Tom Walker questions Professor Stephen Cohen's assertion that "male life
expectancy has plunged to 57 years . . ." This again sent me back to my
Russian notes from 1995. They contain the following based on notes taken
during a lecture by Vladimir I. Markov (Ph.D., economics), Deputy Director,
Russian Academy of Sciences, Institute for Socio-economic Studies of
Population.
"Health: All of the foregoing has had enormous health consequences. Ten
years ago, there was a general similarity between US and USSR health
indicators. Under the Soviet system, the health delivery system was good,
but it has now been destroyed. A health insurance system was to have been
developed, but bureaucratic/ political ignorance screwed this up. People do
not trust what is left of the public health system. A private one is under
development, but the costs are astronomical. Several generations will be
affected by the breakdown of the health and education systems (same for
education).
The past five years have seen increasingly negative trends in Russia.
Population has declined since 1991; it fell by 700,000 in 1994. The birth
rate has fallen from 16 to 9 per 1,000 while death rate has risen from 8 to
16 per 1,000. However, different factors account for the birth and death
rates.
- Birth: This is essentially a demographic decline - there was a relatively
high rate when baby boomers dominated the population and the rate was bound
to fall as the Russian counterpart of North American baby boomers moved
through. It was predicted as early as 1980 that the birth rate would fall.
However, economic and social factors are also involved. People simply
cannot afford to have as many children, and young single mothers do not want
to take on the burden of supporting children (20% of the children now born
are illegitimate).
- Death: Here the rate is rising due to generally negative conditions of
life and factors such as alcohol and drugs. In 1985, annual alcohol
consumption per capita was 8 decalitres; now it is 15 decalitres. The
reform program attempted by Gorbechev during the Perestroika period simply
did not work. As the story goes, instead of spending the lunch hour
drinking vodka, Russian workers spent the whole afternoon looking for vodka.
There are an officially estimated 5 million alcoholics in Russia, or nearly
4% of the population. Use of drugs is spreading rapidly, particularly
cocaine among the "New Russians". Mortality data for men show that
one-third die at working age, and that alcohol, drugs and criminality are
factors. The death rate for men of working age is believed to be the
highest in the world. The very large increase in unnatural deaths was
compared by Markov to the mortality of the Vietnam war - every year now
these are as large in Russia as Americans fatalities in the whole of the
war! The leading causes of death in Russia, in order, are heart disease,
unnatural deaths and cancer."
There is a footnote attached to the last paragraph, above. It reads:
"A recent report indicates that the breakdown of Russia's health care system
has resulted in an unprecedented rise in mortality rates and a fall in life
expectancy, Labor Ministry department head Aleksandr Tkachenko told
ITAR-TASS on 22 August. Tkachenko said the average life expectancy for men
is now 57.3 years and for women, 71.1years. He added that infant mortality
is twice as high as in the U.S. and maternal mortality five to 10 times as
high as in developed countries. Tkachenko attributed the rise in infectious
diseases in Russia to the collapse of the epidemiological system, an
increase in the number of refugees from other CIS countries and elsewhere,
increased contamination of the water supply, a shortage of medicine, and the
fall in the standard of living of much of the population." (Penny Morvant,
OMRI, Inc., August 23, 1995)
It should be noted that the footnote appears to confirm the life-expectancy
figure used by Prof. Cohen. However, Tom's point about the accuracy and
meaningfulness of the figure remains valid.
Ed Weick
