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.

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#Match4Lara: Lara has found her match, but the search for mixed-race donors isn't over

A UK blood cancer charity has seen an "unprecedented spike" in donors from mixed race and ethnic minority backgrounds since the campaign started. 

Lara Casalotti, the 24-year-old known round the world for her family's race to find her a stem cell donor, has found her match. As long as all goes ahead as planned, she will undergo a transplant in March.

Casalotti was diagnosed with acute myeloid leukaemia in December, and doctors predicted that she would need a stem cell transplant by April. As I wrote a few weeks ago, her Thai-Italian heritage was a stumbling block, both thanks to biology (successful donors tend to fit your racial profile), and the fact that mixed-race people only make up around 3 per cent of international stem cell registries. The number of non-mixed minorities is also relatively low. 

That's why Casalotti's family launched a high profile campaign in the US, Thailand, Italy and the US to encourage more people - especially those from mixed or minority backgrounds - to register. It worked: the family estimates that upwards of 20,000 people have signed up through the campaign in less than a month.

Anthony Nolan, the blood cancer charity, also reported an "unprecedented spike" of donors from black, Asian, ethcnic minority or mixed race backgrounds. At certain points in the campaign over half of those signing up were from these groups, the highest proportion ever seen by the charity. 

Interestingly, it's not particularly likely that the campaign found Casalotti her match. Patient confidentiality regulations protect the nationality and identity of the donor, but Emily Rosselli from Anthony Nolan tells me that most patients don't find their donors through individual campaigns: 

 It’s usually unlikely that an individual finds their own match through their own campaign purely because there are tens of thousands of tissue types out there and hundreds of people around the world joining donor registers every day (which currently stand at 26 million).

Though we can't know for sure, it's more likely that Casalotti's campaign will help scores of people from these backgrounds in future, as it has (and may continue to) increased donations from much-needed groups. To that end, the Match4Lara campaign is continuing: the family has said that drives and events over the next few weeks will go ahead. 

You can sign up to the registry in your country via the Match4Lara website here.

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.