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Streetwise Professor

June 29, 2009

Fat, Drunk, and Stupid is No Way to Go Through Life, Son

Filed under: Economics,Politics,Russia — The Professor @ 8:49 pm

Reuters carries this horrific report on a study of alcohol related death, published in the Lancet:

Cheap and illicit alcohol kills more than half Russian men and women in their most productive years and the government must act urgently to reverse the trend, a study to be published in The Lancet at the weekend said.

“Excessive alcohol consumption in Russia, particularly by men, has in several recent years caused more than half of all the deaths at ages of 15-54 years,” the Lancet article said. The research conducted in three industrial cities — Tomsk, Barnaul and Biysk — said “excess mortality from liver cancer, throat cancer, liver disease, and pancreatic disease is largely or wholly because alcohol caused the disease that caused death”.

High mortality from tuberculosis and pneumonia may be partly a result of increased exposure to infection, weak immunity, or decreased likelihood of cure, the research found.

Russia’s mortality rate in people aged 15-54 years was more than five times higher for men and three times higher for women than in Western Europe, the study showed.

Alcohol is responsible for about three quarters of the deaths of all Russian men aged 15-54 and about half of all deaths of Russian women of the same age, the data showed.

. . . .

He estimated Russia had some 2.5 million registered alcoholics and about the same number of unregistered ones.

“Drunkards, not alcoholics, are the main threat to demography,” Nemtsov told Reuters. “Heavy drinkers make up 40 percent of Russian males, but this figure may be bigger.” The proportion of male and female drinkers is 4 to 1, he said.  [The distinction between drunkards and alcoholics is a new one on me, but I think I understand the difference in this context.]

Thirty-thousand people — twice the number the Soviet Union lost during its 10-year war in Afghanistan — die from alcohol poisoning in Russia each year.

To put the last statistic in context, in the United States, the total number of accidental poisoning deaths from all causes in 2004 was  20,950.    And that in a nation with more than twice the population as Russia.  In 1996-1998, there was an average of 317 deaths attributed primarily to alcohol poisoning, with another 1,076 deaths where alcohol poisoning was a contributing cause.  So, roughly speaking, there are at least 25 times more deaths from alcohol poisoning in Russia, with a population of less than half that of the US–making a 50 fold difference in the rate of such deaths between the two countries.  

I know there are those who deny that this is germane to Russia’s demographic prospects, since from a purely biological perspective it is the female population that is the constraint on the number of births.  However, the article notes that although Russian male death rates are an appalling 5 times greater than Western European rates, Russian female death rates are still 3 times greater, which is a demographic drag.  Moreover, moving beyond the purely biological, it must be remembered that there is a choice component to fertility, and fertility choices depend in part on economic prospects.   Women will be far more reluctant to have children when there is a substantial risk of the premature death or incapacitation of their spouse, not to mention the fact that the earning potential of alcoholics (and drunkards!) is impaired (no pun intended) even if they survive, not to mention that the prospect of living with a drunk and the associated pathologies hardly encourages thoughts of children.  (And what of the torment of the children that these men do father?)  

I know there will be some readers that think otherwise, but I don’t write this out of a desire to point out Russian failings.  I find the whole thing truly horrifying and sickening and tragic.  I can only wonder at what leads so many people to destroy their lives in this way.  It really is beyond my comprehension.  But it cannot say anything good about the spiritual health (again no pun intended) of Russia.  Instead, it suggests a profound unhappiness and widespread despair.  How can people brag about “Russia getting off its knees” when a good portion of the population–more than 40 percent of the men–are face first in the gutter in a drunken stupor?   And what drives them there in the first place?

But what is even more incomprehensible to me is that this appears to be a low priority for the government–if it is a priority at all.  The problem is sometimes recognized, but there seems to be little effort to address it.  Putin has admitted the problem, but he merely recommends that “Russians should drink less.”    I guess he has more important things to do, like lowering the price of pork chops. You cannot make this stuff up.  

So, out of genuine curiosity and concern (believe it or not), I ask all self-styled Russophiles: What explains this social catastrophe? What should be done about it? And why isn’t the government doing it?

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  1. I’ve written a lot about this on my blog.

