HEALTH IN RUSSIA
The average lifespan before World War II was 44 years. Today people live much longer than that but more than 26 percent of the population is obese and on average men die about 12 years earlier than women.
Life expectancy at birth: total population: 70.47 years; male: 64.7 years; female: 76.57 years (2015 est.); country comparison to the world: 152. Death rate: 13.69 deaths/1,000 population (2015 est.); country comparison to the world: 10. Infant mortality rate: total: 6.97 deaths/1,000 live births; male: 7.81 deaths/1,000 live births; female: 6.07 deaths/1,000 live births (2015 est.); country comparison to the world: 160. Obesity - adult prevalence rate: 26.2 percent (2014); country comparison to the world: 46. [Source: CIA World Factbook =]
In the mid 2000s, the life expectancy was 60.5 years for men, 74.1 for women—one of the largest life expectancy differentials by sex in the world. Some 53.7 percent of the population was female. The birthrate was 9.9 per 1,000 population; the death rate was 14.7 per 1,000 population. Infant mortality was 15.1 per 1,000 live births, and the average number of children born per woman of childbearing age was 1.3. [Source: Library of Congress, October 2006 **]
The poor quality of air and water in many areas and the prevalence of heavy smoking and alcohol use (especially among men) exacerbate the overall poor health of the nation. Preventive health care is a low priority. The medical conditions most frequently causing death are cardiovascular disease (the cause of more than half of deaths), cancer, respiratory diseases, and diabetes. In the early 2000s, declining health care and housing standards led to increases in communicable diseases such as tuberculosis, diphtheria, and cholera. Among children, poor nutrition has increased the incidence of anemia, stomach ulcers, endocrine disorders, and iodine deficiency. The mortality rate for traffic accidents is nearly twice the rate in Western Europe, and in 2005 some 36,000 people died from alcohol abuse. **
Health conditions in Russia declined in the 1990s. In addition, the prolonged economic downturn of the early and mid-1990s, in which an estimated 31 percent of the population (46.5 million people) had incomes below the poverty level, has increased the incidence of malnutrition, which in turn lowers resistance to common ailments. Only individuals who have their own gardens are assured a regular supply of fruits and vegetables. Even under the Soviet system, the average Russian's diet was classified as deficient, so the population now shows the cumulative effects of earlier living conditions as well as current limitations. Poor economic prospects, together with low confidence in the state's family benefits programs, discourage Russians from planning families; the least positive "reproductive attitudes" have been found in the Urals and in northeastern Siberia. [Source: Library of Congress, July 1996 *]
Responding to Russia’s health crisis, in 2005 President Putin included health care in a list of five top national priorities and called for an increase of 85 percent in health-related allocations in the 2006 federal budget and additional increases in future budgets. Most of the 2006 money was to pay for increased wages for health professionals and facilities improvements.
Books and Articles: The “Environmental and Health Atlas of Russia,” edited by Murray Feshbach, provides useful details on the health crisis and its causes. A series of articles by Penny Morvant, published in the Open Media Research Institute's biweekly Transition in 1995, are concise studies of poverty, the role of women, and the health crisis in Russia.
