Understanding the “Russian Mortality Paradox” in Central Asia: Evidence from Kyrgyzstan

Abstract

In the former Soviet republics of central Asia, ethnic Russians have exhibited higher adult mortality than native ethnic groups (e.g., Kazakh, Kyrgyz, Uzbek) in spite of the higher socioeconomic status of ethnic Russians. The mortality disadvantage of ethnic Russians at adult ages appears to have even increased since the breakup of the Soviet Union. The most common explanation for this “Russian mortality paradox,” is that deaths are better reported among ethnic Russians. In this study, we use detailed mortality data from Kyrgyzstan between 1959 and 1999 to evaluate various explanations for the Russian mortality paradox: data artifacts, migration effects, and cultural effects. We find that the most plausible explanation is the cultural hypothesis because the personal behaviors that appear to generate a large part of the observed mortality differences (alcohol consumption, in particular) seem to be closely tied to cultural practices. We examine the implications of this finding for understanding the health crisis in post-Soviet states.

Infant mortality in Kyrgyzstan before and after the break-up of the Soviet Union

“…These patterns, together with information on causes of deaths, have led researchers to emphasize the role of adult behaviors, such as alcohol consumption and violence, and to relate these behaviors to the stark decline in the country’s economic and social conditions (Shkolnikov et al 1998). In the case of Kyrgyzstan, a much poorer country where the economic crisis has been even more severe than in Russia, adult mortality has paradoxically exhibited stronger resilience, in part because of cultural differences influencing patterns of alcohol consumption (Guillot et al 2011). However, this conclusion does not hold for children.…”

Fertility Changes in Central Asia Since 1980

“…In doing so, it was assumed that no underestimation was affecting the children and women at any age, i.e., under-enumeration factors were kept at 1.0. As age and sex mortality patterns in Central Asia vary, to a large extent, between ethnicity (Andreev, Dobrovolskaya, & Shaburov, 1992;Guillot, Gavrilova, & Pudrovska, 2011), I should have used, ideally, nationally ethnic-specific mortality patterns to reverse-survive the children and women. Access to such data remains, however, difficult for Central Asian countries, and the specificity of the age and sex mortality patterns of each ethnic group makes it difficult to apply indirect procedure to deduce an age and sex mortality pattern from limited information such as under-five mortality.…”

Cardiovascular burden and percutaneous interventions in Russian Federation: systematic epidemiological update

“…Stress is a cause of one fourth of the overall mortality increase (38,39). A significant stratification of the population into socioeconomic groups with sharp differences in levels of health has begun in Russia.…”