    Re-”However, the article notes that although Russian male death rates are an appalling 5 times greater than Western European rates, Russian female death rates are still 3 times greater, which is a demographic drag.” Not really, because ABSOLUTE death rates amongst women in their reproductive age are still negligible – despite being relatively much higher than in W. Europe / the US.

    Re-”I find the whole thing truly horrifying and sickening and tragic. I can only wonder at what leads so many people to destroy their lives in this way.” That’s not how (most) Russians view it. Apart from the chronic alcoholics who die in their 30′s and 40′s (who are a small minority, even amongst men), most Russian drinking happens in binges amongst friends, sometimes lasting several days. Then they may go days or even weeks without touching a drop, leading normal and sometimes successful lives. The only difference is that the accumulation of insults means that they die in their 50′s or 60′s, instead of in their 70′s or 80′s as typical elsewhere.

    It should also be noted that this phenomenon began not in 1990, but at around 1965 (that was when mortality rates for men reversed and began a secular decline), presumably because vodka was cheap and Soviet life was dreary due to the zastoi, etc. By the early 1980′s mortality rates were already about equivalent to today’s. That said, fertility rates were relatively healthy during the Soviet period, fluctuating around replacement level rates (unlike the case in W. Europe), so saying that this is the cause behind the fertility cliff of the 1990′s rather than the transition shock is not borne out by the evidence. Nor is widespread drunkenness necessarily a symptom, let alone a cause, of national stagnation. The US was called the “Alcoholic Republic” in the glorious early days of its founding. ;)

    “But what is even more incomprehensible to me is that this appears to be a low priority for the government–if it is a priority at all.” That is true only for the Yeltsin and early Putin period, but not at all today as any informed observer of the matter would note. However at root this is a lifestyle issue, not a strictly economic-healthcare one, so the options are limited.

    Comment by Sublime Oblivion — June 29, 2009 @ 10:58 pm

  2. Re-the title.

    “Fat, Drunk, and Stupid is No Way to Go Through Life, Son”

    They might be drunk, but not fat. That’s more of an American problem.

    Comment by Sublime Oblivion — June 29, 2009 @ 11:01 pm

  3. PS. They say “immersion” is the best way to learn a foreign language, so considering the circumstances I recommend you read

    Comment by Sublime Oblivion — June 30, 2009 @ 3:01 am

  4. [...] Professor writes about the prevalent high mortality rates among the Russian population, based on figures from the Lancet [...]

    Pingback by Global Voices Online » Russia: Lingering high mortality rates — June 30, 2009 @ 3:42 am

  5. “That’s not how (most) Russians view it.” That says it all.

    The ProfessorComment by The Professor — June 30, 2009 @ 7:36 am

  6. “I know there are those who deny that this is germane to Russia’s demographic prospects, since from a purely biological perspective it is the female population that is the constraint on the number of births.”

    Those people can’t be right unless they are suggesting a society where one man goes around impregnating more than one woman. Most people would agree that a fatherless society like that isn’t any more stable than one with a declining birthrate, and it’s not too likely that many women would be interested in such a proposition.

    Comment by La Russophobe — June 30, 2009 @ 8:23 am

  7. Once again, Sublime Moron reveals his hilarious ignorance and indeed illiteracy.

    Sir, the average American lives TWENTY YEARS longer than the average Russian. Russia does not rank in the top 150 nations of the world for adult lifespan. So it’s more than obvious that, compare to Russia, neither obesity NOR ANY OTHER HEALTH ISSUE is a problem for Americans.

    You go on denying and rationalizing Russian failure rather than seeking to reform it. That is the action of someone who hates Russia and the people who live there, and wants to see it destroyed just as the USSR was. Why do you hate Russians so much? What did they ever do to you?

    Comment by La Russophobe — June 30, 2009 @ 8:25 am

  8. [...] Professor writes about the prevalent high mortality rates among the Russian population, based on figures from the Lancet [...]

    Pingback by Official Russia | Russia: Lingering high mortality rates — June 30, 2009 @ 2:00 pm

  9. Still laughing at the title of your post… and Blutarsky became a Senator after all that. :) In case readers didn’t know, the post’s title is from a wonderful scene in the movie “Animal House”, so if you don’t like the word “fat” in context, please understand why it is there.

