Реферат: Demographic Changes In Russia /english/

Alexander V. Myskin, gr. 301

Demographic crisis in Russia

Recent demographic trends in Russia have caused widespread public
concern. Russia is experiencing unusually high death rates from
nonnatural causes, many related to alcoholism. Life expectancy,
especially among working-age males, has dropped precipitously. The
Russian fertility rate has declined to among the world's lowest, while
its abortion rate is the highest. As a result, for the first time in
Russian history, the annual number of deaths has exceeded the number of
births. Compounding these challenges, the population is aging rapidly--a
trend that will accelerate over the next two decades--and immigration
continues to increase, posing thorny political and social problems for a
nation historically accustomed to a net outflow of people.

These events are widely seen as posing a national crisis for Russia.
Civic leaders and the general public are especially concerned about the
effects these trends may have on the progress of reform--for example,
how a shrinking working-age population will support a growing number of
elderly citizens. Opponents of reform have exploited these trends for
political purposes. They have depicted these events as direct outcomes
of reform and even as a conspiracy aimed at destroying the Russian
state.

Policymakers and analysts are eager to learn more about the causes and
consequences of these trends so that they can define appropriate policy
options as the reform process continues. The underlying causes of these
phenomena had previously not been studied in great depth. Policymakers
in the former Soviet Union had no interest in policy informed by
research; therefore, social and behavioral analyses of demographic
trends were shunned in favor of descriptive, often historical, work.
More recently, scholars using newly available information have begun to
delve into the roots of Russian demographic changes and the long-term
patterns underlying them.

To shed light on these issues, RAND and the Center for Demography and
Human Ecology of the Russian Academy of Sciences invited a group of
Russian demographers to present the results of their research. The
aggregate picture that emerged from this groundbreaking work is more
complicated than the "crisis" language suggests. Some of the demographic
trends currently affecting Russia are the continuation of long-term
patterns. Others are by-products of recent events, although not
necessarily the reforms of the 1990s. Still others are harder to explain
and have probably been exacerbated by the reforms and the current
economic slump.

The "Depopulation" of Russia?

In 1992, Russia's population entered a period of negative growth--that
is, the number of deaths exceeded the number of births combined with the
number of immigrants. This was a first in the peacetime history of
Russia.

This historic population decline has been met with increasing concern in
some Russian circles. The Russian mass media have overflowed with
alarming articles on population issues. Based on popular,
nonprofessional interpretations of available vital statistics, some are
calling "to save Russia from depopulation." As a result, the general
public has been misled about population issues. The average citizen is
likely to draw a direct connection between the current economic slump
and a demographic crisis.

This alarmist view ignores long-term trends in fertility. As in many
Western industrialized nations, Russia's fertility rate has fallen over
the course of the 20th century from a relatively high level to a low
one. In 1920, the average Russian woman was expected to give birth to
about 7.5 children in her lifetime; in 1994, that number had fallen to
1.4. This demographic transition is characteristic of industrial and
industrializing nations and is usually associated with greater numbers
of women joining the work force and increased divorce and cohabitation,
all of which tend to reduce family size and drive down fertility rates.
Similar patterns have emerged in the United States and other Western
countries.

However, Russia's fertility patterns have followed their own unique path
over the past two decades. In addition to the decline in births, the age
patterns of childbearing have been changing. In many Western countries,
the peak childbearing age for women has grown older and now falls
between 25 and 29; by contrast, the peak age in Russia has become
younger, occurring between ages 20-24. Furthermore, by 1991, fertility
between ages 15-19 exceeded that in the age groups over 30 and rivaled
that of the 25-29 age group.

This tendency towards fertility at younger ages is reflected in marriage
patterns. Between 1960 and 1995, the average marrying age of women in
Russia fell by 4.2 years, from 26.2 to 22.0. This trend sharply
distinguishes Russia from other industrialized nations, where the
tendency is for women to postpone marriage and childbearing.

Contributing to this shift toward earlier childbearing and the low
fertility rate has been Russia's high rate of abortion. The incidence of
abortion in Russia is the world's highest. In 1992, there were 225
abortions per 100 births, far exceeding the second highest
rate--Romania's--which was 157 per 100 births. Abortion has become
Russia's main method of birth control. Abortions are easily obtained
free of charge at virtually all clinics, while contraceptives have been
unavailable. Despite the procedure's prevalence, it frequently poses
health risks for Russian women because it is often performed without
proper hygiene or anesthesia. Abortion has also played a role in
concentrating women's reproductive activity in early years. Women try to
achieve their desired number of children at a young age and then abort
subsequent pregnancies without fear of secondary sterility, which often
results from frequent abortions. Only in recent years, as the
availability of effective contraceptives has increased and the negative
effects of abortion have been openly reported by the media, has the
number of abortions begun to decline.

