Published by Oxford University Press on behalf of the International Epidemiological Association
Ó The Author 2006; all rights reserved. Advance Access publication 4 December 2006
International Journal of Epidemiology 2006;35:1400–1405
doi:10.1093/ije/dyl235
Commentary: The Health Crisis in the
USSR: reflections on the Nicholas Eberstadt
1981 review of Rising Infant Mortality in
the USSR in the 1970s
Christopher Davis
Nicholas Eberstadt’s 1981 article, ‘The Health Crisis in the
USSR’, in the New York Review of Books1 played an important
role in publicizing the growing health problems in the USSR
and provided an insightful preliminary analysis of their causes.
His article started with a balanced review of the 1980 US
Bureau of the Census technical report on ‘Rising Infant
Mortality in the USSR in the 1970s’2 that I co-authored
with Murray Feshbach, a distinguished demographer, but then
widened its scope to evaluate the political, economic, social,
and medical factors that could explain the growing difficulties
in the Soviet health sector.
The article by Nicholas and our report challenged three
prevailing conceptions. First, that the socialist countries were
continuing to improve the health of their populations,
measured by reductions in disease and mortality, and therefore
provided models for other nations. Second, that age-specific
mortality rates inevitably declined over time in all countries,
barring catastrophe or war. Third, that variations in life
expectancy (normally meaning increases) were almost entirely
explained by changes in health conditions (better water and
sanitation, improved nutrition) and preventive medicine,
rather than by the performance of curative medicine. This
early work stimulated research in the 1980s on mortality trends
in the USSR and Eastern Europe, a topic which attracted even
more attention in the 1990s because of the mortality crises that
developed in the transition countries in that region and the
improved availability of information.
Historical context
Since the majority of readers of the International Journal of
Epidemiology are younger than those of us who contributed to
the work under consideration, a brief review of the research
environment and conditions of that period of relevance to
research on health might be useful. The article by Nicholas
provides a helpful summary of some key aspects. In the late
1970s the USSR was considered to be a successful and
expanding world power, whereas the West was on the
defensive (e.g. economic ‘stagflation’ following the 1974
OPEC embargo, defeat of the USA in Vietnam, socialist
revolutions in Africa, growing Soviet military power). Many
in both the East and West considered that the ‘correlation of
University of Oxford, Wolfson College, UK. E-mail: christopher.davis@
economics.ox.ac.uk
forces’ was in favour of the socialist bloc and its Third World
allies. There were sharp East–West ideological conflicts and
governments in both the socialist and capitalist blocs supported
propaganda campaigns against each other.
The objective study of health in the USSR was seriously
impeded by the comprehensive and reasonably effective Soviet
censorship system. In the case of mortality rates, during
1955–71 the Soviet Union published the infant mortality rate
(but not perinatal, neonatal, and post-neonatal rates), the
crude death rate, age-specific death rates, and life expectancy at
birth in its annual statistical yearbook, Narodnoe Khozyaistvo
SSSR (there were no electronic databases in those days).
Maternal death rates (quite high) were published only
sporadically in specialist journals. In response to the deterioration in the health situation, the USSR ceased publication of
life expectancy after 1972, infant mortality after 1974 and
age-specific death rates after 1976. Soviet specialists used a
unique and misleading methodology to calculate infant
mortality (high risk live births were excluded from consideration), which underestimated the actual rate by 14.4%.2
Although demographic and health specialists in the Soviet
Union produced thousands of studies in Russian and other
USSR languages on the health situation, and a number of these
scholars were first rate, their access to accurate statistics was
restricted by the government and the censorship system (state
control of all publications) limited their ability to call attention
to serious problems and prohibited them from suggesting that
there were systemic causes of any difficulties. Soviet-Western
academic cooperation was extremely difficult.
Studies by Western specialists were constrained by the facts
that few of them possessed knowledge of Russian language and
that the Soviet Union published only a small amount of
information in Western languages. The USSR provided minimal
quantities of demographic and health statistics to the UN (for
the Demographic Yearbook) and the World Health Organization (but nothing to the World Bank and OECD). All WHO
publications related to health in the USSR were either prepared
by Soviet specialists or vetted by Soviet authorities, and
contained even less critical analysis than that found in Russian
language sources. Official Soviet books on health published in
foreign languages provided some useful basic information, but
essentially were propaganda documents.
