Health and Social Change in Russia and Eastern Europe

By William C. Cockerham | Go to book overview

Chapter 2

The Social Determinants of the Decline in Longevity

It is not completely accurate to say that the health crisis in the former Soviet bloc has been brought about by the socialist vision of society; rather, the crisis seems to be one outcome of European socialism’s unsuccessful efforts at modernization (Watson 1995). The 1950s and early 1960s were a time of dynamic economic growth in the region, but efforts to overtake the West faltered thereafter and this period also marked the onset of rising mortality from natural causes. A review of this situation suggests that socialist health policy, societal stress, or health lifestyles are the most likely social determinants of the premature mortality. Were the health policies of the communist regimes so ineffective that scores of middle-aged men died early deaths for more than 30 years? Or were the stresses produced by adverse societal conditions—such as a failing and stagnant economy—at fault? Or were unhealthy styles of living associated with communism the major culprit? These questions are examined in chapter 3.


Socialist Health Policy

Health care delivery systems and policies are acts of political philosophy; therefore, social and political values underlie the choices made, institutions formed, and levels of funding provided for health (Light 1986). Prior to the collapse of communism in the former Soviet Union and

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Health and Social Change in Russia and Eastern Europe
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Preface ix
  • Chapter 1 - Introduction 1
  • Chapter 2 - The Social Determinants of the Decline in Longevity 29
  • Chapter 3 - Health Lifestyles: a Theoretical Perspective 53
  • Chapter 4 - Russia: Life Expectancy and Social Change 81
  • Chapter 5 - Russia: the Current Health Crisis 99
  • Chapter 6 - Hungary 123
  • Chapter 7 - Poland 143
  • Chapter 8 - The Czech Republic and Slovakia 169
  • Chapter 9 - Romania 193
  • Chapter 10 - Bulgaria 211
  • Chapter 11 - East Germany 227
  • Chapter 12 - Conclusion 245
  • Appendix 253
  • References 255
  • Subject Index 277
  • Author Index 282
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