Drunken Nation: Russia’s Depopulation Bomb

Aspecter is haunting Russia today. It is not the specter of Communism—that ghost has been chained in the attic of the past—but rather of depopulation—a relentless, unremitting, and perhaps unstoppable depopulation. The mass deaths associated with the Communist era may be history, but another sort of mass death may have only just begun, as Russians practice what amounts to an ethnic self-cleansing. 

Since 1992, Russia’s human numbers have been progressively dwindling. This slow motion process now taking place in the country carries with it grim and potentially disastrous implications that threaten to recast the contours of life and society in Russia, to diminish the prospects for Russian economic development, and to affect Russia’s potential influence on the world stage in the years ahead. 

In the postwar Soviet era, Russia’s so-called “total fertility rate” (TFR), which calculates the number of births a typical woman would be expected to have during childbearing years, exceeded 2.0—and in the early years of the Gorbachev era, Russia’s total fertility rate temporarily exceeded 2.2. After 1989, though, it fell far below 2.0 with no signs as yet of any recovery. Russia’s post-Communist TFR hit its low—perhaps we should say its low to date—in 1999, when it was 1.17. By 2005, the total fertility rate in the Russian Federation was up to about 1.3—but this still represented a collapse of about two-fifths from the peak level in the Gorbachev years.

Country	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014
Russia	1.25	1.27	1.3	1.33	1.26	1.27	1.28	1.39	1.4	1.41	1.41	1.42	1.61	1.61	1.61

Is Russia’s post-Communist plunge in births the consequence of a “demographic shock,” or the result of what some Russian experts call a “quiet revolution” in patterns of family formation? At the moment, it is possible to see elements of both in the Russian Federation’s unfolding fertility trends. Demographic shocks tend by nature to be transient; demographic transitions or “revolutions,” considerably less so. But this much is clear: to date, no European society that has embarked upon the same demographic transition as Russia’s—declining marriage rates with rising divorce; the spread of cohabitation as alternative to marriage; delayed age at marriage and sub-replacement fertility regimens—has reverted to more “traditional” family patterns and higher levels of completed family size. There is no reason to think that in Russia it will be any different. 

In addition to its daunting fertility decline, Russia’s public health losses today are of a scale akin to what might be expected from a devastating war. Since the end of the Communist era, in fact, “excess mortality” has cost Russia hundreds of thousands of lives every year. 

The 1960s and 1970s witnessed an increase in mortality rates for key elements of the Soviet population. But Russia’s health patterns did not correct course with the collapse of the USSR, as many experts assumed they would. In fact, in the first decade and a half of its post-Communist history the country’s health conditions actually became worse. Life expectancy in the Russian Federation is actually lower today than it was a half century ago in the late 1950s. In fact, the country has pioneered a unique new profile of mass debilitation and foreshortened life previously unknown in all of human history. 

Like the urbanized and literate societies in Western Europe, North America, and elsewhere, the overwhelming majority of deaths in Russia today accrue from chronic rather than infectious diseases: heart disease, cancers, strokes, and the like. But in the rest of the developed world, death rates from these chronic diseases are low, relatively stable, and declining regularly over time. In the Russian Federation, by contrast, overall mortality levels are high, manifestly unstable, and rising. 

The situation for Russian males has been particularly woeful. In the immediate postwar era, life expectancy for men was somewhat lower than in other developed countries—but this differential might partly be attributed to the special hardships of World War II and the evils of Stalinism. By the early 1960's, the male life expectancy gap between Russia and the more developed regions narrowed somewhat—but then life expectancy for Russian men entered into a prolonged and agonizing decline, while continued improvements characterized most of the rest of the world. By 2005, male life expectancy at birth was fully fifteen years lower in the Russian Federation than in Western Europe. It was also five years below the global average for male life expectancy, and three years below the average for the less developed regions (whose levels it had exceeded, in the early 1950's, by fully two decades). Put another way, male life expectancy in 2006 was about two and a half years lower under Putin than it had been in 1959, under Khrushchev. 

According to the U.S. Census Bureau International Data Base for 2007, Russia ranked 164 out of 226 globally in overall life expectancy. Russia is below Bolivia, South America’s poorest (and least healthy) country and lower than Iraq and India, but somewhat higher than Pakistan. For females, the Russian Federation life expectancy will not be as high as in Nicaragua, Morocco, or Egypt. For males, it will be in the same league as that of Cambodia, Ghana, and Eritrea. 

In the face of today’s exceptionally elevated mortality levels for Russia’s young adults, it is no wonder that an unspecified proportion of the country’s would-be mothers and fathers respond by opting for fewer offspring than they would otherwise desire. To a degree not generally appreciated, Russia’s current fertility crisis is a consequence of its mortality crisis. 

By any reading, the situation in Russia today sounds awful. The Russian Federation is afflicted with a serious HIV/AIDS epidemic; according to UNAIDS, as of 2008 somewhere around 1 million Russians were living with the virus. (Russia’s HIV nexus appears to be closely associated with a burgeoning phenomenon of local drug use, with sex trafficking and other forms of prostitution or “commercial sex,” and with other practices and mores relating to extramarital sex.) Russia also faces a related and evidently growing burden of tuberculosis. As of 2008, according to World Health Organization estimates, Russia was experiencing about 150,000 new TB infections a year. To make matters worse, almost half of Russia’s treated tubercular cases over the past decade have been the variant known as extreme drug-resistant tuberculosis (XDR-TB). 

In Western Europe, age-standardized mortality from injury and poisoning, as tabulated by the World Health Organization, fell by almost half between 1970 and 2006. In Russia, on the other hand, deaths from injuries and poisoning, which had been 2.5 times higher than in Western Europe in 1980, were up to 5.3 times higher as of 2006. 