In the 1970s little was published on Soviet health in Western
academic journals. The primary sources of information for
students and scholars were books. Several of these were written
REPRINTS AND REFLECTIONS
by scholars on the left of the political spectrum3,4 and tended to
be positive about developments in the USSR. Others written by
centre-right authors provided balanced assessments using
Russian-language material, but did not call attention to
mortality trends (which had been adverse since the mid-sixties)
or claim the existence of a ‘health crisis’.5–7
The governments of leading Western nations had intelligence agencies and other organizations that studied the USSR
using covert and published sources. However, the overwhelming focus of their work was on economic, military,
scientific, foreign policy, and labour force (civilian and military)
issues. The subjects of health, education, and social welfare in
the Soviet Union were neglected by Western governmental
bodies.
One exception to this rule was the Foreign Demographic
Analysis Division of the US Bureau of the Census. It was
responsible for carrying out analyses and making projections of
demographic developments in all regions of the world. Most of
its work was based on open source material in original
languages. Murray Feshbach was Chief of the USSR Population,
Employment and R & D Branch and had an encyclopaedic
knowledge of Soviet statistical sources. In the 1970s most of his
work was focussed on general demographic, labour force and
scientific R & D issues, rather than those related to health.
However, a 1976 paper that Murray co-authored briefly
discussed mortality problems in the USSR8:
There has recently been an unexpected but significant rise
in infant mortality, which increased from 22.9 to 27.9 per
1000 live births in the years 1971–74. Not all of this increase
can be explained as due to improved reporting in the
Central Asian republics . . . An extraordinary jump in the
crude death rate occurred in 1975.
Other colleagues in FDAD produced the projections of
demographic developments in the USSR using a wellestablished, but flawed, methodology. A key problem was
that future scenarios were determined by alternative assumption about trends in fertility, whereas age-specific mortality
rates were expected to decline in all cases. In the methodology
section of the 1975 report on projections out to the year 2000,
Baldwin9 wrote:
Only one assumption is made about the future course of
mortality, namely that it will decrease at a modest rate
throughout the projection period. It was assumed that the
decline in mortality would be such that life expectancy at
birth would increase by 2.5 years between 1972 and 2000.
This was accomplished by using model life tables prepared
by Coale and Demeny.
One consequence of the reliance by FDAD on this
projection method was that it had an institutional predisposition to interpret any increase in mortality in the USSR as a
short-term aberration that would be corrected over time. It
would not be an exaggeration to state that in the mid-1970s
neither FDAD nor any other agency of the US government had
an interest in rising mortality in the USSR or an awareness of
its significance.
1401
Overall, the situation with respect to health in the USSR in
the 1970s had some similarities to that outlined by Kuhn10 in
The Structure of Scientific Revolutions. A ‘normal science’
concerning health in the USSR existed that was accepted as
truth by most concerned parties and offered what appeared to
be a reasonable explanation of reality. Certain anomalies had
arisen, notably rising mortality rates, that posed questions
about the prevailing paradigm, but no crisis was perceived to
exist in it and there was little pressure for a paradigm shift.
The genesis of the infant mortality report
My work on health started in 1973 at Cambridge University in
the PhD programme of the Department of Economics, which
followed undergraduate studies at Harvard College with a
concentration in applied mathematics and statistics. My initial
supervisor, Michael Ellman, a specialist on the socialist
economies, insisted that I narrow my topic from the proposed
general one of Soviet economic planning. I decided, somewhat
recklessly, to write my doctoral dissertation on the economics
of health in the USSR, without knowing anything about the
topic. Over the next 3 years I studied economics, demography,
and health (including epidemiology), learned Russian, and
wrote parts of my dissertation. After Michael Ellman moved
away in 1975, Sir Richard Stone became my supervisor because
I had become interested in his system of interlinking social,
demographic, and economic accounting models (absorbing
markov chains, input–output tables).11 I used his approach to
prepare an elaborate model of the interaction of institutions
and variables in the health production process in the USSR
(Figure 1 provides a simple depiction).
During summer 1976 I studied in an intensive Russian
language course at Harvard. I made a short trip down to
Washington, DC to look at material related to health and
demography in the USSR and consult with relevant specialists.
At FDAD I met Murray Feshbach and his colleagues. I outlined
my research plans and we discussed current demographic
developments in the USSR, including the unusual mortality
trends, and statistical sources.