High Mortality Rates in Russia
The social and economic crises that gripped Russia in the early 1990s are reflected in increased mortality and declining life expectancy, especially among able-bodied males. Contributing to Russia's long-term population decline is a projected mortality rate increase from 11.3 per 1,000 population in 1985 to 15.9 per 1,000 in 2005. Russia's mortality rate reached its lowest level, 10.4 per 1,000 population, in 1986 (for which a state anti-alcohol campaign received substantial credit); then the figure rose steadily in the ensuing decade. The largest jump was from 12.2 to .6 per 1,000 between 1992 and 1993; after having reached 15.7 per 1,000 in 1995, the rate was projected to remain virtually flat over the next decade.[Source: Library of Congress, July 1996 *]
According to 1994 statistics, the life expectancy for Russian males had reached 57.3 years and for females 71.1 years. These are the lowest figures and the largest disparity by sex for any country reporting to the World Health Organization, and they are a sharp decline from the 1987 levels of 64.9 years for males and 74.6 years for females. In 1990 the Russian Republic ranked only seventh in this statistic among the fifteen republics of the Soviet Union. The lag in the average life expectancy of males was attributed to alcohol and tobacco abuse; to unsafe conditions at work, on the road, and in the home; and to declining heath care. [Source: Library of Congress, July 1996 *]
The chief natural cause of death is diseases of the circulatory system, which accounted for 769 deaths per 100,000 population in 1993. The next causes in order of frequency are cancer and respiratory diseases. Among people of working age, 41 percent of deaths are attributable to unnatural causes; the proportion of such deaths was highest in Leningrad Oblast, the Permyak Autonomous Region, the Republic of Tyva, and the Evenk Autonomous Region. The number of alcohol-related deaths also climbed in the mid-1990s; the 1994 figure was 25 percent higher than the 1993 total. In some regions, alcoholism has assumed epidemic proportions; in the Bikin Rayon of Khabarovsk Territory on the Pacific coast, nearly half the deaths between 1991 and 1995 were alcohol related. *
The overall aging of the population also is an important factor in the higher mortality rate. Between 1959 and 1989, the percentage of retirees in the population and the percentage of Russians eighty or older nearly doubled, although declining life expectancy already was reducing the impact of that trend in the mid-1990s. *
Since 1987 mortality from accidents, injuries, and poisonings has risen significantly, from 101 to 228 per 100,000 population. Contributing to that figure are an estimated 8,000 fatal workplace accidents per year, largely the result of aging equipment, the proliferation of risky jobs in the unofficial "shadow economy," and the deterioration of work discipline. For the period between 1990 and 1994, the suicide rate rose by 57 percent to a total of nearly 62,000, putting Russia in third place among eighty-four developed countries. The stress of the transition period is one explanation for this rising statistic. The homicide rate rose by more than 50 percent in the same period. In 1994 Russia's 35,000 motor vehicle deaths nearly equaled the 40,000 in the United States, although Russia has less than 1 percent as many automobiles. Deteriorating roads and declining police discipline are the main causes of that fatality statistic.
Poor Health Conditions in Russia
The decline in health is attributable in part to such environmental and social factors as air and water pollution, contamination (largely from nuclear accidents or improper disposal of radioactive materials), overcrowded living conditions, inadequate nutrition, alcoholism, and smoking, and in part to a lack of modern medical equipment and technology. In 1991 life expectancy in Russia was 74.3 years for females and 63.5 years for males. By 1994 the figure for males was 57.3 years. The male-to-female ratio in the population reflects the higher male mortality rate and the enduring impact of losing millions more males than females in World War II. (In all age-groups below thirty-five, there are more males than females.) [Source: Library of Congress, July 1996 *]
By the mid-1990s, Russia's death rate had reached its highest peacetime level in the twentieth century. Curable infectious diseases such as diphtheria and measles have reached epidemic levels unseen since the Bolshevik Revolution, and the rates of tuberculosis, cancer, and heart disease are the highest of any industrialized country. *
Between 1980 and 1989, cancer and its complications increased from 15 percent to 18 percent among causes of death. In 1990 the most common types of cancer were breast cancer, cancer of the stomach and liver, and skin cancer. In the last years of the Soviet Union, about 680,000 new cases were diagnosed annually. The causes of cancer are varied and complex, but contributing factors in Russia are heavy smoking, radiation exposure, and contact with pervasive toxic emissions and chemicals in soil, food, and water. According to the deputy minister of environmental protection and natural resources, about 50 percent of all cancer-related illnesses can be attributed to environmental factors. Heavy-manufacturing regions show especially high rates; in Noril'sk, the metallurgical center located above the Arctic Circle, the incidence of lung cancer among males is the highest in the world. *
Russia's birthrate has shown an increasingly steep decline in the 1990s, amounting to what one commentator calls "the quiet suicide of a nation." For example, the annual birthrate for the first six months of 1992 was 11.2 per 1,000 population--a 12 percent decline from the same period in the previous year. In some areas, the rate was even lower, for instance, 9.2 in St. Petersburg and 8.2 in the Moscow region. Russia's Ministry of Health reported in June 1991 that the country had a negative rate of population change for the first time since records have been kept. The declining number of births is attributed in part to a drop in fertility, which presumably stems from a combination of physiological and environmental factors, and in part to women's reluctance to bear children in a time of economic uncertainty.