    Anyway, Sublime, just a little constructive criticism. You take pride in building your replies with detailed statistics that support your explanations. That’s good. But just once in a while, I’d suggest that you look up and think about what is really being said. SWP has passed on some published data about a national tragedy and you seem to put your nose down into your data and try to explain it away or find inconsistencies or loopholes there. I just left Russia after living there for 5 years (and not in Moscow or St. Petersburg). The problem is not being dealt with adequately at all. Alcohol is still ridiculously cheap, people are still walking the streets with their booze while they push their baby carriages or taking a stroll at 9:00 am on a weekday, and people in their 30′s and 40′s are still dying in the villages. I saw these things with my own eyes, not from statistics. I taught a graduate-level university course there and I mentioned this tragedy to the class. The guys were high-fiving each other when I mentioned that Russia abuses alcohol more than any other country. Statistics and detailed explanations can’t hide madness forever, so give it some thought once in a while. I’m not trying to rag on you, but sheesh, can’t you see a disaster when it’s right in front of your face?

    As for the U.S. being the Alcoholic Republic, the only thing I can say is that we fixed the problem. Now we’re almost famous for being the opposite. We even had Prohibition for god’s sake. Russia has had this problem for centuries and, as you say, the options to fix it are limited. Us “Russophobes” feel terrible about this and wish something could be done. We hate to see people do this to themselves and not try to solve the problem. That’s just as much of the tragedy as the statistics.

    As for the fat comment, I don’t like the obesity you see in America. It is an obvious problem, but for whatever reason, it doesn’t make a huge dent in lifespan. It might explain us being a little behind some other countries, but we still manage to remain resuscitated on our couches. Still, there’s something to be said about the expression “fat and happy”. I told that saying to my Russian girlfriend after she was making fun of fat Americans, and she said, “hmm, I never thought of it that way.” That still doesn’t make obesity a desired lifestyle, but I hope you get my drift.

    And lastly, (I’ve blathered on enough), I just realized that it was a good thing Senator Blutarsky never did a speech at a D-Day ceremony after all the discussion recently about West vs. Soviet appreciation for war efforts. You gotta remember the quote, “Over? Did you say “over”? Nothing is over until we decide it is! Was it over when the Germans bombed Pearl Harbor? Hell no!”

    Anyway, can’t wait to have all my loopholes exposed. Добрый день!

    Comment by Howard Roark — June 30, 2009 @ 3:06 pm

  10. So? I’ve noticed those things too when I’m there. It’s quite sad, but as I said it’s a lifestyle issue that cannot be immediately reversed with two years of government propaganda. Your anecdote about the high-fiving youth merely confirms the point.

    Re-cheap alcohol. If you make it expensive, production will move underground (though I agree that nonetheless the net effects are likely to be positive, though if mini-Prohibition under Gorby is any guide for only a limited time period). To make this work well, you need to mercilessly punish the black marketeers…which Putin is apparently not “authoritarian” enough to do. Though I wish he was.

    Re-”fat and happy”. Lol. IMO, rationalizing nonsense. Being fat is socially ostracizing and (I would imagine) ruins sex. Whereas the concept of the “happy drunkard” has been a staple of drinking societies’ worldview since times immemorial.

    Re-obesity having little effect on US lifespan. This is probably due to the fact the US spends 16% of its GDP on healthcare and has one of the most advanced healthcare systems in the world, geared towards treating chronic afflictions. So far so good (kind of). But should the US ever experience a socio-economic collapse in the style of the USSR which results in massive shrinkage of the healthcare system (and considering its soaring financial imbalances and peak oil, I do not think this is a far-fetched prospect), I think it’s safe to say there will be a similar massive mortality spike. (A while ago I recommended a fat tax to help solve the problem).

    Re-”Now we’re almost famous for being the opposite.” Through very gay means like illegalizing selling alcohol to folks who have the right to pick the President and fight and die for the country.

    Comment by Sublime Oblivion — June 30, 2009 @ 3:42 pm

  11. I know the fat part was not relevant to Russia–but (as Howard apparently agrees) a little inaccuracy is a small price to pay to make an attention-grabbing reference to an iconic movie (at least to those of my era;-)

    And re American obesity–it’s a pet peeve of mine. Really noticeable on venturing into a restaurant in Houston after 3 weeks abroad. My wife is always busting on me for busting on the obese. So although I may be a weight bigot, I’m not a hypocrite overlooking American pathologies while criticizing Russian ones.

