Vodka, capitalism and Russia's "mortality crisis"

When communism ended in Russia, death rates shot up: but how much of that was actually due to economic turmoil?

Via Tim Worstall, a new NBER paper argues that the massive surge in deaths after the end of communism in Russia may have a simple, single cause: "the demise of the 1985-1988 Gorbachev Anti-Alcohol Campaign."

There is no doubt that the period between 1990 and 1994 was one of extraordinary turbulence in Russia. The country experienced, in just four years, a rapid and wholesale transition from an almost entirely centralised economy to one of the freest markets in the world. The opportunism of the change was given as an archetypal example of the "Shock Doctrine" by Naomi Klein, in her book of the same name.

One of the key stats cited to prove the upheaval is the astonishing leap in mortality. As the authors of the paper, Jay Bhattacharya, Christina Gathmann, and Grant Miller (of Stanford university) write:

Crude death rates in Russia soared by 40% between 1990 and 1994, climbing from 11 to nearly 15.5 per thousand. By 2009 standards, the decline in male life expectancy at birth (by nearly 7 years, to 57.6) would tie Russian men with their counterparts in Bangladesh, falling short of male longevity in less-developed countries with troubled population health histories (Botswana, Haiti, North Korea, and Yemen, for example). The magnitude of this surge in deaths – coupled with the Soviet Union’s international prominence – has prompted observers to term this demographic catastrophe “the Russian Mortality Crisis.”

The immediate cause of the surge in deaths isn't economic transition, but a massive rise in alcohol consumption; the types of deaths that increased most were those related to alcoholism, like alcohol poisoning, violent deaths, heart attacks and strokes. Additionally, the deaths were concentrated amongst working age men.

What the authors argue is that, while alcoholism can of course be the result of societal factors, it also suggests that factors more directly related to drinking be examined. Their key prompt comes in the form of the following chart:

 

While the post 1990 spike is very real, the corresponding pre-1990 dip is under-explained by narratives which focus on economic upheaval. But it is potentially explained by the success, and then demise, of the USSR's "Measures to Overcome Drunkenness and Alcoholism", which "ushered in the country’s most stringent anti-alcohol policies since its 1919- 1925 prohibition".

The actual measures are fascinating, especially in the context of today's debate around minimum pricing. They addressed both supply and demand, by:

  • Reducing production of alcohol;
  • Restricting alcohol sales on business days, raising the drinking age, and banning restaurants from selling spirits;
  • Raising prices by around a quarter, then a half;
  • Introducing new sanctions for alcohol related crimes;
  • (and on the demand side) subsidising substitute activities like parks and sports clubs;
  • Propoganda and a ban on glamorous depictions of drinking;
  • And improved treatment of alcoholism.

These measures had a huge success; although the official statistics probably overstate the effect, due to the difficulty of accounting for moonshine production, they show a drop in sales of 50 per cent. That led to a continued decrease in death rates:

 

Importantly, the authors argue that the measures would take a while to unwind once the program ended in 1988, explaining the lag in time between its end and the beginning of the mortality spike.

Not every extra death is explicable by this factor; but the authors estimate that 2.15 million people in the mortality crisis died, not as a result of the larger crisis, but due to these measures being repealed.

Drink responsibly, people.

Boris Yeltsin sips some Vodka. Photograph: Getty Images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

Photo: Getty
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The Republican nightmare shows no sign of ending

The Republican establishment is no closer to identifying the candidate who can stop Trump or Cruz, while Hilary Clinton finds herself in a similar position to Barack Obama eight years ago.

After being cruelly denied by the people of Iowa, we were finally treated to a Donald Trump victory speech in New Hampshire last night. While Trump’s win will come as a “yuge” shock to anyone waking up from a yearlong nap, it was very much in line with more recent expectations. More surprising is John Kasich’s second place finish ahead of the tightly packed trio of Ted Cruz, Jeb Bush and Marco Rubio.

