Russia, the sick man of Europe

Public Interest, Wntr, 2005 by Nicholas Eberstadt

The third, and perhaps most important, obstacle to higher Russian birthrates is that Russian fertility rates are reflective of larger European trends. True, Russia's levels currently list toward the lower end of the European spectrum. Even so, they are actually higher than for some other post-Communist areas whose "transitions" to democracy and free markets look rather more complete--and are scarcely lower than the current levels in a number of the established market democracies of the European Union. Viewed over a longer horizon, Russia's postwar fertility levels and trends look altogether "European." Although the precise timing of Russia's fertility decline is distinct, Russia has nevertheless clearly followed the same general path as Italy, Spain, and Germany.

From a European perspective, in short, Russia's current levels of extremely low fertility would hardly stand out as exceptional. It is thus far from obvious that the further suffusion into Russia of "European" norms and attitudes about family size (to the extent that such attitudes and norms are not already firmly rooted in Russian soil) should serve to buoy childbearing in the Russian Federation. Quite to the contrary. It is equally possible that an embrace of particular aspects of childbearing patterns currently manifest through much of the European Union (EU) could actually depress birth rates in Russia in coming years. Throughout the EU, for example, the median age at marriage for women is the late 20s, while it is still about 22 in Russia; Russia's median female age at first birth, correspondingly, is distinctly lower than in most EU countries (23 vs. 27 to 29). A shift toward these EU patterns of marriage and maternity would have the immediate effect of postponing births, and thus probably lowering annual fertility further.

The grim reaper cometh

If Russia's low fertility rates are cause enough for concern, its mortality rates are scandalously high. Broad segments of the Russian populace have suffered a disastrous long-term retrogression in health conditions.

A marked deterioration of public health in an industrialized society during peacetime is counterintuitive and highly peculiar. At first glance, the very fact that Russia's mortality catastrophe looks so anomalous might seem to suggest that the problem should be intrinsically remediable--if not positively self-correcting. The particulars of Russia's health and mortality woes, however, underscore just how difficult it will be to achieve even modest improvements in the years immediately ahead--and how vulnerable Russia remains to further degradations of public health.

Over the four-plus decades between 1961-62 and 2003, life expectancy at birth in Russia fell by nearly five years for males; it also declined for females, although just slightly, making for an overall drop in life expectancy of nearly three years over this four-decade span. Age-standardized mortality rates cast an even grimmer light on Russia's continuing health crisis: Between the mid 1960s and the start of the twenty-first century, these rates underwent a long and uneven rise, climbing by over 15 percent for women and over 40 percent for men.