Children’s Health in Russia
Some of the same factors shortening the lives of adults cause needless premature deaths of newborns in Russia. Poor overall health care and lack of medicines, especially in rural areas, reduce infants' survival chances. In Russia an estimated 40 to 50 percent of infant deaths are caused by respiratory failure, infectious and parasitic diseases, accidents, injuries, and trauma. For developed countries, this share ranges between 4 and 17 percent. [Source: Library of Congress, July 1996 *]
Infant mortality rates vary considerably by region. Central and northern European Russia's rates have been more in line with West European rates. In the intermediate category are the Urals, western Siberia, and the Volga Basin. The highest rates are found in the North Caucasus, eastern Siberia, and the Far East. Several autonomous republics, including Kalmykia, Chechnya, Ingushetia, Dagestan, and Tyva, consistently record the highest rates in the Russian Federation. In these areas, social and economic underdevelopment, poor health care, and environmental degradation have had an impact on the health of mothers and newborns. *
Infant and child health in Russia is significantly worse than in other industrialized countries. According to official statistics, only one child in five is born healthy. The inability of more than half of all new mothers to breast-feed, mainly because of poor diet, further undermines infants' health in a country where diets generally are unbalanced. Another problem is that most women of childbearing age are employed and thus must place their young children in day care centers, where they often contract contagious diseases. Illnesses such as cholera, typhoid fever, diphtheria, pertussis, and poliomyelitis, which have been virtually eradicated in other advanced industrial societies, are widespread among Russia's children. Vaccines are scarce. Even when immunizations are available, parents often refuse them for their children because they fear infection from dirty needles. *
Poor Health in Russia
Aside from shortfalls in Russia's health facilities and the quality of medical personnel, much of the country's public health crisis stems from poor personal hygiene and diet and lack of exercise. Preventive medicine and wellness programs are virtually nonexistent, as are programs to educate the public about personal sanitation, proper diet, and vitamins. The average Russian does not consume a balanced diet. Vegetables often are scarce in Russia, except in rural areas where they are homegrown, and fruits never have constituted an important element of the Russian diet. Per capita meat consumption also has fallen in the 1990s. [Source: Glenn E. Curtis, Library of Congress, July 1996 *]
In the first ten months of 1996, confirmed cases of human immunodeficiency virus (HIV) were four times more numerous than in all of 1995, with drug addicts accounting for about 70 percent of cases. Although the official estimate of HIV cases was fewer than 2,000 in 1996, other estimates placed the number at ten times that many. The Ministry of Health reported that only 50,000 of Russia's estimated 2 million drug addicts were under treatment for their addiction in 1996. In 1996 health experts identified alcoholism as the number-one cause of premature death in Russia, a situation exacerbated by the estimated 68 percent of alcohol products that contain foreign substances. By 1995 Russia's average life expectancy had fallen to only fifty-seven years for males and seventy-one for females, and natural population growth has been negative since 1992. In the first nine months of 1996, the population showed a net decrease of 350,000, dropping to 147.6 million according to the State Committee for Statistics. *
Declining Health in Russia
In 1965 the life expectancy in the USSR, was 66, roughly equal to that of the U.S. Today the life expectancy for a Russian male is 59, less than Indonesia, the Philippines and many countries in Africa.
According to a United Nations report, Eastern Europe and the former Soviet Union have the highest death rates among people between 15 and 60. The death rate increased by a third in the 1990s due mostly heart diseases and violent deaths. Outside of AIDS ravaged Africa, the only place with a higher death rate than Russia was Haiti.
Only 10 to 15 percent of babies were born healthy in the 1990s. Some 40 percent of children are chronically ill and only 30 percent of teenagers are regarded as healthy. The number of people falling ill and the number of invalids tripled between 1991 and 2001.