    Re “alcohol nation”–as Howard says, we overcame it. Interestingly, government had virtually nothing to do with it. Social reform movements (primarily evangelical Protestant in orientation) in the mid-19th century during the Second Great Awakening) were instrumental in cutting alcohol consumption by an amazing amount. (Thomas Sowell has written about this.) (As did urbanization and improvements in transportation, believe it or not. If you couldn’t sell corn to the market, typically the best thing to do with it was feed it to hogs–or turn it into liquor. So, subsistence farmers in the Midwest and South made a lot of corn liquor and fed hogs. As transportation opened up, farmers transformed from subsistence agriculture to market oriented agriculture, and could sell their surplus rather than distill it;-)

    That said, I doubt the American example is that encouraging for Russia. First, the Russian problem is so deeply rooted culturally. Second, in a post-modern world, a religious awakening in Russia is highly unlikely.

    The ProfessorComment by The Professor — June 30, 2009 @ 6:00 pm

  12. “Second, in a post-modern world, a religious awakening in Russia is highly unlikely.”

    Thank God!

    Comment by Sublime Oblivion — July 1, 2009 @ 1:45 am

  13. Russia’s Medvedev calls for program to fight alcohol abuse
    Gorbachev urges new anti-drinking campaign in Russia

    The problem is widely known, but as with corruption, indeed more action needs to be taken. What needs to be done? Take lessons from Canada. Make alcohol harder to get, take it out of convenience and grocery stores altogether and have the government take control of all sales of alcohol. Thus it will be strictly regulated, and the regulations will be much easier to enforce. Harsh penalties for those who don’t. Of course there will still be bootlegging and the black market, but that problem would be much smaller in scale and would eventually go away on its own as the overall number of alcoholics declined. Some people might not like the idea of government control, but in my opinion it’s better than the freedom to destroy yourself, which is clearly what has/is happening.

    However, as with the overall demographic situation over the past few years, things have been improving rather than worsening which shows that this isn’t necessarily the inevitable destruction of Russia (I know a lot of you are hoping it is, sorry). In January-April 2009 the death rate from alcohol poisoning was 13.7/100,000, compared to 16 in 2008, 18 in 2007, and 30 in 2004 (and around 25-30 for most of the 90s up until then). It’s more than halved in a mere 4-5 years, and while the rate is still way too high compared to, well, anyone, it’s a significant improvement nonetheless. I don’t know the exact cause of this (certainly can’t be the “inadequate” government measures, nor the improving economic situation which isn’t so improving anymore), but I think with a little (a lot actually) more involvement from the government, the problem can certainly be solved.

    Comment by Bob From Canada — July 2, 2009 @ 9:49 am

  14. Bob, my question is still: have you ever been to Russia? Much of Russia’s alcohol consumption is moonshine (самогон). In the countryside, I would say that close to every third villager brews his or her own and the people living in the cities are pretty adept at making their own when push comes to shove. So, unless you start building a lot of jails, police action alone won’t solve the problem of home made alcohol in Russia.

    Comment by Michel — July 2, 2009 @ 10:53 pm

  15. Have you ever been to Russia? Considering 75% of the population lives in the city, and assuming your dubious claim is true, that would leave approx. 8.3% of Russian alcohol consumers using moonshine, with the odd person here or there in the city looking on the black market who I already accounted for. It’s simple math that strict regulation would make significant improvements. Gorbachev already proved that to be the case two decades ago.

    Comment by Bob From Canada — July 2, 2009 @ 11:28 pm

  16. Bob is correct. When it was briefly enforced, mortality rates fell significantly and immediately, rising close to their 1965 peak.

    Comment by Sublime Oblivion — July 3, 2009 @ 2:11 am

  17. When Gorbachev tried to “prove his case” this led to a shortage of sugar in stores as people rushed to get the supplies they needed to brew their own. Bob, sociological research was conducted in Russian villages that documented what and how much people drank. For every liter of store bought vodka, people were consuming 4 to 6 liters of moonshine. Sure, they represent only 25% of the population, but that is quite a bit of moonship. It adds up.

