[Paleopsych] Public Interest: Russia, The Sick Man of Europe
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Russia, The Sick Man of Europe
http://www.thepublicinterest.com/current/article1.html
Winter 2005
By Nicholas Eberstadt
The Russian Federation today is in the grip of a steadily tightening
mesh of serious demographic problems, for which the term "crisis" is
no overstatement. This crisis is altering the realm of the possible
for the country and its people--continuously, directly, and adversely.
Russian social conditions, economic potential, military power, and
international influence are today all subject to negative demographic
constraints--and these constraints stand only to worsen over the years
immediately ahead.
Russia is now at the brink of a steep population decline--a peacetime
hemorrhage framed by a collapse of the birth rate and a catastrophic
surge in the death rate. The forces that have shaped this path of
depopulation and debilitation are powerful ones, and they are by now
deeply rooted in Russian soil. Altering Russia's demographic
trajectory would be a formidable task under any circumstances. As yet,
unfortunately, neither Russia's political leadership nor the voting
public that sustains it have even begun to face up to the enormous
magnitude of the country's demographic challenges.
Negative population growth
On New Year's Day 1992--one week after the dissolution of the Soviet
Union--Russia's population was estimated to be 148.7 million. As of
mid 2004, according to the Russian State Statistics Committee
(Goskomstat), the Russian Federation's population was 143.8 million.
During its first eleven and a half years of post-Communist
independence, Russia's population had apparently declined by almost
five million people, or over 3 percent.
In proportional terms, this was by no means the largest population
loss recorded during that period. According to estimates and
projections by the U.N. Bureau of the Census, over a dozen states with
a million people or more experienced a population decline between mid
1992 and mid 2004, 11 of these amounting to drops of 3.1 percent or
more. Unlike some of these drops, however--Bosnia, for example, whose
population total fell almost 10 percent--Russia's decline could not be
explained by war or violent upheaval. In other places, population
decline was due entirely to emigration (Armenia, Kazakhstan), or
nearly so (Georgia). Russia, by contrast, had absorbed a substantial
net influx of migrants during those years--a total net addition of
over 5.5 million newcomers was tabulated between the territory's
Soviet-era January 1989 census and its October 2002 population count.
Despite the mitigating impact of immigration, Russia's post-Communist
population decline was larger in absolute terms than any other
country's over the past decade. Furthermore, continuing population
decline--at a decidedly faster tempo--is envisioned for Russia for as
far as demographers care to project into the future. The only question
is how steep the downward path will be. The U.S. Census Bureau, for
example, offers the relatively optimistic projection of a "mere" 14
million person drop in Russia's population between 2000 and 2025--an
average net decline of about 560,000 persons a year. The U.N.
Population Division's (UNPD) "medium variant" projection, by contrast,
suggests a drop of more than 21 million over that same quarter
century--about 840,000 persons a year for the period as a whole.
In the years ahead, Russia's population decline will continue to
accelerate because the prospective flow of net migration into Russia
is drying up. The officially tabulated annual levels of immigration
to, and emigration from, Russia have declined markedly since the early
1990s-and officially measured net inflows to Russia have likewise
dropped very significantly. These official numbers reflect the
swelling, cresting, and spending of the migration wave of ethnic
Russians from the "near abroad" who resettled to the Russian
Federation during and immediately after the breakup of the Soviet
Union.
The draw of Russia to the (now smaller) pool of overseas Russians
appears to have been much diminished, while the allure to foreign
ethnics of living on Russian soil does not seem to be increasing
appreciably. Russia's reported economic growth rate in the very first
years of the twenty-first century has been has been positive, even
brisk. Nevertheless, according to official figures, the net inflow of
migration to Russia totaled less than 80,000 in all of 2002, and a
mere 25,000 in the first seven months of 2003. By the first quarter of
2004, according to official statistics, the officially tallied surfeit
of immigrants over emigrants was barely 4,000 persons.
With in-migration flows thus subsiding, Russia's population must
mirror, with ever-greater faithfulness, the actual balance of births
and deaths within the country. And in post-Communist Russia, the
current disproportion between deaths and births is stark, indeed
astonishing.
Russia, to be sure, is not the only European country registering more
deaths than births nowadays--according to the Council of Europe's
numbers, fully 19 European states currently report "negative natural
increase." But, in other European settings, the balance is often still
quite close. For example, in Italy--the poster child in many current
discussions of a possible "depopulation" of Europe--there are today
about 103 deaths for every 100 live births. Russia, by contrast,
currently reports about 160 deaths for every 100 births.
