The idea for this book had its origin in Vienna at the 1992 meeting of the European Society of Health and Medical Sociology. The Vienna meeting was attended by social scientists and physicians from all over Europe, including several researchers from the former socialist countries. Although it was well known that levels of health and life expectancy were seriously declining in the former Soviet bloc, I found that, both in the presentation of papers and in scholarly dialogue, no one—from either the East or the West—could explain why this situation was occurring.
The lack of an explanation presented itself as an intriguing research question, since rising mortality in the region was obviously one of the most important public health problems in the last decades of the twentieth century. The East and West had taken different routes to modernity and the Eastern approach (the “experiment” in socialism) had disastrous health consequences. Yet this development seemed to be generally overlooked by medical sociologists in the West, especially in the United States; while, in the East, sociology in general and medical sociology in particular were only just regaining strength as academic specialties after being either abolished or relegated to a marginal position in the former Soviet Union and Eastern Europe. Communist regimes did not want sociologists identifying and analyzing social problems when such problems were not supposed to exist; patterns of social stratification were a particularly sensitive issue in societies that were officially “classless.” Pointing out that communism was bad for a person’s health was not likely to be allowed, either. So given what could be considered a lack of familiarity with the region on the part of most Western social scientists, and the early state of development of free and uncensored medical sociology in the East, it was clear that collaboration between Eastern and Western researchers was the best way to find answers to questions concerning one of the most significant health problems of the late twentieth century: Why