NOTES ON "SOME CAUSES OF RISING MORTALITY IN THE USSR"

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP83T00966R000100060017-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 20
• Document Creation Date: December 20, 2016
• Document Release Date: March 5, 2007
• Sequence Number: 17
• Publication Date: August 13, 1982
• Content Type: MEMO

Approved For Release 2007/0
DATE
17ug 82
TRANSMITTAL SLIP
TO: Andy
Marshall, D/Net Assessment
ROOM NO.
3A930
REMARKS:
BUILDING
Pentagon
As promised.
FROM: Harry Rowen, C/NIC
RYE~A2NO.
BUILDMG
11qs /CIA
i FEB sss 24a.
REPLACES FORM 36-5
WHICH MAY BE USED.
/05: CIA-RDP83T00966R000100060017-7
?
Arinrnvad Fnr RRlanca 7f1E17/03105 ? r;IA-RDP8 T00 66R0'001-0006Q0-f7=7 -`
 Approved For Release 2007/03/05: CIA-R DP83T00966R000100060017-7
DDI-
13 August 1982
FROM
SUBJECT
Chief, SED
SE/M
Notes on "Some Causes of Rising Mortality
in the USSR"
1. My purpose in writing this memo is to evaluate a recent
article in Russia magazine by Maksudov (pseudonym), "Some Causes
of Rising Mortality in the USSR". The article discusses
demographic developments and in particular Soviet successes
during the 1950s and early 1960s in raising life expectancy and
reducing death rates. Maksudov argues that historical
circumstances such as high rates of infant mortality before the
revolution, civil war (1918-21) and World War II subjected the
population to such a rigorous selection process that the weak
were killed off, and the strong survived, thereby lowering
mortality rates and raising life expectancy. He contends that
mortality has increased since the mid-1960s because the influence
of selection has diminished. Death rates which are no longer
being artifically restrained have been allowed to rise to their
"true level." Maksudov has downplayed--at times ignored--factors
other than the Darwinian ones. he gives that also explain the rise
in mortality rates.
2. Mortality rates in the USSR have been rising for the
last 15 years following a long period of decline. The death rate
for the population increased by 49 percent from its low point in
1964 of 6.9 per 1,000 to 10.3 per 1,000 in 1981. Life expectancy
for men is estimated to-have fallen from 66 years in 1965 to 62
in 1980; for women it has remained static at about 74 years.
Also the infant mortality rate has increased by more than 35
percent since 1971.
3. The Central Statistical Administration has not released
age-specific mortality rates, infant mortality figures, or life
expectancy data since the mid-1970s. The Soviets have also
withheld publication of 1979 census data on the age distribution
of the population, probably betraying their embarrassment over
these trends. These omissions in data make research and analysis
particularly difficult for Western analysts.
Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
 Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
0 ?
4. Maksudov concentrates his discussion on trends in infant
mortality and life expectancy. He neglects to explain the
current rise in adult male mortality, particularly for those in
their 30s and 40s, due largely to the increase in cor.onark heart
disease, cancer and alcohol-related deaths. However paradoxical-
it may seem, the general health-of the population has been
strengthened by the contribution of medicine and improvements in
the diet.
5. Infant mortality historically has been high in the USSR
although tremendous progress has been made in reducing it. After
a long period of decline, infant mortality rates registered a
sharp rise between 1971 and 1974. The rate is much higher than
in the West and the gap seems to be widening. Infant mortality
is currently estimated to be twice that for the U.S. Among the
reasons suggested for the recent rise are rising alcoholism among
pregnant women, use of abortion as the primary form of birth
control, the effect of influenza epidemics on the health of
pregnant women, and environmental pollution.
6. Some evidence also suggests that infant mortality may
have been much higher in the past than the reported figures
showed, so that the recent rise may be somewhat overstated.
Birth registration and infant death reporting particularly in the
high fertility southern tier republics and in parts of the RSFSR
have been incomplete up to the 1970s. Much of the increase in
infant mortality could be due to more comprehensive reporting of
infant deaths in this region.