Examples of extreme surfeits of mortality over natality are, to be
sure, familiar from human history. But in the past, these were
witnessed only during times of famine, pestilence, war, or mass
disaster. As a peacetime phenomenon it is utterly new, and while it is
not unique to Russia these days--the excess of deaths over births is
nearly as great today in Belarus, Bulgaria, and Latvia, and even more
exaggerated in Ukraine--the Russian Federation is perhaps the most
important example of this post-Communist demographic condition.
Russia's abrupt and brutal swerve onto the path of depopulation began
during the final crisis of the Soviet state. Over the two decades
before Mikhail Gorbachev's 1985 accession to power, Russia's births
regularly exceeded deaths; natural increase typically ranged from
700,000 to 1,000,000 during those years. After 1987, however, births
began to fall sharply, and deaths to rise. Both tendencies were
further accentuated after the collapse of the USSR. The first full
year of post-Communist governance for Russia, 1992, also marked the
shift to negative natural increase for the Russian Federation, with
200,000 more deaths than births. A decade later, Russia's death total
was over 50 percent higher than in 1987 (2.3 million vs. 1.5 million),
while its birth level was over one million lower (1.4 million vs. 2.5
million). In 1987, Russia recorded a natural increase of 968,000; in
2002, deaths surpassed births by almost exactly the same magnitude
(935,000).
This is an extraordinary result, but it is hardly exceptional.
Tabulated deaths have outnumbered births by 900,000 or more in Russia
in 1999, 2000, 2001, and 2002, by nearly 900,000 in 2003, and by over
420,000 in the first half of 2004. In all, between the eve of 1992 and
the summer of 2004 the Russian Federation evidently recorded 10
million more burials than births.
Where have all the babies gone?
Russia's current depopulation bears all the trappings of a
"demographic shock," reflecting the vast, historic change from Soviet
totalitarianism to a commercial democracy. Though it might seem
reasonable to expect that earlier, more "normal" demographic patterns
would reassert themselves as the reverberations from Russia's
"transition" subside, there are good reasons to believe that Russia's
current, seemingly anomalous population trends define a new norm for
the country. Remarkably low birth rates and terrifyingly high death
rates can accurately be described as regular, rather than transitory,
features of the new Russian demographic terrain. A powerful and
self-reinforcing network of social factors--forces typically resistant
to rapid or easy emendation--will likely keep fertility low and
mortality high in the Russian Federation. Until these fundamentals
change, depopulation and tragically foreshortened lives will be the
distinguishing features of the Russian population profile.
Consider Russia's current fertility patterns. In a society with the
Russian Federation's present survival patterns, women must bear an
average of about 2.33 children per lifetime to assure population
stability over successive generations. In the late Soviet era, Russian
fertility levels were near replacement: The country's total fertility
rate (TFR) fluctuated near two births per woman from the mid 1960s
through the mid 1980s. But with the collapse of the Soviet Union, the
Russian fertility rate likewise collapsed, plummeting from 2.19 births
per woman in 1986-87 to 1.17 in 1999. Moreover, extreme subreplacement
fertility is not peculiar to certain regions of Russia today; to the
contrary, it prevails across almost the entire territorial expanse of
the Federation.
Since 2001, there have been some indications of a resurgence of
fertility in the Russian Federation. For the year 2002, according to
Goskomstat, the country's total fertility rate has risen to 1.32. And
for the year 2003, according to Russian Federation President Vladimir
V. Putin in his 2004 New Year's Day address, an "especially joyous"
auspice was the absolute increase in births over the previous year.
According to Goskomstat, Russia's total births rose in 2003 to 1.48
million-by that report, a 6 percent increase over the previous year.
Birth figures for the first half of 2004, for their part, are 2
percent higher than for the first half of 2003.
These signs of improvement raise the question: If Russian fertility
fell suddenly and sharply with the demise of the Soviet Union, might
it not also rebound vigorously in an auspicious political and economic
environment? That possibility cannot be entirely ruled out.
Demographic science, after all, lacks any robust techniques for
accurately predicting future fertility patterns. But even supposing an
improvement in social conditions and an increase in general levels of
confidence (improvements, it should be pointed out, not entirely
independent from the demographic trends under discussion here), there
are a number of factors weighing against a significant upsurge in the
Russian birthrate--much less a return to earlier, Soviet-era, levels
of fertility.