Like the trend in fertility, Russia's current net immigration inflow
perpetuates trends that emerged earlier, in this case during the late
1960s and 1970s. The size of this inflow increased dramatically after
the collapse of the Soviet Union but appears to have subsided somewhat.
While Russia currently lacks the infrastructure and experience to deal
with immigrants on a large scale, immigration is sometimes weighed as an
option for offsetting the natural population decline.

Russia's current population picture need not be viewed as a short-term
crisis. A more plausible explanation is that fertility patterns are
resuming their long-term trend after a temporary increase in the 1980s
that stemmed from government policies aimed at inducing families to have
more children. These measures included paid maternity leave and extra
benefits in housing and services for families with three children or
more. The effect of these measures was to shorten the interval between
births. The current pattern suggests that the older timing is
reasserting itself. Economic hard times may have further influenced this
pattern. Although a two-child family is still the norm, economic
difficulties may force postponement of the second child.

The "Graying" of the Russian Population

The decline in fertility is contributing to a rapid aging of the Russian
population. Between 1959 and 1990, the number of persons aged 60 and
over doubled. As a result, at the beginning of the 1990s, the proportion
of the population aged 60 or over reached 16 percent. This figure will
reach 20 percent by 2015. By that year, nearly one of out of every three
people over 60 will be 75 or older.

The trends of population growth and aging in Russia have been profoundly
affected by catastrophic events, such as the two world wars, the civil
war of 1917-1922, and famines in the early 1920s and '30s. These
catastrophes have distorted the population pyramid--the typical age
distribution and balance between male and female in the population. For
example, huge losses during World War II have caused Russia to have the
lowest overall male-to-female ratio in the world, especially among the
elderly. The irregularities of this pyramid will continue to have an
impact on the number of births and the rate of population growth and
aging for several decades. This pattern affects such vital spheres as
school enrollment, employment, and retirement.

Another determinant of the current age structure in Russia has been the
declining fertility rate, which is reducing the number of young people
in the population. In the past, the prevailing age structure compensated
for the long-term trend toward lower fertility. The average age of the
population was relatively young, and many women were of childbearing
age. Beginning in the 1990s, however, this is no longer the case. The
age structure is now such that it will promote a population decrease
rather than an increase. Continued low fertility will only accelerate
this effect.

The Epidemiological Situation: Deteriorating Russian Health

Perhaps the only genuine crisis aspect of current Russian demographic
trends appears in increased rates of mortality, which have been
especially dramatic among working-age men. In 1992, there was a sharp
increase in deaths from nonnatural causes. By 1994, mortality rates for
males between ages 15 and 64 were about twice as high as they had been
in 1986. Rising alcoholism and related conditions have figured
prominently in this trend. In the mid-1980s, an anti-alcohol campaign
championed by Mikhail Gorbachev was responsible for a brief reversal in
the mortality trend, but the increase resumed after the campaign was
abandoned in the late 1980s.

Growing alcohol consumption is not the only explanation of increased
mortality. Deaths from violence, injuries, and other nonnatural causes
have contributed heavily to the latest rise. Russia's rates of homicide
and suicide are among the highest in the world. In addition, deaths from
illness and chronic and degenerative diseases, such as cancer,
respiratory failure, and circulatory and cardiovascular diseases, have
increased sharply. It is interesting to note that environmental
problems, generally given a large share of blame for Russia's health
woes, are in fact not among the main culprits. Environmental problems
cannot explain the increases in accidents, homicides, and suicides or
the much greater increases in mortality for working-age males compared
with other population subgroups.

Mirroring the increase in mortality rates, life expectancy in Russia has
dropped. However, like the fertility trend, the current pattern is not
new. In the mid-1960s, after decades of increase, life expectancy began
to decline. This trend was reversed briefly in the mid-1980s due, many
believe, to the success of the anti-alcohol campaign between 1985 and
1987. However, by 1993, life expectancy fell again. Russia now has the
lowest life expectancy for males in a developed country (58 years) and
the largest disparity in the world between male and female life
expectancy (13.5 years).