    As for the cities, if you actually visit Russia, you will learn that a lot of the alcohol that is drunk is not from stores either. Especially popular are the “spirits” that come from hospitals and other locations. This is in essence pure ethanol.

    Then, there is the drink of choice for the lowest level of alcoholics: cologne. The best know brand is “Тройной одеколон” that could be bought at a fraction of the price of a bottle of vodka.

    Comment by Michel — July 3, 2009 @ 12:33 pm

  18. I didn’t say Gorbachev’s plan was successful on all fronts, it was an economic disaster. I’m neither suggesting that they repeat what he did. But it was effective in that it showed immediate and significant improvements in the health of the country, even despite the fact that samogon production/consumption went through the roof. That proves that state intervention in the production/sales of legal alcohol can and does help the problem. Moonshine consumption isn’t Russia’s problem, it’s a symptom of the problem.

    And why do you assume I haven’t been to or lived in Russia? I’m not answering your question for a reason, and that is you only use personal information to attack people, which is a crutch you use for almost all of your arguments.

    And I haven’t seen you put forth any suggestions yet either. If I’m so wrong, then please inform me as to what will solve the problem.

    Comment by Bob From Canada — July 3, 2009 @ 1:54 pm

  19. Yes, we can agree on the fact that the distillation of moonshine and the consumption of cologne is a symptom of a bigger social ill. However, seeking to solely criminalize the production of moonshine won’t address the underlying causes either.

    Comment by Michel — July 3, 2009 @ 2:04 pm

  20. What will solve the problem? Well, here are a few things that would help. A true democracy in Russia with a state committed to transparency and the rule of law. A society that welcomes competing points of view while actively fighting public corruption. A society where those in power can lose power democratically and where successors and not anointed. A society that truly encourages economic development based on small and mid-sized businesses. In other words, having a government doing everything that Putin & Co. have failed to do in the past 8 years. If Russia had a government truly committed to achieving these social and political goals, then the underlying causes of alcoholism and drug addiction in Russia would gradually wither away as such a society would also begin to prosper economically and socially.

    Comment by Michel — July 3, 2009 @ 2:09 pm

  21. Ahhh democracy, the solution to all of life’s problems!

    So explain to me why deaths by alcohol poisoning (and suicides for that matter, many of which are fueled by alcohol) have more than halved during Putin’s presidency, when he apparently failed on all those accounts? Why is the overall mortality rate falling so rapidly right now with terrible dictator Putin at the helm?

    Honestly you sound like a political opposition figure or something, trying to get support from the dumb liberal masses with empty rhetoric. Nothing worthwhile out of your mouth, just broad useless statements about “democracy and freedom”. *yawn*
    Like politicians, I somehow doubt you could care less about actually solving the problem so long as your dreams of a Putin-free Russia come true.

    Comment by Bob From Canada — July 6, 2009 @ 3:03 pm

  22. Bob,

    They are basically like Soviet ideologues promising Communism and utopia on earth but the reverse.

    In their worlds things like democracy and free markets are supposed to be the cure-all for all the world’s ills. If they don’t work, well, that just means they were implemented wrong, or subverted. Challenge the belief, and you’re a heretic.

    That said with the neoliberal order now falling around in flames their denial of reality – that there can be different paths to democracy and that the West does not have a monopoly over its interpretation; that market fundamentalism erodes the social values that are themselves necessary to make capitalism work; etc, can only get more and more absurd.

    Comment by Sublime Oblivion — July 6, 2009 @ 4:52 pm

  23. * not reverse, but inverse I should say

    Comment by Sublime Oblivion — July 6, 2009 @ 4:52 pm

  24. Bob, you write: “So explain to me why deaths by alcohol poisoning (and suicides for that matter, many of which are fueled by alcohol) have more than halved during Putin’s presidency, when he apparently failed on all those accounts? Why is the overall mortality rate falling so rapidly right now with terrible dictator Putin at the helm?” So, Bob from Canada, what are your sources?

    Comment by Michel — July 7, 2009 @ 10:27 pm

  25. Rosstat.

    (I know, because I’ve noticed the same thing).

    Comment by Sublime Oblivion — July 8, 2009 @ 3:14 pm

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