First, Russia's poor and declining overall health patterns extend to
the area of reproductive health. Notably, involuntary infertility is a
more significant problem for Russia than for any other Western
country. And the problem is getting worse, not better. To be sure,
data on infertility for contemporary Russia are not entirely reliable.
According to some recent reports, however, 13 percent of Russia's
married couples of childbearing age are infertile--nearly twice the 7
percent for the United States in 1995 as reported by the National
Center for Health Statistics. Other Russian sources point to an even
greater prevalence of infertility today, with numbers ranging as high
as 30 percent of all males and females of childbearing age. Whatever
the true level, medical diagnoses of infertility in Russia are clearly
on the rise--suggesting that the 13 percent estimate and others of its
ilk are more than just a statistical fluke.
With respect more specifically to female infertility, Russia suffers
today from two pronounced and highly unusual risks. For one thing,
Russian womanhood has, quite literally, been scarred by the country's
extraordinary popular reliance on abortion as a primary means of
contraception--with the abortions in question conducted under the
less-than-exemplary standards of Soviet and post-Soviet medicine. A
Russian woman nowadays can expect to have more abortions than births
over the course of her childbearing years. In 1988, at the end of the
Soviet era, Russian women underwent an officially tabulated 4.6
million abortions--two for every live birth. In 2002, the country
officially reported 1.7 million abortions--over 120 for every 100 live
births.
And the problem of involuntary infertility in Russia today is further
exacerbated by the current explosive spread of potentially curable
sexually transmitted infections (STIs). According to official figures,
for example, the incidence of syphilis in 2001 was one hundred times
higher in Russia than in Germany, and several hundred times higher for
Russia than a number of other European countries. One recent survey in
St. Petersburg calculated that 15 percent of the college students
questioned had at least one sexually transmitted disease. Since
untreated or inadequately treated STIs can result in sterility the
potential for inadvertent impediments to childbearing for Russia's
young men and women due to such infections could be appreciable.
A second obstacle to an increase in the Russian birthrate is the
Russian family itself. Russian patterns of family formation have been
evolving markedly over the past generation--and not in a direction
conducive to larger families. Simply put, young Russians are now much
less likely to marry--and ever more likely to divorce if they do.
Between 1981 and 2001, marriage rates fell by over one third, while
divorce rates rose by one third. In 2001, Russia recorded three
divorces for every four new marriages--a breakup ratio even higher
than Scandinavia's. The human import of these trends can perhaps be
better understood by thinking in terms of a woman's odds of getting
married or divorced. In 1990, under Russia's then-prevailing
nuptiality patterns, marriage was almost universal--and the odds of
eventually divorcing were about 40 percent. By 1995, the odds of
getting married were down to 75 percent--while the odds of eventual
divorce had risen to 50 percent. In just five years a Russian woman's
odds of forming a lasting marriage dropped from about three in five to
three in eight. Since then, the odds of having a lasting marriage in
Russia seem to have declined still further.
At the same time that Russian marriages were becoming less common--and
more fragile--the disposition to childbearing outside of marriage was
increasing. In 1987--the recent high-water mark for Russian
fertility--about 13 percent of the country's newborns were out of
wedlock. By 2001, the proportion had more than doubled, to nearly 29
percent. The overwhelming majority of Russia's newly emerging cohort
of illegitimate children, it seems, were being raised by single
mothers. Consensual unions and cohabitation still account for the
living arrangements of only a tiny fraction of Russia's young adults.
The rapid decline of the two-parent family in contemporary Russia
undercuts prospects for substantial increases in national fertility
levels. Relative to available household resources, all other things
being equal, raising children in a mother-only family is a much more
expensive and difficult proposition than in an intact family. It is
true that fertility rates in Russia are currently 20 to 30 percent
below those of the Scandinavian countries, even though the level of
marital commitment in the Nordic countries is low, and the level of
illegitimacy is high. But unlike the Scandinavian welfare states,
Russia does not provide generous public benefits to help mothers raise
their young children--nor could the Russian state afford to do so even
if it were so inclined.
