The increase in death and disease under "katstroika"

The Rise of China as an Economic Power

In the twenty years since the Cultural Revolution, China has maintained fast real growth. This occurred despite China having similar problems to other transitional economies, e.g. loss-making State Owned Enterprises (SOEs), eroding fiscal revenues and inflation, (Section 3).

Although China initially adopted the Soviet central planning model, after the 1950s break Chinese planning changed towards a regionally-based system with local planning (Section 2). In contrast to the centrally-based, functionally-specialised (U-form or unitary structure) Soviet model, the Chinese economy is organised on a multi-layer-multi-regional (M-form) basis. This encour aged development of small size township and village enterprises (TVEs), the main engine of Chinese growth.

Power and control remained with the Party and the State, but was diffused much more widely, regionally and locally. This allowed initiatives at lower (political) levels to establish institutions, both in agriculture (the ‘household responsibility system’) and industry (TVEs), without state protection. Even among regionally controlled SOEs, ‘tournament rivalry’ between regions, etc., and between SOEs and TVEs provided competition.

Cross-country evidence on the social determinants of the post-socialist mortality crisis in Europe: a review and performance-based hierarchy of variables

An unprecedented mortality crisis befell the former socialist countries between 1989 and 1995, representing one of the greatest demographic shocks of the period after the Second World War. While it is likely that country-level variation in the post-socialist mortality crisis in Eastern Europe can be explained by a constellation of political and socio-economic factors, no comprehensive review of the existing scholarly attempts at explaining these factors exists. We review 39 cross-national multi-variable peer reviewed studies of social determinants of mortality in post-socialist Europe in order to assess the social factors behind the post-socialist mortality crisis, determine the gaps in the existing literature and to make suggestions for future research. We propose a novel methodology to determine the relative importance of variables based on the ratio of significant to insignificant findings for each variable. The literature identifies inequality, welfare payments, religious composition, democracy, economic performance and unemployment as the leading factors that have a significant influence on mortality outcomes. Existing cross-country studies fail to establish a definitive connection between mortality and diets, drinking patterns, liberalisation, trust, health expenditure and war. We also point out that the level of analysis is not a neutral methodological choice but might influence the results themselves.

The Changing Capabilities of Cohorts of the Elderly in Russia during 1990-2020: Measurement using a Quantitative Index

Russia has had a high elderly share of its population like the OECD countries, but has had a more turbulent history over the past 100 years, which has caused fluctuations in the capabilities of those turning 60 (measured by education and training, income, enabling environment, medical care, and health status). This article analyses the life experiences and capabilities of five Russian birth cohorts turning 60 over the period 1990–2020. It presents relevant concepts, reviews past research, and evaluates the importance of health factors (health environment, health-related behaviours, medical care, health status) in determining the activities and contributions of older people in Russia. A Human Capabilities of the Elderly in Russia Index (HCERI) with 22 indicators is developed. Russian data are used in the calculation of the HCERI for the cohorts turning 60 in 1990, 1995, 2000, 2010 and 2020. The article then presents evaluations of the experiences and changes in capabilities for each of the five selected cohorts of the elderly in four periods of life: Childhood (1–15 years), Young Adult (16–49), Mature Adult (50–59), and Early Elderly (60–69). The implications of changes in the characteristics of the elderly for Russian government policies are discussed.

Does Alcohol Matter? Public Health in Russia and the Baltic Countries Before, During, and after the Transition

Since the mid-1980s public health in Russia and the Baltic countries has shown vast fluctuations. After a notable improvement during the second half of the 1980s, the early 1990s saw a dramatic deterioration with soaring mortality rates. This article describes some particularities of this rise and fall in public health, primarily concerning age, gender and cause of death, which have been remarkably similar in all four countries. The article identifies three phases in the development in alcohol policy and alcohol consumption, and in public health as such, during the past 15 years. There are many questions and few definite answers concerning the driving forces behind the recent public health turbulence, but developments are frequently related to two important events: the anti-alcohol campaign during the 1980s, and the economic and political transition following the breakup of the Soviet Union. Although the public health crisis is a result of unique historical experiences, there are general lessons to be learned, and the similarity in trends is noteworthy. Moreover, internationalization will enhance a certain convergence in consumption patterns and policy responses in the future, although local provisions will ensure a certain diversity in policies.