Russia's poor health has contributed to a population decline of 800,000 people a year. If something isn't done experts predict it will cripple the economy and poses "a clear threat to the political viability." Nationalists have embraced the death rate in Russia as an the issue as proof of the cost of reforms. The decline in Russian health has been blamed on the large numbers of smokers and drinkers and some of the world’s highest rates of heart disease, accidental death, suicides, tuberculosis, hepatitis and syphilis.
Cultural Disregard for Health in Russia
There are many jokes about the poor state of Russia health. One goes: What's good about life in Russia? Answer: It's hard but short. Less than six percent of Russians exercise daily. One Health official told the Washington Post, "When you walk down the street with a bottle, no one looks twice. But when you are jogging, they stare at you like some sort of strange creature.”
Describing the Russian attitude towards health, Dostoevsky wrote in 1876: "It is the indifference towards everything that is vital—toward the truth of life, everything that nourishes life and generates health." "In our day this indifference—compared, let us say, with the outlook of other, European nations, is almost a Russian disease."
The health official told the Washington Post, "In the Soviet Union it was embarrassing to care about your health. We were made to think that. The Ministry of Health was in charge of your health. Your priority was to work for society. if you thought about your own health, people would call you an egoist." Explaining why wasn’t planning to change her sexual activity even though she spent hundreds of dollars for syphilis medicine, one Russian woman told Newsweek, "We have one life to live, and we all inevitably get sick at various points in our life—that's the way it goes."
One doctor told the Los Angeles Times, "If there's a person who should not be anywhere near a smoker, he smokes himself. If there's a person who should not get even a whiff of alcoholic fumes, he gets himself drunk. If there's a person already in a weak and perilous health, he applies for and takes a job working in hazardous conditions.”
The idea of health care is to feel better. Many Russians view disease, ailments and death as something that is a matter of fate and that one can do little about. On health and fater, some Russians say, "He who is fated to hang will not drown."
High Death Rate Among Russian Men
The life expectancy of men in Russia peaked at 65 in 1987, hit a low of 57.4 in 1994 and rebounded somewhat to 59 in 2000. In some rural area, particularly in the north, the life expectancy for men is below 50. The statistic mean that 46 percent of boys under 16 will die before 60. By contrast, the life expectancy for women has remained stable at around 72 years in the 1990s, more than 12 years higher than for men. The high death rate of young and middle age men has resulted in a low ratio of men to women.
The life expectancy of Russian men is lower than men in all countries in Europe and all in Asia except Afghanistan and Cambodia. The life expectancy for males in Bangladesh, Bosnia and Guatemala are higher than that for Russian males. Russian males die 17 year earlier than Swedish males and 13 year earlier than American males. In 1965, life expectancy for men was 63 in Russia and 67 in the United States.
The British medical journal Lancet called the decline in Russian male life expectancy "without parallel in the modern era." The only times higher rates have been recorded were during times of war, famine or epidemic. The mortality rate of men between 40 and 49 was 163 per 1,000 in 1995, 77 percent higher than in 1990, when it was 9.2. If Russian male mortality rates remain high, a man aged 20 will only have 1 in 2 chance of reaching the age of 60, compared to 9 out to 10 in Britain and France. Poor health among men is more of problem in the countryside. The mortality rate among rural men in 47.9 per 100,000 and 42.4 among urban men.
The average mortality rate for Russian men is 45 per 100,000, compared to 10 per 100,000 for Russian women. The world’s largest gaps between male and female death ages are all in the former Soviet Union. According to the World Health Organization: Where women outlive men by the most years (in years): 1) Belarus (11); 2) Russia (10.1); 3) Latvia (10); 4) Estonia (9.9); 5) Kazakhstan (9.7).
Mortality rates are especially high for able-bodied males in rural areas. Served poorly by the health care system and lacking basic sanitary facilities and conveniences, many farming communities have been transformed into enclaves for the elderly, the indigent, and the sick. Moreover, indigenous nationalities such as the Evenks and the Nenets have suffered catastrophic declines in life expectancy and high rates of sickness and death that have prompted speculation that some of those groups may become extinct. Geographically, the lowest average life expectancy in Russia is in the Siberian Republic of Tyva, and the highest figures are in the Caucasus Republic of Dagestan and in the Volga region. In the first half of the 1990s, the imbalance between the birth and death rates was especially acute in major cities. In Moscow and St. Petersburg, the number of deaths in 1992 was almost double the number of births. [Source: Library of Congress]
Reason for Declining Health of the Russian Men
The poor health of men is at least partly attributed to self-destructive behavior such as smoking, drug and alcohol abuse, crime, accidents and violence and unhealthy lifestyle and fat-laden diets and lack of exercise.
