life expectancy in Russia DECLINING sharply

[Guest guest]

Here's an interesting article that was in Sunday's Washington Post about

searching for the reasons why life expectancy in Russia is declining,

something described below as " unprecedented in the world of demographics " :

Case Not Closed

Forget who may be killing the great chefs of Europe. Here's a real-life

mystery that's worth at least a book and maybe even a movie: What's killing

off Russians, particularly men, in the prime of their lives? And why did

they start dying in disquieting numbers in the years immediately after the

collapse of Soviet communism?

The statistics are shocking and the reasons for the deaths are equally

surprising, assert economists Brainerd of College and

M. Cutler of Harvard University.

Between 1989 and 1994, life expectancy for Russian men fell by more than

six years. In the slow-mo world of population demographics, that kind of

movement is " almost unprecedented in its speed and scope, " Brainerd and

Cutler claim. Moreover, the Russian death rate increased most dramatically

among middle-aged men and not the very young or the very old. Russian women

also were dying younger, losing about three years in life expectancy during

the same period, they found.

The rate hasn't improved much since then. The average Russian male born in

2002 will live to be 58.5 years old, a slight improvement from the 1994

figure of 57.6 years and down from 64 years in the mid-1980s. In terms of

life expectancy, Russia ranks 122nd in the world, at the same level as

Guyana and North Korea, these researchers reported.

Sobering data, to say the least. So what happened? To find out, the two

professors analyzed data from a variety of sources, including studies

conducted by the World Health Organization and the Russia Longitudinal

Monitoring Survey, which collected data from tens of thousands of Russians

between 1994 and 2002.

As in any good mystery, the three most likely suspects turned out to be

innocent.

The researchers first considered the role of the state-run health care

system, which had declined dramatically in the transition period between

Soviet communism and Russian-style democracy. But as hard as they looked,

" we find no evidence that this deterioration played a major role in the

demographic disaster, " they wrote in a new paper published by the National

Bureau of Economic Research. For example, the maternal mortality rate, often

a key indicator of the quality of a country's health care system, did not

increase at the same time that men were dying in ever-increasing numbers.

Then they looked to see whether changes in diet, obesity or smoking might

explain the drop in life expectancy. Nyet, they concluded. The proportion of

Russians who were overweight or underweight hadn't changed much. Nor had the

composition of their diets. And while Russian men do smoke like chimneys,

per capita cigarette consumption had barely budged.

Unemployment soared after communism ended. Was that the culprit? Once

again, close analysis pointed elsewhere. The best measures of material

deprivation -- income levels, share of household income spent on food,

whether families had to sell possessions to buy food -- appeared unrelated

to the surge in mortality.

Then Brainerd and Cutler turned their attention to two less likely

suspects: alcohol consumption and feelings of hopelessness. This time, they

concluded, the evidence seemed solid.

They found that alcohol consumption soared by about 25 percent in the years

following the fall of the Soviet Union -- an increase that all by itself

would bump up mortality from heart disease by about 10 percent, they

estimated. (Contrary to the stereotype, the average Russian typically drinks

slightly less alcohol than other Europeans.)

They also determined that accidental alcohol poisoning represented about 7

percent of the increase in male mortality and 6 percent of female mortality

-- " and may play a role in other violent deaths as well, either by

instigating murder or suicide, or as a disguised cause of them, " they wrote.

Alcohol consumption explained about 25 percent of the decline in life

expectancy after 1989, according to their estimates.

Then Brainerd and Cutler tracked down survey data measuring optimism about

the future, a bold stroke worthy of the foxy old TV detective Columbo.

" Greater despair or hopelessness among middle-aged men is associated with

higher risk of heart disease and heart attack, as well as earlier onset of

artery disease, " even after controlling for alcohol consumption and smoking,

they claimed.

One question in the Russian survey asked, " Do you think that in the next 12

months your family will live better than today, or worse? " They found the

odds of dying were about " 30 percent lower for men who have positive

expectations about the future; for women the odds of dying are 50 percent

lower. " When analyzed with other data, they estimated that increases in

levels of despair explained about 25 percent of the drop in mortality during

the 1989-1994 period.

Okay, so you have half the answer. That's good but not great detective

work. What explains the other half?

That's still a mystery, these researchers conclude.

Did somebody say " sequel " ?

That army of cell phone voters that was supposed to sway the election for

Democratic presidential candidate F. Kerry showed up at the polls on

Election Day -- but so did everyone else, muting their impact, according to

exit polling.

Buried in the survey data is the answer to a critical question raised

during the campaign about traditional telephone surveys. Critics of the

pre-election polls claimed that some voters, including many young people,

now use only cell phones and have abandoned household phone service.

That makes them unavailable to pollsters, who are prohibited by law from

calling cell phone numbers. The problem is, there are scant studies

measuring how many Americans, not to mention voters, rely exclusively on

their cell phones, so it's difficult to judge the effect on the quality of

the polls.

The exit pollsters cast new light on the issue by asking people leaving the

voting booths about their phone service and use.

The good news for pollsters is that only 7 percent of all voters in 2004

were using cell phones as their sole service. The bad news is that this

figure swelled to nearly 20 percent among voters between the ages of 18 and

29 years old.

Uh-oh. Not only are there lots of young people without household phone

service, but these cell-phone-only voters voted 56 percent to 41 percent for

Kerry, meaning missing them in telephone polls could produce polls that

underestimated the Kerry vote.

But, happily, one other fact may have saved pollsters, at least during this

campaign. Young people with cells were not much more likely to back Kerry

than those in homes with traditional phone service only or those who had

both cell and traditional service. So missing them wouldn't dramatically

skew the results.

morinr@...