Social Factors Influencing Russian Male Alcohol Use over the Life Course: A Qualitative Study Investigating Age Based Social Norms, Masculinity, and Workplace Context

The massive fluctuations occurring in Russian alcohol-related mortality since the mid-1980s cannot be seen outside of the context of great social and economic change. There is a dearth of qualitative studies about Russian male drinking and especially needed are those that address social processes and individual changes in drinking. Conducted as part of a longitudinal study on men's alcohol consumption in Izhevsk, this qualitative study uses 25 semi-structured biographical interviews with men aged 33-60 years to explore life course variation in drinking. The dominant pattern was decreasing binge and frequent drinking as men reached middle age which was precipitated by family building, reductions in drinking with work colleagues, and health concerns. A minority of men described chaotic drinking histories with periods of abstinence and heavy drinking. The results highlight the importance of the blue-collar work environment for conditioning male heavy drinking in young adulthood through a variety of social, normative and structural mechanisms. Post-Soviet changes had a structural influence on the propensity for workplace drinking but the important social function of male drinking sessions remained. Bonding with workmates through heavy drinking was seen as an unavoidable and essential part of young men's social life. With age peer pressure to drink decreased and the need to perform the role of responsible breadwinner put different behavioural demands on men. For some resisting social pressure to drink became an important site of self-determination and a mark of masculine maturity. Over the lifetime the place where masculine identity was asserted shifted from the workplace to the home, which commonly resulted in a reduction in drinking. We contribute to existing theories of Russian male drinking by showing that the performance of age-related social roles influences Russian men's drinking patterns, drinking contexts and their attitudes. Further research should be conducted investigating drinking trajectories in Russian men.

The Gorbachev Anti-Alcohol Campaign and Russia's Mortality Crisis

Political and economic transition is often blamed for Russia's 40% surge in deaths between 1990 and 1994. Highlighting that increases in mortality occurred primarily among alcohol-related causes and among working-age men (the heaviest drinkers), this paper investigates an alternative explanation: the demise of the 1985-1988 Gorbachev Anti-Alcohol Campaign. Using archival sources to build a new oblast-year data set spanning 1978-2000, we find a variety of evidence suggesting that the campaign's end explains a large share of the mortality crisis - implying that Russia's transition to capitalism and democracy was not as lethal as commonly suggested.

Rapid large-scale privatization and death rates in ex-communist countries: an analysis of stress-related and health system mechanisms

During the transition to capitalism, the postcommunist countries have experienced devastating rises in mortality, although there has been considerable variation within and between countries and regions. Much of this population-level variation remains unexplained, but alcohol and psychological stress are found to be major proximal causes of rising mortality rates. The authors show that implementation of neoliberal-inspired rapid, large-scale privatization programs ("mass privatization") was associated with significant declines in life expectancy, as well as with greater alcohol-related deaths, heart disease, and suicide rates. The authors interpret these findings as evidence that rapid organizational reform created excess psychosocial stress, which, consistent with the public health literature, increases risk of death at the individual level. However, they also find that rapid privatization modestly contributed to a decline in health care resources, such as the number of physicians, dentists, and hospital beds per capita, although there is weak evidence that these reductions in health system capacity explain substantial differences in mortality at the country level.

Testing for an economic gradient in health status using subjective data

Can self-assessments of health reveal the true health differentials between 'rich' and 'poor'? The potential sources of bias include psychological adaptation to ill-health, socioeconomic covariates of health reporting errors and income measurement errors. We propose an estimation method to reduce the bias by isolating the component of self-assessed health that is explicable in terms of objective health indicators and allowing for broader dimensions of economic welfare than captured by current incomes. On applying our method to survey data for Russia we find a pronounced (nonlinear) economic gradient in health status that is not evident in the raw data. This is largely attributable to the health effects of age, education and location.

