Health and Social Change in Russia and Eastern Europe

In each of the former socialist countries discussed thus far, the long-term decline in life expectancy has shown either recent (Russia, Hungary, and Poland) or definite (Czech Republic and Slovakia) signs of improvement. This is not the case in Romania. Mortality is continuing to rise and male life expectancy to decline. In fact, longevity among Romanian males is lower in the mid-1990s than it was in the mid-1960s. The health crisis in Romania is clearly not over and this chapter explains why this is the case.

Romania was an independent kingdom 100 years ago. But its modern origins go back to the Roman Empire’s province of Dacia, which gives present-day Romanians more of a Latin than Slavic quality in appearance and language (Dogaru and Zahariade 1996). “Like the rest of the Balkans,” states Flora Lewis (1987:468), “Romania was late in developing, cut off from the European mainstream by Turkish overlordship, with feudal habits and extremes of wealth and power.” The society consisted of a small elite group of landowners who controlled a huge peasant class producing foodstuffs in an agrarian economic system. For over two centuries, the Romanian people had struggled to free themselves of Turkish rule through armed revolt and negotiation. By the mid-1800s, with the Ottoman Empire weakening, the Romanians were able to establish an

This chapter was written with the assistance of Daniela Vâlceanu, M.D., Institute of Health Services Management. Bucharest. Romania.

-193-