4% rated their health as unsatisfactory. Residents of East Berlin rated their health more frequently as unsatisfactory than residents of West Berlin (Or age adjusted = 1.29, 95%CI 1.08, 1.52), these diVerences occurred predominantly in the over 60 years age group. Logistic regression showed significant independent eVects of stressful life events, social support, education, and health promoting life style on self rated health. The eVects of education and health promoting life style were observed to be more pronounced in the western part of Berlin. Old age and female sex showed a stronger association with unsatisfactory health status in the eastern part of Berlin. Conclusions-For subjects aged over 60 years there was evidence that living in the former East Berlin had an adverse eVect on health compared with West Berlin. The impact of education and a health promoting lifestyle on self rated health seemed to be weaker in a former socialist society compared with that of a Western democracy. This study supports an "additive model" rather than a "buVering model" in explaining the eVects of psychosocial factors on health. (J Epidemiol Community Health 2000;54:575-580)