7. Maksudov accepts the explanations already discussed, but
again reverts to his selection argument. He also blames
"deterioration of the quality of the birthing population"--i.e.
women weak in childhood, who with medical assistance survived to
become mothers, but of genetically weak children! Since these
women were born in the 1950s, long after the war ended, it seems
specious to assume that their mothers were suffering from
malnutrition. Much more to the point in explaining rising infant
mortality is the fact that the USSR has a much higher proportion
of infants who die from exogenous factors such as infection,
prematurity and early childhood diseases as well as birth defects
than in the West. Health officials have responded to this
increase by calling for the expansion of fetal and infant care
centers, earmarking more funds for maternity homes, clinics for
children and the like.
8. Maksudov notes that progress made by Western countries
in reducing infant deaths caused by endogenous factors has
boosted their burden of supporting a growing population of
mentally and physically handicapped people who can weaken the
"general vitality of the population." Since weak infants in the
USSR do not have the same survival rate, Soviet costs in this
area are not as high.
 Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
9. Maksudov notes that the oldest cohorts in the USSR have
always had a high life expectancy, primarily due to high infant
mortality and social and military catastrophes which killed off
younger cohorts. This seems to be an extreme position since many
of those subject to the greatest risks during wartime-would have
been among the strongest and healthiest in the population. The
relative calm since World War II has led to a growth in
mortality.
10. Life expectancy at birth of Soviet males as a group has
been declining and the gap between men and women now stands at 11
1/2 years. Such a gap exceeded that for all other countries in
the world except Gabon, according to United Nations figures.
Maksudov fails to explain this gap since females were similarly
at risk during the upheavals. He also omits discussion of the
more recent contribution of the changing disease pattern and
changing life style--notably high intake of sugar and animal
fats, cigarette smoking, and heavy alcohol consumption--making
coronary heart disease and cancer leading causes of death. The
upturn in adult mortality over the last 15 years is in fact
primarily a result of coronary heart disease, which accounts for
almost all of the increase in total deaths.
 Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
SOME CAUSES OF RISING MORTALITY IN THE USSR
Recently the American press has given much atten-
tion to a heated discussion of demographic problems in
the Soviet Union. Of special interest is the rise in mortal-
ftty rates over the last decade. 1 The discussion begun af-
ter Christopher Davis and Murray Feshbach published
their "detective" work (as one of the participants, Nick
Iberstadt, rightly called it) 2 on the trends in Soviet in-
lint mortality in the 1970s. Unfortunately the authors
could investigate only the rust half of the decade (1970-
1.975), but this was hardly their fault. After 1975, Sov-
iet demographic statistics avoid mention of infant mor-
tality. or or that matter mortality in any age groups.
11is silence itself speaks volumes.
This discussion has revealed a great deal. For one
thing it became obvious that life expectancy and low
mortality are two of the most important criteria for
measuring the quality of life of the population. Second-
ly, these criteria aid Western scholars who attempt to
iiudy the character of socialist society. As Eberstadt has
urtated, a boy in Delhi can expect to live longer than the
boy of the same age in the USSR. 6 Not long ago drops
In mortality rates and rises in life expectancy served Sov-
iet propaganda as convincing evidence of the superiority
of the socialist system. Now the situation has changed,
but the politicization of the problem remains and this
makes it more difficult to examine the problem. The de-
lbate is making it possible for the first time to answer
iwme of the questions involving the life and death of
Soviet man. It reveals some disturbing facts: mortality
for almost all age groups continues to rise - infant mor-
tality by up to 40% - while life expectancy is falling.
The question, however, still begs an answer: how can
it be that a backward society emerging from the Stalinist
era just twenty years ago could have overtaken many
more developed countries in life expectancy by the
1960s?
First we should try to determine how the country
could have attained such a demographic pinnacle. I will
try to show that the high life expectancy among the Sov-
iet po lion in the 50s and 60s was a cidental re-
sult, not of medical or social improvements, but of his-
en *,---I circumstances. The population was subject to rig-
orous natural selection whereby the weak and the sick
died off, leaving the strong to carry on.
The first stage of selection takes place at birth. Infant
mortality prior to the revolution reached 30% of live
births, up to 50% before age five. Doubtless generally
only the healthiest and most vigorous survived.