The third, and perhaps most important, obstacle to higher Russian
birthrates is that Russian fertility rates are reflective of larger
European trends. True, Russia's levels currently list toward the lower
end of the European spectrum. Even so, they are actually higher than
for some other post-Communist areas whose "transitions" to democracy
and free markets look rather more complete--and are scarcely lower
than the current levels in a number of the established market
democracies of the European Union. Viewed over a longer horizon,
Russia's postwar fertility levels and trends look altogether
"European." Although the precise timing of Russia's fertility decline
is distinct, Russia has nevertheless clearly followed the same general
path as Italy, Spain, and Germany.
From a European perspective, in short, Russia's current levels of
extremely low fertility would hardly stand out as exceptional. It is
thus far from obvious that the further suffusion into Russia of
"European" norms and attitudes about family size (to the extent that
such attitudes and norms are not already firmly rooted in Russian
soil) should serve to buoy childbearing in the Russian Federation.
Quite to the contrary. It is equally possible that an embrace of
particular aspects of childbearing patterns currently manifest through
much of the European Union (EU) could actually depress birth rates in
Russia in coming years. Throughout the EU, for example, the median age
at marriage for women is the late 20s, while it is still about 22 in
Russia; Russia's median female age at first birth, correspondingly, is
distinctly lower than in most EU countries (23 vs. 27 to 29). A shift
toward these EU patterns of marriage and maternity would have the
immediate effect of postponing births, and thus probably lowering
annual fertility further.
The grim reaper cometh
If Russia's low fertility rates are cause enough for concern, its
mortality rates are scandalously high. Broad segments of the Russian
populace have suffered a disastrous long-term retrogression in health
conditions.
A marked deterioration of public health in an industrialized society
during peacetime is counterintuitive and highly peculiar. At first
glance, the very fact that Russia's mortality catastrophe looks so
anomalous might seem to suggest that the problem should be
intrinsically remediable--if not positively self-correcting. The
particulars of Russia's health and mortality woes, however, underscore
just how difficult it will be to achieve even modest improvements in
the years immediately ahead--and how vulnerable Russia remains to
further degradations of public health.
Over the four-plus decades between 1961-62 and 2003, life expectancy
at birth in Russia fell by nearly five years for males; it also
declined for females, although just slightly, making for an overall
drop in life expectancy of nearly three years over this four-decade
span. Age-standardized mortality rates cast an even grimmer light on
Russia's continuing health crisis: Between the mid 1960s and the start
of the twenty-first century, these rates underwent a long and uneven
rise, climbing by over 15 percent for women and over 40 percent for
men.
Russia's upswing in mortality was especially concentrated among its
working-age population, and here the upsurge in death rates was
utterly breathtaking. Over the three decades between 1970-71 and 2001,
for example, every female cohort between the ages of 20 and 59
suffered at least a 30 percent increase in death rates; for men
between the ages of 40 and 59, the corresponding figures uniformly
reached, and some cases exceeded, 60 percent.
What accounted for this peacetime collapse in public health standards?
To go by Russia's (admittedly less than perfect) cause-of-death
statistics, nearly all of the increase in mortality rates for men--and
absolutely all of the increase for women--can be traced to an
explosion in deaths attributed to cardiovascular disease (CVD--heart
disease plus strokes) and injuries. Between the mid 1960s and the end
of the twentieth century, CVD mortality rates in Japan, Western
Europe, and North America fell sharply. Russia, by contrast, suffered
an explosion of cardiovascular death over the same period. Between
1965 and 2001, Russia's age-standardized death rate for CVD surged by
25 percent for women--and it soared by 65 percent for men. Today,
CVD-related mortality in Russia is four times higher than in Ireland,
five times higher than in Germany, and eight times higher than in
France.
As for mortality attributed to injury--murder, suicide, traffic,
poisoning, and other violent causes-age-adjusted levels for Russian
men and women alike more than doubled between 1965 and 2001. Among
contemporary societies at peace, Russia's level of violent deaths
places the country practically in a category of its own. For men under
65 years of age, Russia's death rate from injury and poisoning is
currently over four times as high as Finland's, the nation with the
worst rate in the EU. Russia's violent death rate for men under 65 is
nearly six times as high as Belgium's, over nine times as high as
Israel's, and over a dozen times that of the United Kingdom. As is
well known, men are more likely than women to die violent deaths--but
in a gruesome crossover, these death rates for Russian women are now
higher than for most western European men.