About 53 percent of all the deaths among Russian men are the result of heart and circulatory disease. This figure isn't all that different from men in the United States but men are much likely to die of these ailments at a younger age and are at a much higher risk. Russian men are three times more likely to suffer heart or circulatory failure and seven times more likely to have cerebrovascular disease than American men. Cardiovascular stress associated with smoking, alcoholism and working is a major cause of death. Women are stressed for working hard in the workplace and working hard at home,
Two thirds of men smoke and a typical Russian man drinks two pints of pure alcohol everyday. Cheap alcohol and smuggled cigarettes are widely available. Less than six percent of Russians exercise daily. Sausage, bacon and pork fat are common dinner items.
Next to heart disease, violence and accident are the leading causes of death among Russian men. More men die every year from accidents, poisoning, drownings, homicides and suicides than die of cancer. Roughly 17,000 Russians, most of them drunk, die from drownings.
Cultural Disregard for Health Among Men
Sociologists say that many Russian men see few reasons to worry about their health. Russian men make fun of Americans for their health conscious ways and scoff at things like wearing seat belts. Visiting the doctor is viewed as a sign of weakness. The Washington Post interviewed one 40-year-old Russian father who had already suffered two heart attacks yet he continued to smoke two packs of cigarettes a day as he had since he was 16, loaded up on sausages and sour cream and occasionally downed eight pints of vodka a day.
Sociologist Dr. Velery Yelizarov of Moscow State University told the New York Times, "What bothers me is most is how people assume it is inevitable, part of the Russian male mentality. Russian men have always had an indifference to their health. But it has to stop or the consequences will be too awful to predict."
Explaining the low regard for life and health, Moscow State University sociologist Anatoly Antonov told the New York Times, "Nobody put the cost of life before the cost of building [Soviet] society. When a boy scrapes his knee here, he is not allowed to cry. We were taught to suffer, and we were taught that we will probably die in the next war. In that event, why worry about how you are going to survive to old age. Unfortunately life her does not have the same value as it does elsewhere."
Drunkenness and Alcoholism in Russia
Drunkenness has been a fixture of life in Russia for as long as anyone can remember. A Dutch visitor to Russia in 1876 wrote: “We saw only ye scandalous behavior of debauchees, glorified by the thronging crowd for their proficiency for drunkenness.” Russians refer to a nasty hangover as "the fish that rots from the head down."
Public drunkenness doesn't raise eyebrows in Russia. No one is outraged if the mail isn't delivered because the mailman is lying in a drunken stupor under a table. People who don't drink are sometimes regarded with the kind of suspicion traditionally given lepers.
It has been said that drunk Russians like to walk down the street with their arms around each other’s shoulder so that if one person falls down they all fall down. Drunks who get out of control or piss in the staircases on local ferries are sometimes wrestled to the ground and tied up to metal pipes until they sober up. So called sober cells in local prisons are often full
Alcoholism is a big problem in Russia. Most Russian families have an alcoholic member. Studies have shown that men who drink heavily often beat their wives and that pregnant women who drink often damage their unborn children. Many rural Russians estimate that half the people who live in their villages drink excessively. One Russian psychologist told AP, "Alcoholism has always been our national habit, but now there are absolutely no limitations on when you can get hold of liquor or how much you can drink."
In many cities, drunk men often stumble outside and fall sleep in small clearings. Industrial accidents are high because people show up to work drunk. People drink more in the winter and alcohol treatment centers report a huge influx of patients.
