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Rediscovering Russia: A Sick State

by annapope December 7, 2014
Russian health collapsed with the Soviet state, worsening during the political instability of the
1990s and continuing to suffer in the 21st century. In 1991, Russias Ministry of Health reported a
negative rate of population change for the first time in the nations records. Unheard of for a world
power, Russias dire state of public health was caused by a combination of factors, including
high mortality rates, low fertility, and poor, inefficient health care.
Between 1992 and 1995, Russia witnessed an excess mortality of 1.8 million people more than
the 1.7 million Russian combatants killed during World War. Disease, many common and curable,
and chronic health issues were the main causes of this staggering death rate, creating major
demographic changes and shortening life expectancy. Russia experienced epidemic levels of
influenza, diphtheria, and measles, and its rates of tuberculosis, cancer, and heart disease are the
highest of any industrialized country.
Alcoholism, which follows cardiovascular disease and cancer as one of Russias top three critical
health problems, escalated when prohibition was eased in 1988. After Gorbachevs anti-alcohol
campaign ended, alcohol consumption increased from the pre-1985 level of eleven liters to fourteen.
Moreover, chain-smoking had become prevalent in Russian society, as 55% of Russians smoked
regularly in 1996. Linked to the problem of heroin addiction, Russia developed an HIV/AIDS issue,
with as many as 1.2 million HIV-positive in 2009. This plethora of health problems took a toll on the
nations population, skewing the average life span and gender-balance. Not surprisingly, life
expectancy for males decreased from 63.5 years for males in 1991 to 57.3 in 1994, with a ratio of
884 males per 1,000 females in 1993.
Another reason death rates dominated life in the 1990s was the low fertility and birthrate, generated
by abortions and high infant mortality. The annual birthrate decreased by 12% in 1993, and in 1997
there were twice as many abortions as live births. That amounts to about 2.5 million terminated
pregnancies in one year, free of charge at most Russian hospitals and clinics in the first trimester.
Work and living environments also affected infant mortality levels, as 1.5 million women are exposed
to unfavorable working conditions, and millions more to industrial pollutants and harmful airborne
substances, taking a toll on their pregnancies.

David Granlund- 2009

Health Care Protests November 2014

These devastating health concerns have not gone unaddressed, but government reforms have
changed the face of public health without producing adequate results. The Glasnost period of the
1980s illustrated the obstacles of state health care, as the system was highly stratified by location
and political status. While there was an abundance of medical staff, most were poorly trained and
lacked proper medical equipment. Moreover, corruption plagues the system, as the commonality of
low salaries among medical workers led to the normalcy of bribes, causing the quality of treatment to
be determined by the patients wealth. In 1993, President Yeltsin signed a decree entitled On
Immediate Measures to Provide Health Care for the People of the Russian Federation,
constitutionally changing the previously socialist model of health care to include compulsory medical
insurance. While private funding and new free market providers was intended to promote both
efficiency and patient choice, public health was allotted less than 1% of the budget in 1995, while
the United States budgeted more than 12%, limiting the resources to finance the new law.
Russias health has scarcely improved since the 1990s, but the gravity of the situation is growing
more apparent. In 2011, Prime Minister Vladimir Putin pledged more than 300 billion rubles ($10
billion dollars) in the next few years to improve health care in the country. These funds will go
towards modernization of medical institutions, increasing access to medical services, and increasing
salaries of medical personnel. However, the November protests of Putins plans to close over 20
hospitals and fire about 7,000 health care professionals in the Moscow area confirm the shallow
intent of health care reform, leading 5,000 Russians to march in the city streets. Already struggling to
maintain domestic peace over international tensions and a poor economy, this public upheaval may
persuade Putin to reevaluate the urgency of further health care reform.

Works Cited:

Russian Health (Country Studies)

Russian Health Status in the 1990s
AIDS and Heroin Addiction in Russia
Healthcare in Russia
Putin says Russia needs major health care reform
Putins Health Care Disaster
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