The second major element in the selection process
was the period of the civil war. Starvation and disease
carried off many millions; the end of the war not by ac-
cident coincides with a sharp decline in mortality.
A third factor was the Second World War which
brought with it new terrors of illness and malnutrition -
and a higher death rate among all age groups. Once
again the end of the war saw a rise in life expectancy.
All of these circumstances were of a temporary na-
ture. The influence of selection gradually diminished and
death rates in all groups began to rise in the 60s. It was
not a true rise but a return to the "natural" level that
had been artificially restrained.
Before turning to the more alarming situation of to-
day, let us look back, first to Russia at the time of the
first census of 1897, and then to the Soviet Union in the
1970s.
In Russia, birth control was practically unknown. A
family with five children was small, while ten children
in a family was not considered particularly unusual; in-
fant mortality was incredibly high.
The birth rate in Russia at that time was close to the
physiological limit. ' The demographic behavior of the
Russian -nuzhik at the turn of the century was marked
by early marriage and lack of means of birth control.
This behavior was dictated by a socio-psychological pat-
tern that had developed in the rural countryside over the
course of centuries and depended little on the desires or
personal characteristics of individuals. s Tradition de-
manded marriage as early as possible, boys at 18 to 20
years of age, girls at age 16 to 18. Differences in age be-
tween spouses were small (in rural communities it was
considered disgraceful for a woman to marry an "old"
man more than 2 to 3 years her senior). To remain
unmarried was a disgrace (35% of women in the 20-24-
year age group were unmarried, but only 5% in the 45-
49 age bracket). Divorce was a grave sin; adultry and il-
legitimate children were serious crimes. Interfering with
conception was not only a sin but a criminal offence .9
Nevertheless, the stereotype did not extend to child
care in the modem sense. The well-known writer D.V.
Grigorovich wrote, "The most affectionate father, the
most caring mother will leave their child in the hands of
fate with almost unconscionable carelessness, and not a
 ?
thought even for the child's physical development, de-
spite the fact that it is their single most important con-
cern, simply because nothing better ever occurred to
them. No sooner is the child out of diapers than he is
handed over to his sister, herself no more than 4 or 5
years of age" 10 Average births for a woman at that time
was 10 or 11, according to some researchers. The woman
was turned into a baby-making machine. "The tremen.
dous physiological stress of giving birth was added to the
already enormous physical burden of housekeeping and
agricultural labor. "The sickly, undernourished, crippled
and prematurely wizened and aged figure of the rural
woman, with obtuse, depressed and mournful expres-
sion ....."'= It is no coincidence that the mortality of
middle-aged women in 1897 outstripped that of men.
Overall, life expectancy among men and women was
about equal and generally low. (See table 1.) The per.
centage of men over age 60 was about 69, about the
same as for women, 7. The corresponding figures for
1979 (8.7% and 16.7%) " differ almost by a factor of 2.
The population was surprisingly young. Children and ad-
olescents (up to age 19) accounted for almost half of the
population (in 1979, one third), while the same group
accounted for two thirds of the deaths (in 1970, 7%).14
Most of the demographic characteristics above were
not peculiar to Russia. A well-known demographer
wrote, "Russian mortality was generally typical for an
agricultural economy lagging behind in hygiene and cul-
tural development. But for its extraordinary high death
rate in the lower age groups and its extremely low death
rate among the aged, Russia occupies a special place a-
mong analogous states." 11
Another peculiarity in the Russian mortality figures
was her greater mortality levels in the cities than in the
countryside. Except for children, the rural population
(particularly men) lived significantly longer than the urb-
an. The coefficient of mortality between the ages of 40
and 44 for male dwellers in 1897 was 1.8.7, for males in
rural areas, 111; for women living in cities the figure
was 12.9, while for rural women it was 11.1. Corres-
ponding figures for the 50-54 age group were 28.8, 19,
173, and 169. And for ages 60-64 they were 47.6, 33.4,
32.1, and 34.1. 16
Of special interest is the proximity of the indexes for
rural men and for rural women (slightly higher for wom-
en) as well as the minor difference between the mortal-
ity figures for rural as opposed to urban women. Only
men going to the cities to work in factories were in a
worse position demographically.