During academic year 1976/77 I studied in the Soviet Union
as a US participant in the official USA–USSR exchange of
graduate students. I was based in the Department of the
Economics of the Non-Productive Sphere (which included
health) in the Faculty of Economics of Moscow State
University. My supervisor was a well-known health planner,
Georgii Alexeevich Popov, who had recently published a book
on the economics of health in the USSR.12 I read this book and
other important Soviet works carefully and discussed with him
the many issues they covered.
Throughout the year I collected statistics from a wide variety
of Soviet sources for my socio-demographic accounting model
in the areas of demography, living standards, illness rates,
medical care provision, medical industry, and health finance.
This was a challenging task because of the inconveniences
of the general censorship system and the specific obstacles
placed in my path by librarians at the Lenin Library whenever
they considered that I had ordered an inappropriate book or
journal. For example, in order to prepare a basic table on
1402
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Figure 1 The health production process in the USSR and Russia
age-specific death rates (similar to Table 1) I had to extract
material from 12 statistical yearbooks. This was because the
official yearbook provided one new set of rates per year but
excluded most previous ones, apparently to make it more
difficult to discern trends. All data had to be copied out of
publications onto paper and, since portable computers did not
exist, statistical calculations had to be made with pocket
calculators (Soviet shop keepers were still using the abacus).
Even a cursory examination of Table 1 reveals that the USSR
had rising mortality rates for most age groups.
During my exchange year I had many discussions of health
and mortality issues with Soviet students, scholars, and
government officials, and visited numerous medical facilities.
This gave me insights into the realities of Soviet health
conditions and medical care (e.g. poor hygiene, chronic
shortages, technological backwardness, and low quality of
medical services) (see Knaus13 for an American doctor’s
assessment of Soviet health in this period). My contact with
colleagues in the West was negligible since email did not
exist, telephone calls were carefully monitored, and post was
slow.
After I returned to Cambridge in summer 1977 I contacted
Murray Feshbach to discuss my experiences and findings. We
agreed to work together on a paper about rising mortality in
the USSR, but the lack of interest of FDAD in the topic meant
that it was not possible for me to obtain funding from it to
support my work and it was difficult for Murray to be allocated
much time in his official workday to carry out research on such
a tangential topic. However, he helped me to win a small grant
from the Kennan Institute for Advanced Russian Studies to
work in Washington, DC for a month with him. In November
1977 I completed a detailed statistical paper on mortality and
life expectancy in the USSR during 1959–75.14 In February
1978 I travelled to Washington, DC.
At FDAD I met John Dutton, a graduate student at Duke
University, who was completing a piece of research on the
influence of excessive alcohol consumption on mortality in the
USSR and had received help from Murray. We decided to avoid
overlaps in our research by having Murray and I focus on
infant mortality and John concentrate on adult mortality. He
completed the initial draft of his paper in March 1978 and it
was published in the following year.15 During my stay Murray
and I produced a detailed outline of our paper, reviewed source
material and wrote a newspaper article on Soviet mortality
problems.16
By the summer of 1978 we had completed a first draft of our
paper. In brief, it reviewed published evidence about mortality
trends, considered the influences on the official infant mortality
rate of improved statistical reporting and structural changes
(e.g. more births in high mortality Central Asia), and used the
health production process framework mentioned above to
evaluate social, environmental, economic, and medical factors
0.6
1.0
1.6
2.0
2.5
3.1
3.8
5.0
7.8
10.8
17.2
24.4
64.2
10–14
15–19
20–24
25–29
30–34
35–39
40–44
45–49
50–54
55–59
60–64
65–69
70 and Over
65.8
25.5
17.2
11.1
7.9
5.1
3.9
3.2
2.6
2.0
1.6
1.0
0.6
0.8
6.9
26.1
7.3
1965/66
66.1
25.9
17.4
11.3
7.9
5.3
4.1
3.4
2.6
2.0
1.5
1.0
0.6
0.8
6.9
26.0
7.5
1966/67
66.8
26.3
17.8
11.5
8.0
5.5
4.3
3.5
2.7
2.1
1.5
1.0
0.6
0.7
7.0
26.4
7.7
1967/68
ASMR are 2 year moving averages.
b
Crude death rate: deaths per 1000 population.
c
Infant mortality rate: deaths during first year of life per 1000 live births.
