Growing Old The Hard Way: China, Russia, India

Policy Review, Apr/May 2006 by Eberstadt, Nicholas

To get a sense of just how bad health and mortality conditions are for Russian adults nowadays, we can compare survival rates for Swiss men with their Russian counterparts for 1999, thanks to information compiled by the Human Mortality Database13 (see Figure 3). In Switzerland, a zo-year-old man had a five-out-of-six chance of making it to 6 5 years of age; in Russia, he stood less than even odds. (In 1999, by the way, Russian adult survival schedules were somewhat better than they are today.)

If Russia's adult mortality levels are so "unnaturally" high today, won't more "natural" levels more or less automatically reassert themselves in the coming decades? The dismaying answer is: not necessarily, for in Russia's demography the "abnormal" seems to have become the new norm. Unlike other parts of the industrialized world, Russia's health trends are characterized by a heavy measure of what we might call negative momentum: that is to say, an unfavorable accumulation of immunological insults and health risks in today's adult population by comparison with their parents' generation. To the extent that death rates provide evidence about general health conditions, modern Russia's mortality data strongly suggest that each new cohort is more fragile than its predecessor.

In other industrialized Western societies in the postwar era, younger generations have routinely come to enjoy better survival rates than their predecessors: In contemporary Japan, for example, men born in 1950 have, over their adult life course thus far, experienced age-specific death rates 30 percent to 80 percent lower than those recorded for the cohort born 2.0 years before them.

By contrast: In Russia today (to invert the popular "boomer" mantra) "30 is the new 40." That is to say, there has been no improvement in survival schedules among the two generations of Russian men born between the late 19 zos and 1970. Quite the contrary: Over the life course, each rising cohort of Russian men seems to be charting out a slightly more dismal mortality trajectory than the one traced by its immediate predecessors. (The same sorts of patterns, incidentally, are evident among Russian females.)

This negative momentum makes the objective of major, sustained improvements in public health especially problematic. Partly for this reason, demographers generally have low expectations for health progress in Russia over the years immediately ahead. The U.S. Census Bureau, for example, imagines the male life expectancy in Russia will steadily lag below India's, Pakistan's, and even Bangladesh's through 2025.14

Russia's lingering health and mortality crisis promises to be an anchor against rapid economic development, frustrating the effort to move Russia onto a path of swift and sustained material advance. It is difficult to see how Russia can expect, in some imagined future, to achieve an Irish standard of living if its labor force still faces an Indian schedule of survival - or worse. Widespread debilitation and premature mortality among working age cohorts depresses economic potential directly and immediately - but also has adverse and far-reaching effects on longer-term productivity. The expectation of a seriously foreshortened working life alters the cost-benefit calculus for higher education and technical training, lowering investment in human capital. And since Russian working-age adults "present" as far older than Western counterparts of the same calendar birth-year,15 the scope for "economically active aging" - for enhancing the labor force participation rates and economic contributions of persons in middle age and beyond will be far more constrained for Russia than for OECD Europe.