Demographically, the USSR today differs greatly
from old Russia. People, their relationships, and the
demographic stereotype of behavior have changed.
Women now have not ten. but one, two, or at most three
children (with the exception of Muslim groups) and their
children are 10 times less likely to die in infancy.
Later marriages, large gaps between the ages of
spouses, large numbers of unmarrieds, divorces, and
births out of wedlock - all these have become com-
monplace occurrences. Birth control, only squeamishly
approached by the progressive writers at the turn of the
century and which they attributed to the wealthier
classes, " is now so widely practiced that the USSR has
easily held the world record for some time now in absol-
ute and relative numbers of abortions.
Removing from women such overwhelming physical
and physiological burdens, plus other social and medical
developments, have led to a complete reversal in the
mortality figures for men and women. Death rates
among women in practically all age groups are lower
than for men. Women live longer and outnumber men in
the middle ages. IS
Significant shifts have also occurred in comparisons
of mortality between urban and rural populations. To-
day deaths in almost all age groups are higher in the
countryside than in the cities.
The age structure of the population has also changed.
The population is older and the number in their working
years has increased. The distribution of deaths by age
group today is completely different. Almost 90% of the
population lives to age 30 (3 times greater than in old
Russia) and 40% live past age 70 (6 times greater than
before). 19
But the primary socio-psychological outcome might
be considered to be the change in attitude toward chil-
dren, toward their upbringing, and a sharp decline in in-
fant mortality which, in any case, remains very high in
comparison with other countries.
Infant Mortality in the USSR
Let us now briefly consider the study which has laid
the groundwork for general discussion of the problem
and, not surprisingly, generated a lot of interest. Davis
and Feshbach painstakingly compiled data from widely
scattered sources. Together with some peripheral data
and additional suppositions, they were able to calculate
a coefficient for infant mortality in the USSR for 1975
and 1976. Davis and Feshbach, moreover, examined dif-
ferences in methodology for determining infant mortal-
ity in the Soviet Union and the US and then recalculated
the Soviet statistics using the Western methodology. 70
This allowed them to compare data on infant deaths in
the USSR with worldwide statistics.
In considering the reasons for increases in infant mor-
tality in the USSR, the authors considered the fol-
lowing:
a) changes in numbers of children born in cities and in
the countryside occurred in favor of the cities where
death rates are lower and therefore could not depress the
Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
 X- R D P83T00966 8000100060017-7
? ?
overall coefficient of infant deaths;
b)) rises in birth rates in the "Muslim" republics with
higher infant mortality rates amounted to 1 b% for the
period 1970-1976 and could only in small measure be
due to the general use in the rate of deaths among chil-
dren;
c) the increase in the birth rate from 1.7% in 1969 to
184 % in 1976 was too small to influence the rise in
deaths;
d) the age of motherhood during the period under re-
view dropped somewhat, which, however, could not
have played a significant role;
e) changes in order of births. It is known that deaths are
more frequent among first-born than among second
births, and higher among second children than among
third-born. Over the given period the share of first- and
second-born children in the total number of births grew,
which would imply a general rise in death rates. Refer-
ring to American statistics, Davis and Feshbach demon-
strate that this factor also played little part in the rise of
USSR mortality rates.
The major reasons for the growth in infant mortality
according to Davis and Feshbach are not demographic
but social, economic, and medical: more mothers who
irnoke and drink, more working women, poor health
among mothers (according to Davis and Feshbach, seri-
ous illness in the mother can increase the probability of
death for a newborn child by a factor of ten), more a-
ibortions, 21 inadequate medical care during pregnancy,
poor nutrition among mothers and their infants, poor
housing conditions, more children with genetic defects,
a decline in the level of child care at home due to disin-
tegration of families of multiple generations, poor qual-
ity of training among medical personnel, epidemics of
flu and pneumonia.