Russia's dismal health record can be explained in terms of a
multiplicity of unfavorable social, behavioral, and policy tendencies:
pervasive smoking; poor diets; sedentary life styles; increasing
social atomization and anomie; the special economic stresses of
Russia's "transition"; the unimpressive capabilities of the Soviet
medical system and the limited coverage of its successor. At the end
of the day, however, it is impossible to overlook the deadly
contribution of the Russian love of vodka.
From the sixteenth century--when vodka was first introduced to a
receptive public--up to the present day, Russians have always
demonstrated a predilection to drink heavy spirits in astonishing
excess--a fact remarked upon by visiting foreigners for centuries.
Russia's thirst for hard liquor seems to have reached dizzying new
heights in the late Soviet era, and then again in the early
post-Communist era. By 1984, according to some estimates, the per
capita level of alcohol intake in Russia was roughly three times as
high as in 1913 (that pre-revolutionary era not exactly being
remembered as a time of temperance). By the mid 1990s, Russian per
capita alcohol intake may have even slightly surpassed its previous,
Communist-era, zenith. In 1994, for example, the estimate of pure
alcohol consumed by the population aged 15 and older amounted to 18.5
liters per capita annually--the equivalent of 125 cc. of vodka for
everyone, every day.
As it happens, in recent decades variations in alcohol consumption
seem to track fairly closely with changes in Russian mortality (and
especially with male mortality)--the former being a leading indicator
for the latter. Heavy drinking is directly associated with Russia's
appallingly high risk of deadly injury--and Russia's binge drinking
habits also seems to be closely associated with death through cardiac
failure.
At the moment, the expert prognosis for Russian mortality in the years
immediately ahead is pessimistic. The U.N. Population Division, for
example, estimates the life expectancy for Russian men today to be
lower than the average for men from the world's "less developed
regions" (such as Africa, Asia, and Latin America)--and though UNPD
projections envision improvements for Russia in the coming decades,
Russia does not reach the level of the less developed regions until
around 2020. The U.S. Census Bureau, for its part, estimates that life
expectancy for Russian men over the coming two decades will
approximate the levels for their counterparts in Bangladesh and
Pakistan--and will remain steadily below the levels anticipated for
India.
Yet somber as these readings appear, they may nevertheless prove
excessively optimistic. The Census Bureau projections for Russian
mortality, for example, have tended to err on the high side: Where the
Census Bureau projections in 2002 put Russian male life expectancy for
2002 at 62.3 years, Goskomstat's actual data for that year turned out
to be three and a half years lower. And although the UNPD is imagining
unexceptional improvements in male health levels over the next two
decades--less than four years' increase between 2000-5 and
2020-25--there are reasons to think such a goal highly ambitious under
Russia's current circumstances. The problem, simply put, is that
today's Russians seem to be less healthy than their parents.
Consequently, merely managing to re-attain the survival rates reported
by that earlier generation will take some doing. It is an
accomplishment that cannot be taken for granted.
Comparing the mortality schedules of successive birth cohorts in
Russia places the problem of "negative health momentum" in even
clearer perspective. In industrialized Western societies in the
postwar era, younger generations have come routinely to enjoy better
survival rates than their predecessors. Sometimes these improvements
have been truly dramatic. In contemporary Japan, for example, men born
in the early 1950s have, over their life course thus far, experienced
death rates roughly half as high at any given age as those that were
recorded for the cohort born 20 years before them. By contrast, there
has been no improvement in survival schedules for rising birth cohorts
among the two generations of Russian men born between the late 1920s
and the late 1980s. Quite the opposite: Over its life course, each
rising cohort of Russian men seems to be charting out a more dismal
mortality trajectory than the one traced by its immediate
predecessors.
The "negative momentum" apparent in Russia's modern-day mortality
trends makes the objective of broad, sustained improvements in public
health especially unlikely in the years ahead. And this analysis, it
is worth noting, has yet to take into account the possibility of
additional new health troubles on the horizon. Yet such problems are,
quite plainly, gathering today. Foremost among them may be Russia's
still-mounting epidemic of HIV/AIDS. As we have already seen, curable
STIs are now rampant in Russia--and generally speaking, epidemic
levels of curable STIs seem to serve as a leading indicator for the
spread of HIV.
