Russia, the sick man of Europe

Public Interest, Wntr, 2005 by Nicholas Eberstadt

As it happens, in recent decades variations in alcohol consumption seem to track fairly closely with changes in Russian mortality (and especially with male mortality)--the former being a leading indicator for the latter. Heavy drinking is directly associated with Russia's appallingly high risk of deadly injury--and Russia's binge drinking habits also seems to be closely associated with death through cardiac failure.

At the moment, the expert prognosis for Russian mortality in the years immediately ahead is pessimistic. The U.N. Population Division, for example, estimates the life expectancy for Russian men today to be lower than the average for men from the world's "less developed regions" (such as Africa, Asia, and Latin America)--and though UNPD projections envision improvements for Russia in the coming decades, Russia does not reach the level of the less developed regions until around 2020. The U.S. Census Bureau, for its part, estimates that life expectancy for Russian men over the coming two decades will approximate the levels for their counterparts in Bangladesh and Pakistan--and will remain steadily below the levels anticipated for India.

Yet somber as these readings appear, they may nevertheless prove excessively optimistic. The Census Bureau projections for Russian mortality, for example, have tended to err on the high side: Where the Census Bureau projections in 2002 put Russian male life expectancy for 2002 at 62.3 years, Goskomstat's actual data for that year turned out to be three and a half years lower. And although the UNPD is imagining unexceptional improvements in male health levels over the next two decades--less than four years' increase between 2000-5 and 2020-25--there are reasons to think such a goal highly ambitious under Russia's current circumstances. The problem, simply put, is that today's Russians seem to be less healthy than their parents. Consequently, merely managing to re-attain the survival rates reported by that earlier generation will take some doing. It is an accomplishment that cannot be taken for granted.

Comparing the mortality schedules of successive birth cohorts in Russia places the problem of "negative health momentum" in even clearer perspective. In industrialized Western societies in the postwar era, younger generations have come routinely to enjoy better survival rates than their predecessors. Sometimes these improvements have been truly dramatic. In contemporary Japan, for example, men born in the early 1950s have, over their life course thus far, experienced death rates roughly half as high at any given age as those that were recorded for the cohort born 20 years before them. By contrast, there has been no improvement in survival schedules for rising birth cohorts among the two generations of Russian men born between the late 1920s and the late 1980s. Quite the opposite: Over its life course, each rising cohort of Russian men seems to be charting out a more dismal mortality trajectory than the one traced by its immediate predecessors.