A number of other factors could be added here. For
example, deterioration of the "quality of the birthing
population" - the appearance among mothers of indiv-
iduals who, weak in childhood, nevertheless survived
thanks to modem medicine; decreasing effectiveness of
7 antibiotics in mothers and as passed from mother to
child; appearance of new strains of viruses and bacterias;
extreme lags in the availability of new, relatively expen-
sive drugs (some, such as rondomycin, sigmamycin, cep-
arin, etc. have been around for more than ten years, but
physicians are forbidden to prescribe them since they
an be obtained only in clinics for.the elite).
Another serious problem is the cositamination of mat-
ernity centers and children's health clinics, in particular,
with staphylooocc. In the opinion of a number of phys-
idans this has become a growing concern in recent years
and affects the health of mothers as well as children. The
health of children is also adversely affected by the em-
ployment of women in hazardous industries. (Research
in the USSR has shown that among women working on
tractors the probability of their having children with
birth defects rises by orders of magnitude.)
Thus, the rise in infant mortality in the USSR is de-
fined by social and medical factors. But the distribution
of the increase geographically and by nationality plays a
very important role.
From Table 2 it is not difficult to see that overall
mortality in the Soviet Union is rising faster than in the
RSFSR, the Ukraine, or the Baltic region. It follows
then that the rise in the overall _coefficient is due r~ rr--
o increases in infant mom lit in the republics of
Central Asia and the Caucasus, whose data is not pub-
lished. Given the fact that these regions accounted for
nearly a third of the births in 1976, one can reconstruct
their average coefficient of infant mortality (see Table
3).
The results appear somewhat strange. Death rates in
. the Asian territories of the USSR (the East) dropped
sharply in 1960 (by more than 20%), and it remained
stable at a low level for 12 years, after which it rose a-
gain over a four-year period by 50%. Both the dramatic
rise between 1973 and 1976 and the stable low level be-
tween 1960 and 1972 appear suspicious. One could be
led to believe that mortality rates in the 60s were under-
estimated. And in fact, such was the proposition of Gos-
plan official A. Smirnov in an interview with Western
correspondents. 23 Let us assume that these assertions
are legitimate, and that the rise in the death rate in the
70s in the Asian areas of the country followed the trends
in the Russian republic and the Ukraine (about 10%).
This would mean that in 1970-72, infant deaths in these
regions amounted to approximately 45 per thousand
births, and that the underestimation was about 30%. A
derivation of the infant mortality rate using such as-
sumptions is illustrated in Table 4. The result seems fair-
ly convincing. The drastic rise and close correspondence
in rates to the figures of Western areas in some years -
an artifact unsupported from the medical and social
point of view - has disappeared.
A recomputation of the rates for the country as a
whole, adjusted for missing data and using the Western
methodology, shows that the level of infant mortality in
the nation in the 60s and 70s was noticeably higher than
has been generally accepted. It never dropped below 30
per thousand. The rise in infant mortality in the 70s was
not as sharp as it appeared - amounting to 10-15%. Over
the last 10 to 15 years we can see not so much a growth
in the rate of infant mortality, but a stabilization, or
lack of decline. This is a rather unusual p enomenon,
putting a ovtet Union in a special position, since vir-
tually all countries (at least those which keep track of in-
fant death rates) have cut mortality rates among new-
borns significantly.
 We Expectancy. in the USSR and Elsewhere
The reconstruction of infant mortality rates in the
USSR on the Western model conducted by Davis and
Feshbach has clarified many issues. From Table 5 it is
evident that infant deaths in the Soviet Union during the
60s and 70s was noticeably higher than in the developed
West. This gap has since widened, not as a consequence
of any catastrophic rise in mortality in the USSR, but as
a result of dramatic decreases in mortality in the West.
The explanation therefore, lies less in any mysterious
changes in the Soviet Union, but, on the contrary, in the
very lack of any substantial change. Maintenance of
alth care and a level economic situation should cause a
rise in a eath rate due to deterioration in the effec-
tiveness fable drugs, changes in the etltnic coataos-
ition (a more rapt raie ofjrowth in the Muslim popula-
3T-
tions , as wellas a number of other factors.
s its in tact w at Ws 5murred:-Over--the past 20
years, the death rate for the country has not dropped,
and not surprisingly. Indeed it would be amazing for a
nation with the biggest military industry to allocate
enough additional resources for health care and social
welfare in order to overtake more industrially developed
countries not burdened with such enormous unproduc-
tive expenses.'',
The Soviet Union's position in Table 5 is fairly well
defined. Based on the two fundamental demographic in-
dicators of infant mortality and life expectancy, the
USSR should not belong in the ranks of developed na-
tions - nor should it have claimed membership 20 years
ago despite the arguments of the Soviet propagandists.