A broadly negative relationship was evident between mortality from injuries and per capita income. In other Western countries in 2002, an increase of 10 percent in per capita GDP was associated with a drop of about 2 points in injury deaths per 100,000 population. Yet Russia’s toll of deaths is nearly three times higher than would be predicted by its GDP. No literate and urban society in the modern world faces a risk of deaths from injuries comparable to the one that Russia experiences. 

Russia’s patterns of death from injury and violence (by whatever provenance) are so extreme and brutal that they invite comparison only with the most tormented spots on the face of the planet today. The five places estimated to be roughly in the same league as Russia as of 2002 were Angola, Burundi, Congo, Liberia, and Sierra Leone. To go by its level of mortality injury alone, Russia looks not like an emerging middle-income market economy at peace, but rather like an impoverished sub-Saharan conflict or post-conflict society. 

Taken together, then, deaths from cardiovascular disease and from injuries and poisoning have evidently been the main drivers of modern Russia’s strange upsurge in premature mortality and its broad, prolonged retrogression in public health conditions. One final factor that is intimately associated with both of these causes of mortality is alcohol abuse. 

Unlike drinking patterns prevalent in, say, Mediterranean regions—where wine is regarded as an elixir for enhancing conversation over meals and other social gatherings, and where public drunkenness carries an embarrassing stigma—mind-numbing, stupefying binge drinking of hard spirits is an accepted norm in Russia and greatly increases the danger of fatal injury through falls, traffic accidents, violent confrontations, homicide, suicide, and so on. Further, extreme binge drinking (especially of hard spirits) is associated with stress on the cardiovascular system and heightened risk of CVD mortality. 

How many Russians are actually drinkers, and how heavily do they actually drink? Officially, Russia classifies some 7 million out of roughly 120 million persons over 15 years of age, or roughly 6 percent of its adult population, as heavy drinkers. But the numbers are surely higher than this. According to data compiled by the World Health Organization, as of 2003 Russia was Europe’s heaviest per capita spirits consumer; its reported hard liquor consumption was over four times as high as Portugal’s, three times that of Germany or Spain, and over two and a half times higher than that of France. 

Yet even these numbers may substantially understate hard spirit use in Russia, since the WHO figures follow only the retail sale of hard liquor. But samogon—home-brew, or “moonshine”—is, according to some Russian researchers, a huge component of the country’s overall intake. Professor Alexander Nemstov, perhaps Russia’s leading specialist in this area, argues that Russia’s adult population—women as well as men—puts down the equivalent of a bottle of vodka per week. 

From the epidemiological standpoint, local-level studies have offered fairly chilling proof that alcohol is a direct factor in premature mortality. One forensic investigation of blood alcohol content by a medical examiner’s office in a city in the Urals, for example, indicated that over 40 percent of the younger male decedents evaluated had probably been alcohol-impaired or severely intoxicated at the time of death—including one quarter of the deaths from heart disease and over half of those from accidents or injuries. But medical and epidemiological studies have also demonstrated that, in addition to its many deaths from consumption of ordinary alcohol, Russia also suffers a grisly toll from alcohol poisoning, as the country’s drinkers, in their desperate quest for intoxication, down not only sometimes severely impuresamogon, but also perfumes, alcohol-based medicines, cleaning solutions, and other deadly liquids. Death rates from such alcohol poisoning appear to be at least one hundred times higher in Russia than the United States—this despite the fact that the retail price in Russia today is lower for a liter of vodka than a liter of milk. 

It is not obvious that Russia will be able to recover rapidly from its health katastroika. There is an enormous amount of “negative health momentum” in the Russian situation today: with younger brothers facing worse survival prospects than older brothers, older brothers facing worse survival prospects than their fathers, and so on. Severely foreshortened adult life spans can shift the cost-benefit calculus for investments in training and higher education dramatically. On today’s mortality patterns, a Swiss man at 20 has about an 87 percent chance of making it to a notional retirement age of 65. His Russian counterpart at age 20 has less than even odds of reaching 65. Harsh excess mortality levels impose real and powerful disincentives for the mass acquisition of the technical skills that are a key to wealth generation in the modern world. Thus Russia’s health crisis may be even more generally subversive of human capital, and more powerfully corrosive of human resources, than might appear to be the case at first glance. 

Putin’s Kremlin made a fateful bet that natural resources—oil, gas, and other extractive saleable commodities—would be the springboard for the restoration of Moscow’s influence as a great power on the world stage. In this gamble, Russian authorities have mainly ignored the nation’s human resource crisis. During the boom years—Russia’s per capita income roughly doubled between 1998 and 2007—the country’s death rate barely budged. Very much worse may lie ahead. How Russia’s still-unfolding demographic disaster will affect the country’s domestic political situation—and its international security posture—are questions that remain to be answered. 

Written Spring of 2009

DYI Comments:  Nothing has changed since 2009 except with the very real possibility that conditions are worse.  On a demographic basis Russia is having their last flurry on the world's stage before their population bust is so severe maintaining a military becomes inhibited.

To illustrate, Russia's land mass is 6.592 million sq. miles as compared to the continental U.S. (excluding Alaska, Hawaii) at 2.959 million sq. miles and yet the population difference is staggering, despite a land size 122% larger, Russian is 142 million as compared to the U.S. with 320 million or 55% less people.  Guarding Russia's vast frontiers requires man power for their army and air forces a task that becomes more and more difficult due to their demographic disaster.  If their population were to drop below 100 million holding onto the political subdivision east of the Urals would become impossible.

DYI