HEALTH CRISIS IN RUSSIA .1. RECENT TRENDS IN LIFE EXPECTANCY AND CAUSES OF DEATHS FROM 1970 TO 1993

Since the mid-1960s, the trend of life expentancy at birth in Russia h as differed from those of the majority of other Western populations. U ntil the beginning of the 1980s, life expectancy of women has remained unchanged, and that of men has declined. Some progress was made follo wing the anti-alcohol campaign launched by Gorbachev in 1985, but it p roved to be ephemeral. After 1987, the fall in life expectancy continu ed for both sexes, and even accelerated in 1993. The decline is not af fected by correcting the level of infant mortality which has been unde restimated, because the negative trend is linked mainly to a rise in a dult mortality rates, particularly among men. Unpublished data on caus es of death have made it possible to construct time series for the per iod from 1970 to 1993 for deaths classified into the 185 causes in the Soviet Classification of Causes of death. Increases in the prevalence of cardio-vascular diseases which the health system was unable to tre at have contributed to the long-term negative trend. Deaths from viole nce were responsible for fluctuations towards the end of the 1980s. Fi nally, the recent fall in life expectancy in 1993 applies to deaths fr om all causes and is undoubtedly related to the economic crisis in tha t year which contributed to the disorganization of the health system.