The Soviet Union occupies a place among the countries
of South and Eastern Europe, though she has lost her
place as a leader in this group. But is the situation so bad
as to give support to a notion of degeneration of the
population and demographic atastrophe? Tble
does not bear this out.
The Soviet Union lags behind the US by approximate-
ly 5 years in life expectancy, and leads the US by a fac-
tor of more than 2 in infant deaths. But there is an al-
most identical gap between the US and Sweden, and in
favor of the latter. The gap between the Soviet Union
and the developing world is much larger. In Latin Amer-
ica, for example, infant mortality on average is almost
twice as high, and life expectancy lags behind the Soviet
Union by nearly 4 years. Africa and Southern Asia,
moreover, trail Latin America by more than ten years in
expected lifespan, and infant death rates are 2 to 3 times
-higher. Compared against worldwide levels, then, the
shifts in the demographic situation in the USSR do not
appear so calamitous; they represent a more or less tradi-
tional lag behind the industrialized world. The USSR's
"catastrophic" levels will remain for decades only a dis-
tant dream for underdeveloped countries.
Life Expectancy in the USSR and in the US
in the 20th Century
The Soviet Iag appears even less threatening when life
expectancy among other age groups is examined. Table 6
"shows that Americans between the ages of 10 and 30 an
expect to live 3 years longer than their counterparts in
the USSR. This would be 5.7% of their expected life
spans. For a 40-year-old, the gap narrows to 2 years, and
by age 50 to only 1 year. Twenty years ago the compari-
son would have been similar, but in favor of the USSR.
Curiously, life expectancy for most age groups in the
US in 1978 coincides with figures for the USSR in 1958.
.year period America has risen to the level of
Over the 20-
the Soviet Union, while the USSR has fallen to the prev-
ious US position. There is nothing especially uncommon
about the simple fact of a narrowing of life expectancy
by 1% to 2 years. American census statistics covering the
20th century show 21 occurences of shortened life ex-
pectancy over a 78-year period, from relatively small
changes on the order of 0.2-0.3 in 1963 and 1968, to
very large (3.6 in 1928, 3.2 in 1936), not to mention the
extraordinary drop of 11.8 years in 1918. An overall rise
in life expectancy in the US was punctuated by periods
of stagnation and even decreases in expected lifespan
(1921-1931, 1933-1943, 1961-1968). The later period is
somew t reminiscent of the situation in the 70s in the
USSR life expectancy settled at about 70.2 years in the
US as a exult of a rise in death rates among males in a
number of age groups. The life expectancy of males
reached 668 years in 1959 and hovered about this figure
through 1969. Only in 1970 did it begin rising once a-
gai> It is worth noting that, as differs from the USSR
where the drop in life expectancy was determined in
part by a rise in infant mortality, in the US the deterior-
ation in the position of the male population occurred
against the backdroa_of aTrpy..n.nt in infant rteath
ratesLi e. , at the expense of other age~roups. Non-white
males appeared to be in as especially poor position. Life
expectancy among non-white males reaching age 5 in
1959-1961 was 1% years higher than in 1969-1971. The
same applies to 10-15- and 20-year-olds. In the 25-40-
year group, the gap narrows to one year, or a half year,
and only among men aged 75 years do we notice some
progress in life expectancy over the ten-year period.
Neither the lag of several years behind the US, nor
the decreases in life expectancy is therefore particularly
surprising. Such a situation might be expected in a coun-
try that puts all of its resources into the development of
heavy industry and the arms race. Such was the case be-
fore the revolution and prior to the Second World War.
