More than two decades after the fall of communism, most former Soviet countries still have mortality rates significantly higher than those in Western Europe.
Cardiovascular disease, high infant-mortality rates, infectious diseases, and a decrease in the quality and financing of public health-care systems were the main factors driving the trend, according to an article that appeared last week in "The Lancet
," a British medical journal.
The combined effect of a steep increase in alcohol and tobacco consumption, both among working-age people and the younger generation, is the main trigger of cardiovascular disease, the article, "Health and Health Systems in the Commonwealth of Independent States," concluded.
The article's author is Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine. He spoke about his findings at a press conference in London.
"What's going on? Well, a number of things but one of the key points -- particularly in Russia, Ukraine, Belarus, and the north Slavic states -- [is] alcohol, a huge problem with alcohol. Vodka? Yes, but that's not the main issue, that's not what is killing the majority of the people," McKee said.
"It's the technical alcohols, the surrogate spirits, the aftershave, or the eau de cologne in Russian, and the samogon [homemade alcohol] that's made in the rural areas. Stuff that is actually sold in the clear knowledge that people will drink it [that's] 95 percent ethanol. And [people are] drinking in these binges -- the word 'zapoi' in Russian -- which is not just a binge for an evening, it's a binge for several days," he continued. "A huge problem with alcohol."
Drop In Life Expectancy
The report names cardiovascular disease as the No. 1 cause of death in Russia.
Moreover, according to "The Lancet," heavy drinking is related to up to six out of every 10 deaths among working-age men in Russia and one in three among working-age women.
Infectious diseases like tuberculosis and AIDS, as well as automobile accidents, are also cited as factors driving down life expectancy in Russia.
Male life expectancy in Russia fell from 63 years in 1990 to 58 in 2000, and rose again to 62 years in 2009. Female life expectancy in Russia has remained fairly steady. It was 74 years in 1990, dipped to 72 in 2000, and rose back to 74 years in 2009.
Belarus and Ukraine also saw a drop in male life expectancy. In Belarus it fell from 66 years in 1990 to 64 in 2009 and in Ukraine it declined from 65 years in 1990 to 62 in 2009.
Kazakhstan is the former Soviet republic with the lowest life expectancy, falling from 61 years to 59 over the same period.
Male life expectancy edged upward in eight other Commonwealth of Independent States (CIS) members and in Georgia, a former Soviet republic that is not in the CIS.
Female life expectancy in most CIS states went up slightly or stayed the same -- the highest being in Belarus: 76 years. Only one country, Ukraine, registered a regression in a woman's life span, from 75 years to 74.
On the whole, life expectancy in the CIS is now around 12 years lower for men and eight years lower for women than in the European Union.
Education, Better Care Needed
Between 1990 and 2009, the average life expectancy rose by six years in the EU, where both men and women can expect to live to nearly 80 years of age.
According to the study, a 20-year-old man in Russia has just a 63 percent chance of reaching the age of 60, as compared to a 90 percent chance in the EU.
To improve life expectancy in the CIS, the article recommends tighter controls on alcohol and tobacco and better public-education campaigns about their health hazards.
It also recommends improving primary health care and access to health services, and singles out the quality of care as an urgent problem.
McKee noted that "health reforms are in place but health systems still have a long way to go," while health-care services were still "fragmented."
"A key issue in the former Soviet countries [is that] evidence-based clinical practice has a very long way to go, because in the Soviet time, there was a rejection of the concept of randomized controlled trials of evidence-based medicine," McKee added, "the whole idea of science was very ideological, and that is still quite a struggle."