by

Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina

DEATH IN RUSSIA

If you want to live forever, forget it. If you want to live a long life, then settle in the United States. (Life expectancy in the U.S. is high-- almost 72 years for men, at least four to five years longer for women.) If you want to put life behind you as quickly as possible, then move to Russia. Chances are, you'll die there a lot sooner than you would in this country.

For a number of decades life expectancy has increased throughout the world, and for a long while the same was true in Russia. In the 1960's, 1970's, and most of the 1980's, longevity also increased in the Soviet Union. Then it took a nose dive.

As a matter of fact, between 1990 and 1994, life expectancy at birth fell in Russia by 6.2 years for men (from 63.8 to 57.6) and by 3.4 years for women (from 74.4 to 71.0). The major changes occurred in males from 20 to 45 years. The very young and the very old were unaffected.

How to explain this sudden and unprecedented drop? The phenomenon was studied by a group of scientists from the London School of Hygiene and Tropical Medicine in collaboration with the Demography and Human Ecology Unit from Moscow. Their findings appeared in the August 9, 1997 issue of Lancet(Vol.350, pp.383-387.) The Lancet, a distinguished international medical journal, also published a companion editorial discussing the results of the study.

The investigators began with the knowledge that changes in environment can affect mortality rates, even over a short period. For example, during World War II, a large number of young men were killed who might otherwise have survived into old age. But something else happened as well: Wartime shortage of alcohol, cigarettes, and high-cholesteral foods resulted in a decrease in death from heart attacks. Thus between 1941 and 1945, privation led to better health. Was the same principle operative in Russia in the 1990's? The investigators concluded that something of the sort was indeed at work.

The culprit wasn't cigarettes or butter. There was no increase of tobacco consumption, and food remained as scarce in the 1990's as it was in the 1980's.

After examining the records, investigators immediately concluded that cancer wasn't the problem. Mortality rates for this disease remained constant during the entire period. However, they found several categories in which deaths increased dramatically.

The first of these was death from alcohol-related causes. There was also a substantial increase in death from accidents and violence. And finally, there was a jump in deaths from infections, circulatory disease, and respiratory disease.

The Russians have been known as heavy drinkers from the time of the Cossacks to the present. Gorbachev acknowledged this national problem in the mid 1980's when he instituted an anti-alcohol campaign. The results were apparently beneficial. Death rates dropped during this period.

However, as a result of stringent government control, people started to distill their own alcohol, resulting in a number of accidental poisoning deaths. By the early 1990's, the government had relaxed its stringent rules; and alcohol consumption rose.

During the same period, accidents, murders, and suicides increased considerably. Why? For one thing, not only were Russians consuming more alcohol, but they were making a habit of binge drinking.

Of course, the sharp rise in male homicides (Threefold between 1984 and 1994) was probably not the result of alcohol alone. There has been a marked increase in crime since the collapse of the Soviet Union-- particularly crime related to black market activity, which increased in the 1990's. However, alcohol was surely one factor in the elevated murder rate.

Heavy consumption of alcohol could also have been contributory to an increase in deaths form circulatory disease in the form of cardiac arrhythmia (which can cause sudden death), and cardiomyopathy, a disease affecting the heart muscle. We know that alcoholics are much more prone to such disease-- and at an earlier age.

Clearly, the Russians are discovering that expanded freedom involves risks. When Gorbachev and the Communists were in power, they could impose rigid controls on the behavior of individual citizens, as well as on the market place. So Gorbachev, wielding the power of the state, was able to restrict the consumption of vodka-- the Russian national drink. But when Russians gained their freedom, they had to rely on their own will power, which appeared to be weakened after more than 70 years of a nanny government.

What lessons can Americans learn from this study of Russian mortality? The same ones we hear repeated over and over again by American medical authorities: In addition to avoiding tobacco and unhealthy foods, be moderate in your consumption of alcohol. An ounce of alcohol every day can contribute to longevity. A pint a day can lead to serious problems and shorten your life. A quart a day can kill you in a hurry.

Americans are used to accepting complete responsibility for their own health. Russians are not. Let's hope Russians are fast learners.



The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.


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