The invisible hand: how British American Tobacco precluded competition in Uzbekistan

BACKGROUND

Tobacco industry documents provide a unique opportunity to explore the role transnational corporations (TNCs) played in shaping the poor outcomes of privatisation in the former Soviet Union (FSU). This paper examines British American Tobacco's (BAT's) business conduct in Uzbekistan where large-scale smuggling of BAT's cigarettes, BAT's reversal of tobacco control legislation and its human rights abuses of tobacco farmers have been documented previously. This paper focuses, instead, on BAT's attitude to competition, compares BAT's conduct with international standards and assesses its influence on the privatisation process.

METHODS

Analysis of BAT documents released through litigation.

RESULTS

BAT secured sole negotiator status precluding the Uzbekistan government from initiating discussions with other parties. Recognising that a competitive tender would greatly increase the cost of investment, BAT went to great lengths to avoid one, ultimately securing President Karimov's support and negotiating a monopoly position in a closed deal. It simultaneously secured exclusion from the monopolies committee, ensuring freedom to set prices, on the basis of a spurious argument that competition would exist from imports. Other anticompetitive moves comprised including all three plants in the deal despite intending to close down two, exclusive dealing and implementing measures designed to prevent market entry by competitors. BAT also secured a large number of exemptions and privileges that further reduced the government's revenue both on a one-off and ongoing basis.

CONCLUSIONS

BAT's corporate misbehaviour included a wide number of anticompetitive practices, contravened Organisation of Economic Cooperation and Development's and BAT's own business standards on competition and restricted revenue arising from privatisation. This suggests that TNCs have contributed to the failure of privatisation in the FSU. Conducting open tenders and using enforceable codes to regulate corporate conduct would help deal with some of the problems identified.

The Russian health crisis and the economy

Russia experienced a severe health crisis in the 1990s, as reflected by a drop in life expectancy. It has been suggested in literature that this poor state of health is likely to endure and will significantly retard economic growth in the country. This paper uses evidence from other former Communist countries and studies of income–health relationship across economies to evaluate these claims. It concludes that the mortality increases of 1988–94 and 1999–2000 were the effects, rather than causes, of the economic recession. The state of health is unlikely to put a brake on future economic growth.

The operation failed, but the patient survived: varying assessments of the Soviet Union's last anti-alcohol campaign

From the mid 1980s mortality levels have fluctuated greatly in the former Soviet Union. After dropping substantially during the late 1980s, mortality rose to unprecedented levels during the early 1990s. The sharp fluctuations in mortality are commonly linked to variations in alcohol consumption in connection with the anti-alcohol campaign launched in 1985. This large-scale natural alcohol policy experiment has produced very mixed appraisal and this article provides a systematic review of the wide variety of judgments, focusing on goals, implementation, and effects on life expectancy, alcohol consumption, mortality, crime, etc. Deviant evaluations are in part ascribable to a general schism between narrowly focused epidemiological perspectives on public health interventions and broader social science approaches to political reform.

Explaining rising mortality among men in eastern Europe

Since the mid-1960s, rates of premature mortality have increased among men in all Eastern European countries, giving rise to an East-West health divide. The paper examines the existing data concerning the possible role of levels of smoking, fats consumption and/or environmental factors in explaining this phenomenon. An overview is offered of the key ways in which social experience in Eastern Europe has diverged from that in the West and it is argued that such an overview is pre-requisite for understanding the deteriorating health of men in the East. The importance of the 'incongruity' between aspirations and the means of achieving them is highlighted, as is the centrality of family-based coping strategies. It is argued that the devaluing of the public sphere and valorization of the private domain contribute to the greater health vulnerability of men under in Eastern Europe. The importance of the private sphere is reflected in the fact that the rise of premature male mortality has been overwhelmingly concentrated in the non-married population in the East European countries for which data is currently available.