The Failing Health-Care System

The increase in deaths from preventable causes points to problems in
Russia's health-care system. Again, these problems are not a recent
phenomenon. They have accumulated over many years. One characteristic of
the Soviet period was a lack of incentives to improve medical services.
When changes in the health of the population occurred--such as a
decrease of infectious disease and a rise in "civilized" ills, such as
alcoholism, smoking, traffic accidents, and pollution, in the
mid-1960s--the health-care system failed to adapt appropriately.
Excessive reliance on ideology led to ineffectual goals and an emphasis
on activities that addressed neither the medical problems at hand, the
level of national development, existing medical capabilities, nor public
demand. In the 1980s, the system finally made attempts to cope with the
changing health environment, but the strategy was poorly implemented and
lacked necessary investments in facilities and equipment.

Although these problems were not created by the current socioeconomic
crisis, they have been aggravated by the breakdown of the old social
system. In the Soviet era, virtually all health care was provided free
by the state, whose system emphasized the quantity of medical personnel
and facilities, overlooking the quality of services, and pursued goals
set on the basis of political ambitions rather than on objective medical
needs and economic capabilities.

As the command economy crumbled, the public-health sector plunged into a
financial crisis. The system found itself in an emerging market
environment without the capacity to function successfully in it. Left
without proper funding, health-care facilities were forced to abandon
new construction, renovation, and other basic investments. Cost cutting
necessitated switching to cheaper technologies, which proved
insufficient to maintain needed levels of care. Available funds were
frequently diverted to current needs. As a result, the health status of
the Russian population is deteriorating, and diseases long thought to be
eliminated or controlled--such as diphtheria--are now spreading again.

Reviving an effective health-care system in its current form presents a
near-impossible task. Many important medical research centers,
especially at the federal level, have been left without proper financial
support. Progress in all spheres of health care is under great stress.
Faced with this situation, the Russian government has attempted to
reform the health-care sector through privatization, marketing services
in state-owned facilities, and promoting the private medical sector. One
of the main goals of reform is to establish compulsory health insurance
financed through taxes and operated by both the state and the private
sector. However, the reform has yet to produce noticeable results.
Russians are used to receiving free health care and many are unwilling
and frequently unable to pay for health services.

In addition, serious health-care problems exist that extra spending
alone will not address. There are no clearly defined federal and local
health-protection policies, no effective programs for monitoring
outcomes, and no openly declared systems of control and delegation of
responsibilities for state and public health institutions. Moreover, the
incidence of destructive behaviors, such as violence and alcohol
consumption, has increased. Heavy tobacco use contributes to a high rate
of mortality from lung cancer, which occurs 60 percent more frequently
in Russia than in the United States. Without attention to these
problems, additional funding for health care per se is likely to have
little effect.

Looking Toward the Future: Policy Outlook

The current economic crisis significantly limits the Russian
government's ability to deal with demographic trends through policy
intervention. In particular, the problems of the elderly will be
difficult to manage. The retired population is growing, while the
financial resources the state devotes to the elderly dwindle. With the
declining real value of pensions and the rising costs of health care,
the elderly are among the most economically disadvantaged and vulnerable
social groups in Russia. The problems that appear most amenable to
policy intervention are those related to the health-care system.
Thoroughly crafted health-care reform components are essential; an
ill-designed benefit package, hasty decentralization, and overreliance
on the private sector will only aggravate the situation. At the same
time, promoting healthier lifestyles among Russians--reduced smoking and
alcohol consumption, better diets--could improve health substantially.

Knowledge about Russia's demographics should help dispel the popular
notion of a demographic crisis. The continuation of several long-term
patterns, such as declining fertility and historically high mortality,
accounts for many of the current trends. While it is undoubtedly true
that economic conditions have aggravated current problems, there is no
strong evidence linking these problems with recent economic and
political reforms. Some of the most dramatic changes appear to be
compensatory effects following the abandonment of previous policies: for
example, the retreat from pronatalist and anti-alcohol initiatives of
the 1980s. In fact, it has been suggested that whatever crisis features
are present in Russia's current situation might be attributable to a
delay in reforms--for example, delay in reforming the health-care
system. This delay hampers the adaptation of social institutions to the
new realities of economic and family behavior in Russia. Furthermore,
the most recent data suggest that the mortality and life-expectancy
situation has begun to improve.

The new demographic realities in Russia are not fundamentally different
from those facing most industrial nations--a decreasing population,
aging, shifts in family composition. Since it is impossible for Russia
to avoid these changes, the challenge lies in addressing them
effectively. Toward that end, a great deal of further research is
required to disentangle the effects of earlier policies, current
reforms, and other factors in explaining Russia's demographic patterns.
Although they may not add up to a crisis, these trends will continue to
pose difficult challenges for those deciding the direction of Russian
policy.