Russian authorities have registered a cumulative total of just under
300,000 cases of HIV, while the U.N. Joint Programme on HIV/AIDS
(UNAIDS) estimates that over 800,000 Russians were living with HIV as
of 2003 (with an upper estimate of 1.4 million). The U.S. National
Intelligence Council (NIC) suggests that the true number as of 2002
could have been as high as 2 million. If the UNAIDS central estimate
were accurate, Russia's adult HIV prevalence rate would be over 2
percent; by the NIC's 2002 estimates, it could already have been as
high as 2.5 percent in 2002. The future course of Russia's HIV
epidemic is likewise clouded in uncertainty. Clearly, though, HIV has
the potential to cancel any prospective health progress in Russia over
the coming generation.
Progress is, of course, to be prayed for--and under the right
circumstances, some progress may be achieved. But major reductions in
Russia's awful toll of excess mortality do not look to be in the cards
any time soon.
The tightening demographic straitjacket
Russia's demographic trends have unambiguously negative implications
for Russian development and security. The ramifications are manifold
and far-reaching, some of them complex--but the basic outlines of the
more important considerations can be briefly and simply adduced.
Russia's lingering health and mortality crisis promises to be a brake
on rapid economic development. In the modern era, the wealth of
nations is represented, increasingly, in human rather than natural
resources--and the richer the country, the more pronounced the
tendency for "human capital" to overshadow or replace physical capital
in the production process. Human health figures importantly in the
overall composition of human capital, and thus the correspondence
between human health and economic productivity has been fairly robust.
In recent years, to judge by U.N. and World Bank data, an additional
year of male life expectancy at birth has been associated with an
increment of GNP per capita of about 8 percent.
The relationship between health and economic productivity, to be sure,
is multidimensional and simultaneous--improved wealth also makes for
better health, and does so through a variety of avenues. But it is
difficult to see how Russia can expect, in some imagined future, to
maintain a western standard of living if its work force suffers from a
third-world schedule of survival--or worse.
Skeptics might argue that health does not seem to be constraining
Russia's economic progress today--recorded growth rates, after all,
have been high for the past several years. Perhaps poor health will
not overly constrain Russian economic development in the years ahead,
since Russia can earn large dividends from the exploitation and sale
of its abundant natural resources. But Russia's dependence upon
extractive industries only emphasizes just how limited the role of
"human capital" is in Russia's current international trade profile.
Russia's poor health prospects, furthermore, stand to influence its
economic potential far into the future. According to year 2000
survival schedules, for example, a 20-year-old Russian youth had only
a 46 percent chance of reaching age 65 (compared with a 79 percent
chance for an American counterpart). That discrepancy will surely
affect the cost-benefit calculus of investments in education and job
training--and not to the benefit of Russia's younger generation or its
overall economic outlook.
In the short run, the collapse of Russian fertility may have little
practical (as opposed to psychological) import for daily life or
affairs of state. If, however, extreme subreplacement fertility
persists, current and continued childbearing patterns would directly
shape the Russian future. In some nontrivial respects, it could
materially limit Russian national options. In the decades immediately
ahead, for example, Russia looks set to contend with a sharp fall-off
in the nation's youth population. Between 1975 and 2000, for example,
the number of young men aged 15 to 24 ranged between 10 million and 13
million--but by 2025, in current UNPD projections, the total will be
down to barely 6 million. Those figures would imply a 45 percent
decrease between 2000 and 2025 in the size of this pivotal population
group--as compared with a projected 15 percent decline in Russia's
overall population.
The military implications of the envisioned disproportionate shrinkage
of the age group from which the Russian army draws its manpower are
obvious enough. But there would also be serious economic and social
reverberations. With fewer young people rising to replace older
retirees, the question of improving (or perhaps maintaining) the
average level of skills and qualifications in the economically active
population would become that much more pressing. And since younger
people the world over tend to be disposed toward, and associated with,
innovation and entrepreneurial risk-taking, a declining younger
population could have intangible, but real, consequences.
In a world of still-growing populations and generally improving health
conditions, Russia would seem to face an uphill struggle. Between 2000
and 2025, by UNPD medium variant projections, Russia's share of total
global population is envisioned as shrinking by a third, from 2.4
percent to 1.6 percent. Over the same period, improvements in Russia's
life expectancy are expected to under-perform the global average
somewhat. Simply to maintain its share of world output, Russia's per
capita economic growth would have to exceed the world's average by 1.6
points a year for the quarter century under consideration to
compensate for relative population decline. To some important extent,
a country's relative economic potential limits its international
political influence and its international security. Russia's
demographic prospects thus establish an obvious challenge for the
nation over the coming generation. Can it avoid, through compensatory
economic policies and foreign policy stratagems, the geopolitical
marginalization to which demographic trends alone would seem to
consign it?