Rubio’s underperforming his polling average by about four points at time of writing (with 89 per cent of precincts reporting) – perhaps partly the natural erosion of his post-Iowa bump, perhaps also due to his mauling at the hands of Chris Christie in Saturday night’s debate. Meanwhile Ted Cruz’s 12 per cent compares favourably with past Iowa winners’ New Hampshire performances: Mike Huckabee got 11 per cent in 2008 and Rick Santorum 9 per cent in 2012, but neither came close to winning the nomination.

The result offers little help to those “establishment” Republicans who’d been planning to coalesce around whichever of Jeb Bush, Chris Christie, John Kasich and Marco Rubio emerged from New Hampshire in the best position.

Christie and Carly Fiorina are probably done. Both got less than 2 per cent in Iowa; both finished in single digits in New Hampshire after focusing heavily on the state; both are stuck at the bottom of the national polls, and neither has raised all that much money (relatively speaking). Christie is heading back to New Jersey to “take a deep breath”, “get a change of clothes” and “make a decision” tomorrow.

But who will party elites rally around to stop Trump and Cruz? Kasich, who came second in New Hampshire but is on just 3 per cent nationally? Rubio, who beat expectations in Iowa and is best of the bunch in national polls but disappointed badly tonight after a terrible debate performance? Or Bush, who’s had more than $75 million spent on him by the “Right to Rise” super PAC with just three per cent in Iowa and 11 per cent in New Hampshire to show for it? Nobody has won either party’s nomination in the modern primary era without a top-two finish in New Hampshire – does either Rubio or Bush really seem like the candidate to break that trend?

Jeb does have plenty of money and organisation, and is guaranteed some extra support from one prominent establishment Republican in South Carolina: his brother. George W has recorded an ad for the Jeb-supporting “Right to Rise” PAC, calling his brother “a leader who will keep our country safe”, which is already running on South Carolina TV (and which ran in New Hampshire during the Super Bowl). He will also join his brother on the campaign trail in the run up to the primary. Bush 43 left office very unpopular and remains the most disliked former President, but he is very popular with Republicans. A Bloomberg/Selzer poll in November found that 77 per cent of them have a favourable opinion of him, making him far more popular than any of this year’s candidates. (Jeb calls his brother “the most popular Republican alive”, which is a bit of a stretch. Nancy Reagan? Clint Eastwood?)

Trump leads convincingly from Cruz in the most recent polls in both South Carolina and Nevada, but there haven’t been any polls from either state since the Iowa caucus. Neither state is as friendly territory for “establishment” candidates as New Hampshire: South Carolina’s electorate is much more evangelical, and Nevada’s much more conservative. Newt Gingrich won South Carolina handily in 2012 and Huckabee came a close second in 2008. Cruz and Trump are doing best with evangelicals and very conservative voters this time around. Thanks to the state’s winner-take-all rules, whoever prevails in South Carolina will get the small ego boost of going into Super Tuesday with the most delegates.

On the Democratic side, Bernie Sanders secured a big win over Hillary Clinton (60 per cent to 38 per cent with 90 per cent of precincts reporting). What seemed incredibly unlikely a year ago has been almost certain for the past week or so. As he heads south and west, though, Sanders faces a new challenge: winning over African American voters.

Just two per cent of those who voted in the two Democratic contests so far have been black; in the next ones that number will be a lot higher. (In 2008, it was 15 per cent in Nevada and 55 per cent in South Carolina). In national polls, Clinton holds a 58-point lead among African American voters compared to her six-point lead with white voters, and she’s 31 points ahead overall in FiveThirtyEight’s average of South Carolina polls (all taken pre-Iowa).

Ironically, Clinton now finds herself in a similar position to the one Barack Obama was in when battling her for the nomination in 2008: heading to South Carolina, having won Iowa but lost New Hampshire, hoping African American voters will help her win big and regain the momentum as we head towards Super Tuesday.