2
Source: Davis and Feshbach.
a
0.8
5–9
27.2
7.1
1964/65
7.2
b
0–4
0–1
c
All ages
Age-specific mortality rates (deaths per 1000 in the age group)
a
Table 1 Age-specific mortality rates in the USSR, 1964–76
67.3
27.5
18.2
12.1
8.1
5.6
4.6
3.5
2.8
2.2
1.5
1.0
0.6
0.7
7.0
25.8
7.9
1968/69
75.7
27.5
18.0
11.7
8.7
6.0
4.7
3.7
2.8
2.2
1.6
1.0
0.6
0.7
6.9
24.7
8.2
1969/70
74.9
26.9
17.9
11.8
8.7
6.0
4.7
3.8
2.8
2.2
1.6
1.0
0.5
0.7
6.7
22.9
8.2
1970/71
74.8
26.8
18.1
11.9
8.8
6.1
4.8
3.7
2.8
2.1
1.6
1.0
0.5
0.7
6.8
24.7
8.4
1971/72
75.5
27.2
18.0
12.5
8.6
6.2
4.8
3.6
2.8
2.1
1.6
1.0
0.5
0.7
7.2
26.4
8.6
1972/73
73.5
27.0
18.2
12.3
8.8
6.4
4.9
3.6
2.8
2.0
1.6
1.0
0.5
0.7
7.7
27.9
8.7
1973/74
73.3
27.4
18.3
13.0
9.0
6.7
5.2
3.7
3.0
2.1
1.7
1.0
0.5
0.7
8.2
29.4
9.0
1974/75
75.0
28.0
18.9
13.4
9.3
6.9
5.3
3.8
3.0
2.1
1.7
1.0
0.5
0.7
8.7
31.1
9.4
1975/76
117
115
110
124
119
138
139
123
120
105
113
100
100
100
130
136
132
1975/76 as %
of minimum
since 1964/65
REPRINTS AND REFLECTIONS
1403
1404
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
that could cause increases in infant mortality through their
impacts on the health of pregnant women and of infants during
neonatal and post-neonatal periods. The bibliography contained over 100 sources (two-thirds in Russian language), some
from quite obscure journals (e.g. Voprosy Virusologii) that had
been collected either over the years by FDAD or by me in
Moscow. The paper was circulated for discussion and improved
in response to comments.
Although our original intention had been to publish our
findings in an academic journal, in early 1979 FDAD expressed
a willingness to publish the paper in its highly regarded but
rarely read International Population Reports series. Since Murray
worked for FDAD and I was trying to cope with the
requirements of my new job as a Lecturer at the University
of Birmingham (Centre for Russian and East European Studies)
while completing my PhD dissertation (submitted in November
1979), we agreed to go with this option for simplicity.
Additional refereeing and revisions were needed to satisfy
the concerns of the US Bureau of the Census (as with most
bureaucracies, it was highly risk-averse) and to adapt it to the
corporate style. The Davis–Feshbach infant mortality report was
published in June 1980. Over the next several months there
was relatively little reaction to it.
The Eberstadt article and its aftermath
Another young scholar, Nicholas Eberstadt, changed this. He
had graduated from Harvard College in 1976, obtained a
master’s degree from the Harvard School of Public Health, and
from 1979 was working on a PhD dissertation. In parallel with
his academic studies he wrote articles for various journals,
including the New York Review of Books. Through his health
work he became aware of and interested in the topic of rising
mortality in the USSR and contacted Murray Feshbach in late
1979 to learn more about it (see the accompanying commentary by Nicholas Eberstadt). Murray gave him a draft of our
report and he obtained a commission from the NYRB to prepare
a review, which was published in February 1981. Although our
report provided a focal point for his article, he developed a
more general analysis of the health situation in the USSR and
its implications that was of interest to many readers.
By coincidence, the political and ideological environment
had changed in the USA, which was reflected in the election of
Ronald Reagan as President in November 1980 and an
intensification of the ideological battle with the ‘Evil Empire’.
This resulted in an amplification of the impact of stories about
negative trends in the USSR, such as rising infant mortality.
Indeed, the timing of the publication of the article was so
perfect that some people thought it represented a clever
propaganda operation by an omniscient and efficient US
government.
The topic of infant mortality in the USSR attracted both
short-term media attention and new academic research.
Among the initial responses in the USA was an article entitled
‘Infant mortality in the Soviet Union: Anti-Sovietism in the
United States’.17 The main message of this left-wing critique of
the Davis–Feshbach report and the Eberstadt article was that
‘Both publications disparagingly misrepresent the situation in
the Soviet Union as regards infant mortality, health care, and
other social programmes as well as social and economic
conditions’.