The politics of depopulation
Russia's political leaders are by no means incognizant of the
demographic vise gripping their nation. The country's politicians and
policy makers talk about the nation's population constantly. However,
Moscow has done almost nothing worth mentioning to reverse the
demographic catastrophe that has been unfolding on Russian soil over
the past decade.
To the extent that Russian policy makers have concerned themselves
with the country's negative natural increase problem, they have
focused almost entirely upon the birth rate--and how to raise it. Not
surprisingly, this pro-natalist impulse has foundered on the shoals of
finance. In plain terms, serious pro-natalism is an expensive
business, especially when the potential parents-to-be are educated,
urbanized women accustomed to careers with paid recompense. To induce
a serious and sustained increase in childbearing, a government under
such circumstances must be prepared to get into the business of hiring
women to be mothers--and this is a proposition that could make the
funding of a national pension system look like pin money by
comparison. Consequently, Russia's government has concentrated most of
its pro-natalist efforts on attempting to "talk the birth rate
up"--and as a century of experience with such official chatter in
Western countries will attest, that gambit is almost always utterly
ineffectual.
In 2003, the Russian government began experimenting with another
variant of "pro-natalism on the cheap": a quiet attempt to restrict
the previously unconditional availability of abortion on demand. There
are, of course, ethical reasons for opposition to the promiscuous
destruction of fetuses. But from a strictly demographic standpoint,
the dividends derived from a slight and gradual tightening of the
rules on pregnancy termination are distinctly limited.
Reducing the number of abortions, after all, does not mechanistically
increase birth totals. If it did, there should have been a baby-boom
in post-Communist Russia. (Remember: Russia had about three million
fewer abortions in 2002 than in 1987--but also about a million fewer
births.) To the extent that Russia's tentative steps toward the
regulation of abortion may be seen as a factor boosting the nation's
fertility, the effect would largely be felt through the eventual
enhancement of fecundity--which is to say, fewer Russian women would
be rendered involuntarily sterile through such procedures in the years
ahead. But in the greater scheme of things, that could hardly be
described as much of a stimulus.
While Russian policy circles trained their attention on a literally
fruitless and largely misdirected effort to revitalize the birth rate,
they treated the country's catastrophic mortality conditions--upon
which sustained interventions would have yielded some predictable
results--with an insouciance verging on indifference. Indeed, Russian
authorities have adopted a remarkably laissez-faire posture toward the
calamitous conditions that currently lead to the "excess mortality" of
something like 400,000 of their citizens each year.
Russia's devastating cardiovascular epidemic and its carnage from
violent death might not be immediately controlled or completely
prevented, but their cost could be at least somewhat contained through
carefully tailored public policies. Yet government policy makers have
shown no interest in pursuing such options.
Crisis in democracy
Moscow's feckless approach to its ongoing national health emergency
would be regarded as a scandal in most foreign quarters. But to
Western eyes it also constitutes something of a mystery: How is it
possible that such a manifestly inadequate health regimen is tolerated
in a still somewhat open and pluralistic political system? The
proximate explanation for this puzzle is that, until now, no great
political pressure has been brought to bear for correction or
adjustment of the government's course--and the absence of such
articulated pressures reflects in turn a lack of perceived political
concern by the public at large. Russia may have already lost the
equivalent of its casualties in two, or more, World War I's through
premature mortality since 1992. But as yet there has been almost no
public outcry about this peacetime outrage, and none of the dozens of
competitive parties in Russia's new electoral environment have seen
fit to champion the promotion of the nation's health as its own
political cause. This is more than a health crisis. It constitutes
nothing less than a fundamental test for Russia's troubled fledgling
democracy.
This essay is based on the author's "The Russian Federation at the
Dawn of the Twenty-First Century," NBR Analysis 15, no. 2 and is
published with permission of the National Bureau of Asian Research
Copyright of The Public Interest, Issue #158 (Winter 2005), National
Affairs, Inc.
Nicholas Eberstadt is the Henry Wendt Scholar in Political Economy at
the American Enterprise Institute, and is a member of the Publication
Committee of The Public Interest.
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