Drinking and Poor Health in Russia
Binge drinking is regarded as the primary cause of the decline in the life expectancy of Russian men since the early 1990s. Two thirds of Russia men die drunk, whether from an accident, heart attack or suicide. Many die on Monday at the end of a long weekend of drinking. Under the anti-alcohol campaign of Mikhail Gorbachev in the later 1990s, when vodkas became more expensive and harder to get, life expectancy rose sharply in just three years.
Russia's high rate of alcohol consumption is a major contributor to the country's health crisis, as well as to low job productivity. Rated as Russia's third most critical health problem after cardiovascular diseases and cancer, alcoholism has reached epidemic proportions, particularly among males. In the twentieth century, periodic government campaigns against alcohol consumption have resulted in thousands of deaths from the consumption of alcohol surrogates. The latest such campaign was undertaken from 1985 to 1988, during the regime of Mikhail S. Gorbachev (in office 1985-91). Although some authorities credited reduced alcohol consumption with a concurrent drop in Russia's mortality rate, by 1987 the production of samogon (home-brewed liquor) had become a large-scale industry that provided alcohol to Russians while depriving the state of tax revenue. [Source: Library of Congress, July 1996 *]
A 1995 Russian study found that regular drunkenness affected between 25 and 60 percent of blue-collar workers and 21 percent of white-collar workers, with the highest incidence found in rural areas. Because alcohol remains cheap relative to food and other items, and because it is available in most places day and night, unemployed people are especially prone to drunkenness and alcohol poisoning. Alcohol consumption among pregnant women is partly responsible for Russia's rise in infant mortality, birth defects, and childhood disease and abnormalities. *
Alcohol-Related Deaths in Russia
Each year alcoholic kills about 200,000 people in Russia. Around 160,000 people die from alcohol-related illnesses. Another 40,000 die from alcohol-related accidents, suicides, fatal falls, and poisonings. Police said that 43 percent of murders committed in the Moscow area in 1997 were somehow connected with alcohol.
Every winter drunks pass out during freezing cold night and die from exposure. Many drunks freeze to death after they collapse in a snow drift, sometimes with bottles still in their hands. Some bodies lie undiscovered until the spring thaw.
Drunk Russians die from choking on their vomit and falling out of windows. In some Siberian villages people freeze to death in the winter because the get so drunk they can't cut or carry the firewood needed to keep the, warm.
In 1994 some 53,000 people died of alcohol poisoning, an increase of about 36,000 since 1991. If vodka is unavailable or unaffordable, Russians sometimes imbibe various combinations of dangerous substances. The Russian media often report poisonings that result from consumption of homemade alcohol substitutes. Production of often-substandard alcohol has become a widespread criminal activity in the 1990s, further endangering consumers.
In 1999, about 30,000 people died from alcohol poisoning after drinking low-quality, illegal vodka and other alcoholic drinks. This was down from 32,000 in 1998 and 43,000 people in 1997. By comparison only about 300 people die a year from alcohol poisoning in the United States. The poisonings often result from impurities or distilling too soon.
Drunk Drowning in Russia
Roughly 17,000 Russians, most of them drunk, die from drowning in Russia each year. According to official statistic, 16,157 people drowned in 1998 and 20,458 drowned in 1995. The annual drowning rate in Russia is 8 per 100,000 (compared to 1.68 per thousand in the United States). The majority of the victims are men who drowned when they were drunk.
Hundreds of drink people drown in the Moscow River every year. In July 2001, 219 people died, including 18 on a single steaming hot Saturday, and around 90 percent were drunk when they died. One Moscow doctor told AFP, "The situation on the beaches gets worse in the evenings as Muscovites come to bathe after work. For some drinking beer has become a tradition."
A diver who fishes the bodies out of the Moscow River told the Washington Post, "The typical thing is for people to drink, swim, and decide to take a rest. A lifeguard who rescued a 53-year-old unconscious man told the Baltimore Sun, "He was drunk and he tried to swim across the lake." Many drunk men also die after falling threw the ice while ice fishing in the winter.
Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Lonely Planet Guides, Library of Congress, U.S. government, Compton’s Encyclopedia, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Foreign Policy, Wikipedia, BBC, CNN, and various books, websites and other publications.
© 2008 Jeffrey Hays
Last updated May 2016