Over the next several years the general findings that
mortality really had risen in the USSR and that serious health
problems existed there became widely accepted in the West and
a component of a new paradigm that interpreted the Soviet
Union as a failing system. However, several serious articles
challenged our analyses. Jones and Grupp18 observed that the
growing awareness of the upward trends in mortality in the
USSR resulting from the Davis–Feshbach and Eberstadt
publications ‘has contributed to an abrupt reversal of Western
perceptions of Soviet medicine and its system of health care’.
They argued in their conclusions that this negative assessment
was unwarranted because ‘it is clear that much of the highly
publicized increase in reported rates between 1971 and 1974
reflected improved vital registration, not a deterioration of the
medical system or of maternal and child health conditions’.
A demographic study by Anderson and Silver19 concluded that
‘the evidence for a real increase in infant mortality in the
Soviet Union since 1971 is weak’. In contrast, Mark Field, a
renowned specialist on Soviet health, argued with respect to
the rise in infant mortality that ‘we must assume that from one
half to three quarters was real’.20
A characteristic of the contributions to the debate in the
1980s was that the authors had knowledge of Russian language
and the Soviet system, which was necessary given the
continuing lack of information in Western languages. None
of the three authors of the original works under consideration
played a significant role in the ensuing debate due to other
commitments and evolving research agendas. Murray retired
from FDAD in the early eighties to take up several academic
and advisory positions and to carry out research on health and
the environment in the USSR (e.g. Feshbach and Friendly21,
Feshbach22). Nicholas shifted his attention back to his
dissertation and went on to produce publications about
demography and health in Cuba, East Germany, and North
Korea (e.g. Eberstadt and Banister23). I focussed my research
on several theoretical economic issues (shortage, disequilibrium, and priority) and carried out empirical work on the
other institutions in the Soviet health production process
(e.g. Davis24,25).
The responses to the Davis–Feshbach report and Eberstadt
article in the USSR were mixed. In the first half of the 1980s
there was a tightening of Soviet censorship in the health field
in an attempt to keep a lid on the story of deteriorating health.
The official attitude toward our findings was quite critical and
several Soviet publications took issue with them. The most
detailed critique was published in Anitsovetizm Burzhuaznoi
Demografii (The Anti-Sovietism of Bourgeois Demography).26
According to it, the Davis–Feshbach report was ‘exceedingly
tendentious in its essence, but had the appearance of scientific
objectivity’. Both of the publications were ‘a fundamental part
of the anti-Soviet campaign, directed toward the ideological
preparation of the population of the USA for the cold war’. At
the unofficial level, there was considerable interest in our work
and Murray and I received some favourable feedback during
our trips to the USSR.
Following Gorbachev’s accession to power in 1985 the
Communist Party line changed substantially. The previous
decade became known as the ‘era of stagnation’ and many
REPRINTS AND REFLECTIONS
acute social problems associated with it were identified,
including rising mortality, as a result of the new policy of
glasnost’ (openness). The official publication of mortality and
life expectancy statistics resumed, reforms were introduced to
correct problems in the health sphere, and mortality rates
temporarily declined.27
Following the 1989–90 revolutions in Eastern Europe and
the collapse of the USSR in 1991 health conditions deteriorated
and age-specific mortality rates increased in virtually all the
transition countries. Due in part to the knowledge Western
analysts had about past mortality problems in the East, the new
health crises were detected quickly. In the changed circumstances of democracy and openness relevant data were provided
by East European/FSU governments both in national and
Western languages and made easily accessible through
electronic databases and the Web. Furthermore, health
specialists from the countries concerned were freed from
political controls and were able to engage in unhindered
international cooperation. This resulted in a flourishing of
studies of mortality problems in the East (e.g. Ellman28,
Shkolnikov and Meslé29, Cornia and Paniccià30).
Despite the many important contributions that have been
made to the analysis of mortality increases in the transition
countries, much remains unexplained and unexplored. I
certainly continue to have a full research agenda in this area
(see the list of my publications and working papers at http://
www.economics.ox.ac.uk/Faculty/). I hope that some younger
scholars who read this issue will become interested in exploring
the fascinating topic of health in the USSR/FSU and Eastern
Europe.
References
1
2
3
4
5
6
7
8
9
Eberstadt N. The health crisis in the USSR, New York Review
Books 1981; February 19: 23–31. (Reprinted Int J Epidemiol
2006;35:1384–94.)
