The upsurge of mortality in Russia: Causes and policy implications

This note summarizes conclusions reached at a recent international conference that considered the causes and policy implications of the upsurge of mortality in Russia following the collapse of the communist regime in 1989. The mortality crisis is genuine, not a case of ''Glasnost in statistics.'' There is Little evidence to support the popular perception that the crisis is due to environmental deterioration or the collapse of medical services. These problems are real but they do not account for the rise in mortality. Rather, the crisis is the manifestation of economic, social, and political pathologies in Russian society. The responsible causes are probably a combination of historical and contemporary forces: catch-up effects from previous lifestyle risks and deferred deaths from the successful anti-alcohol campaign in the late 1980s; and current turmoil characterized by economic impoverishment, widening social inequality, and the breakdown of political institutions. Russia does not and did not conform to the standard model of ''health transition'' distilled from Western experience. Although there are some signs that the crisis may be abating, its future course remains uncertain.