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The Russian Mortality Crisis

Eco/Soc 572 Research Methods in Demography
Prof. Josh Goldstein

Mini-Project #1 The Russian Mortality Crisis (Due Monday Feb. 23, 1998)

The goal of this mini research project is to investigate the nature and causes of the Russian mortality crisis.

Nowhere else in the developed world has life expectancy stopped increasing, let alone fallen, as it has in Russia. There is much debate over what's behind the increase in mortality. On the one hand, some argue that the crisis is a short-term fluctuation, a result of the social and economic disorder that Russians have experienced since the collapse of the communist state. According to this view, the rise in mortality reflects a broad range of  contemporary  phenomena, ranging from increased alcohol consumption, to a crisis in hospital care, to economic pressures, to environmental pollution, to the psychological stress of rapid social change. On the other hand, others argue that the current high levels of mortality are really the continuation of longer term trends that were well in place even before the fall of the Soviet Union. In its strongest form, this interpretation would predict mortality to be at its current levels even if communism had not collapsed.

This debate is a charged one, involving two different interpretations of history, and radically different consequences for the future. If the short-term fluctuation argument is correct then the health crisis in Russia can be corrected if the society stabilizes and begins to grow again. If the long-term theory is correct then mortality rates will be relatively unresponsive short-term economic and political changes, and will only begin to show improvement over the course of generations.

We will be using data collected by France Mesle, Vladimir Shkolnikov, Veronique Hertrich and Jacques Vallin, a team of Russian and French demographers. To download the data go to the 572 homepage. Data files are available in ascii, Lotus 123, and Stata formats. You may use any computer package you wish to analyze the data, but it is important that the program allow you to draw graphs. Some tips for programming in Stata are available on the home page. It will probably be easier to do some of the calculations by hand, for example, in calculating life-expectancy in the absence of alcohol related deaths. Do not chain yourselves to the computer.

It will be useful to read

L. Chen et al. (1996) "The Upsurge of Mortality in Russia: Causes and Policy Implications," Population and Development Review 22(3):517-530.

V. Shkolnikov et al. (1996) "Health crisis in Russia. I. Recent trends in life expectancy and causes of death from 1970 to 1993" and "Health crisis in Russia. II. Changes in causes of death: a comparison with France and England and Wales (1970 to 1993)," Population: An English Selection 8:155-190.

N. Eberstadt (1994) "Demographic disaster: The Soviet legacy," The National Interest 1994
You don't need to become experts in recent Russian history, but you should keep the following dates in mind. Gorbachev came to power in 1985. He began a stringent anti-alcohol program in 1985, the effects of which lasted several years (for alcohol consumption estimates, see Shkolnikov p. 168). Yeltsin was elected as president of Russia in June 1991. By the end of 1991, the Soviet Union had ceased to exist and Gorbachev had left power. 

Please feel free to be creative in both your methods and your write-up. Try to keep your write-up concise. I expect that your reports will consist of about 5 pages of text (about 1 page per question), plus figures and tables.

Question #1 What has been the general evolution of mortality in Russia since the 1960s? What has been the relationship between political change and mortality?

(Important note: life expectancy for each year from 1960 to 1993 is published in Shkolnikov et al in Appendix 1. The only calculation you need to do is for 1994).

Is life expectancy at birth the best measure of mortality trends? If you could have asked Shkolnikov to publish a table of one and only one of the following measures - life expectancy at birth, the crude death rate, standardized mortality rates - what would you have said and why?

Question #2 What has been the age and sex pattern of the Russian mortality crisis and what does this tell you about its underlying nature?

(a) At what ages has mortality worsened the most? Was the age pattern of mortality increase similar before Gorbachev's anti-alcohol program as it has been since? What does the age pattern of mortality increases suggest about the underlying nature of the mortality crisis?

(Note: a simple way to measure the age pattern is to look either at differences or percentage change in mortality rates from one date to another, e.g. 1960 to 1994)

(b) What ages show the most short-term variation during Gorbachev's anti-alcohol program? Does the pattern differ for men and women?

(It may be easiest to answer this question graphically, plotting mortality rates for all ages either on the same axes or side-by-side. You may want to plot the rates in the log scale.)

Question #3 Who appears to be under more stress during the Russian political and economic transformation: men or women?

Use cardiovascular causes of death as a proxy for stress related mortality. Calculate standardized cause-specific mortality rates by sex from the 1960s to 1994. Plot the two time-series and interpret the similarities and differences.

You may want to base your standardized mortality rate on the Russian population age structure of 1980, given below.

Population   Age
(thousands) 
0   2169 
1-4   8494 
5-9   10066 
10-14   9251 
15-19   11496 
20-24   13006 
25-29   12191 
30-34   10032 
35-39   6439 
40-44   11299 
45-49   8586 
50-54   10223
55-59   6540 
60-64   4552 
65-69   5527 
70-74   4121 
75-79   2604 
80-84   1190 
85+   698

Question #4 Would Russian male mortality resemble male mortality in countries like France, Japan, and the United States if the alcohol problem were somehow solved?

Alcohol consumption probably underlies many causes of death. Shkolnikov et al. argue that it is perhaps most directly related to deaths classified as "Injury and poisoning."

(a) Calculate male age-specific probabilities of death in the absence of "injury and poisoning" for 1993.

(b) Calculate male life expectancy for 1993 in the absence of "injury and poisoning". How does it compare do Russia's observed life expectancy of 58.9 for men? If all "injury and poisoning" were averted, would Russian male life expectancy be in the same ballpark as life expectancy in France, Japan, and the United States? (See Shkolnikov et al Appendix 1) You might also want to discuss the appropriateness of the independence of the competing risks and whether you think this might bias your results.

Question #5 Nicholas Eberstadt of Harvard has speculated that increased individual liberty might somehow lead to higher mortality. He notes that Black mortality in the United States also increased sharply after emancipation. (see footnote 16 of Chen et al.) Is such an interpretation based on the mortality crisis being a direct result of the fall of Communism. Do you think this theory has merit, in light of what you have found in your research about the short-term or long-term nature of the crisis? 

 

 
 
 
 
 
 
 

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