Davis C, Feshbach M. Rising Infant Mortality of the USSR in the 1970s,
Washington DC, US Bureau of the Census. International Population
Reports: Series P-95, No. 74, 1980.
of the Census. International Population Reports, Series P-91, No. 24
1975.
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hyde G. The Soviet Health Service: A Historical and Comparative Study.
London: Laurence and Wishart, 1974.
Navarro V. Social Security and Medicine in the USSR: A Marxist Critique.
Lexington, MA: Lexington Books, 1977.
26
Field M. Soviet Socialized Medicine: An Introduction. New York: The Free
Press, 1967.
27
Kaser M. Health Care in the Soviet Union and Eastern Europe. London:
Croom Helm, 1976.
Ryan M. The Organization of Soviet Medical Care. Oxford: Basil
Blackwell 1978.
28
29
Feshbach M, Rapawy S. Soviet population trends and policies. In: US
Congress Joint Economic Committee. Soviet Economy in a New
Perspective. Washington, DC: USGPO, 1976.
Baldwin G. Projections of the Population of the USSR and Eight
Subdivisions, by Age and Sex: 1973–2000, Washington DC, US Bureau
1405
30
Kuhn T. The Structure of Scientific Revolutions. 2nd edn. Chicago:
University of Chicago Press, 1970.
United Nations, Towards a System of Social and Demographic
Statistics. New York: UN Studies in Methods, Series F, no. 18, 1975.
Popov GA. Ekonomika i Planirovanie Zdravookhraneniya (The Economics and Planning of the Health Service). Moscow: Izdatel’stvo
Moskovskogo Universiteta, 1976.
Knaus WA. Inside Russian Medicine: An American Doctor’s First-Hand
Report. New York: Everest House, 1981.
Davis C. An analysis of mortality and life expectancy trends in the USSR,
1959–75, Cambridge University, Department of Economics,
Postgraduate Student Working Paper, 9 November 1977.
Dutton J. Changes in Soviet mortality patterns, 1959–77. Popul Dev
Rev 1979;5:267–91.
Davis C, Feshbach M. Life expectancy in the Soviet Union. Wall Str J,
1978.
Kutzik AJ. Infant mortality in the Soviet Union: Anti-Sovietism in the
United States. New World Review, September–October 1981.
Jones E, Grupp FW. Infant mortality trends in the Soviet Union.
Popul Dev Rev 1983;9:213–46.
Anderson BA, Silver BD. Infant mortality in the Soviet Union:
Regional differences and measurement issues. Popul Dev Rev
1986;12:705–38.
Field M. Soviet infant mortality: a mystery story. In: Jeliffe DB, Jeliffe
EP. (eds). Advances in Maternal and Child Health. Oxford: Oxford
University Press, 1986.
Feshbach M, Friendly A. Jr. Ecocide in the USSR: Health and Nature
Under Siege. New York: BasicBooks, 1992.
Feshbach M. Continuing negative health trends in the Former USSR.
In US Congress, Joint Economic Committee. The Former Soviet
Union in Transition, Washington DC: USGPO, 1993.
Eberstadt N, Banister J. The Population of North Korea, Berkeley,
Institute of East Asian Studies 1992.
Davis C. Developments in the health sector of the Soviet economy:
1970–90. In US Congress, Joint Economic Committee. Gorbachev’s
Economic Plans. Washington DC: USGPO, 1987.
Davis C. Priority and the shortage model: The medical system in the
socialist economy. In: Davis C, Charemza W. (eds). Models of
Disequilibrium and Shortage in Centrally Planned Economies. London:
Chapman and Hall, 1989.
Zhuraleva NI. Antisovetizm Burzhuaznoi Demografii (The AntiSovietism of Bourgeois Demograpy), Moscow: Mysl’, 1987.
Davis C. The health sector in the economy: Illness, medical care and
mortality. In: Granville B, Oppenheimer P. (eds). The Post-Communist
Russian Economy. Oxford: Oxford University Press, 2001.
Ellman M. The increase in death and disease under katastroika.
Cambridge J Econ 1994;18:329–55.
Shkolnikov V, Meslé F. The Russian epidemiological crisis as mirrored
by mortality trends. In: DaVanzo J. (ed). Russia’s Demographic Crisis.
Santa Monica: RAND, 1996.
Cornia GA, Paniccià R. (eds.) The Mortality Crisis in Transitional
Economies. Oxford: Oxford University Press, 2000.