Strange were the shifts in relative rates of mortality be-
tween the two great powers, in particular the unexpec-
ted zig-zag during the 1950s. At the turn of the century
the advantageous position of the US as regards life ex-
 Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
. .
pectancy is noted in all age groups under 70, while Rus-
sian elderly lived longer. By the end of the 20s.40s dif-
Eerences in mortality in the middle age groups evened
cut (the US is ahead in ages 40 and above). By the end o
cf the 50s we see the USSR with a clearly dominant pos-
ition, which then began to quickly erode (Table 6).
We must note that over the entire period under con-
sideration the Soviet Union maintains an even or better
position in life expectancy in the older age groups. The
primary reason for this phenomenon is evident.
Dependence of Middle Age Mortality on Levels
of Infant Mortality
The extraordinary longevity of older people in Russia
at the turn of the century drew the attention of contem-
porary researchers who pointed to the quiet life of the
Russian peasant. 26 But yet another factor played a sub-
stantial role - high infant mortality. Nearly half of all
babies born died before age five. This severe selection
process carried off the weaker segments a popu -
tion. Th survivors lived longer but made up a smaller
share of the total population than in ountrtes
er rates of in ant ea . e o serve a similar phenomen-
c+n when compartng white and non-white groups in the
US population (Table 7). The white population experi-
ences lower infant mortality and dominates the middle
age groups, but their life expectancy beyond 70 years of
age is somewhat lower. We we a similar situation when
comparing mortality of various groups in the USSR, as
for example between Ukrainians and Uzbeks. Death
rates in the higher age groups are less among populations
;vith higher rates of infant mortality. In the 0-4 age
Loup, Uzbeks experience death rates 2'h times as high as
Ukrainians (13 and 5.1 per thousand); by age 40 the rel-
ative mortality rates even out (4.4 per thousand); for
groups over 70 years of age, mortality among Uzbeks is
noticeably lower at 45.6 per thousand as opposed to
77.5 per thousand for Ukrainians. 2 7
An analagous picture is presented when comparing
urban and rural populations in the USSR. Up to ages 40-
45 mortality is noticeably higher in the countryside than
in the cities; but after age 50 the reverse is true. Among
those aged 65 to 69 deaths amounted to 29.1 per thous-
and in urban areas and 243 per thousand in rural
areas. 28
So it becomes apparent that the most diverse ethnic
and social groups experience an inverse relationship be-
tween deaths among infants and among older people.
l: ' infant mortality serves as a severe selector, ensurin
somewhat ' e yability in older generations. This,
In pares lps to confirm the somewhat higher eve o
life expectancy in older age groups in the USSR when
compared with the US, which we noted a a icr. tiant
mortality in Russia/the USSR - up until the 1950s -
was significantly higher than in America and it is exact-
ly this which in large part helped to assure longevity in
the older population.
With the sharp decline in infant mortality in the
1950s, this "advantage" began to disappear, to the point
where today the situation is about the same for cohorts
up to 25 years of age in both the US and the USSR. But
not quite, since the West at the time began in intensive
~issault on infant mortality.
On the Threshold of a Second Demographic Revolution
As in the past, to today, infant mortality is due to the
three primary factors: disease contracted by a child from
the environment (infection, colds, intestinal ailments,
etc.); traumas arising from the birth process (prematur-
ity, asphyxiation, dislocations); and birth defects, main-
ly genetic deficiences. Under conditions of high infant
mortality and when numbers of deaths among infants
approximate deaths in the older age groups, the primary
cause of death among newborns was infection. The as-
sault on infant mortality, begun in the developed coun-
tries in the 19th century - and in the underdeveloped
countries in the middle of the 20th century - led to a
sharp drop in deaths among children from causes of the
first group. Where the curve describing general mortality
once had the shape of "U", it has more recently taken
on the shape of a "T' - mortality among infants is now
considerably lower than among the oldest generations. A
demographic explosion occurred - the first demographic
revolution. 2 9
It is worth noting the differences between reasons for
the drop in infant mortality in the USSR and in the
West. 30 In the developed countries it-happened gradual-
ly; as the culture developed, more attention was paid to
the needs of the child and his environment improved.
Medical discoveries and general social advancement sup-
ported this tendency which then was adopted by the
family. In the USSR and in the underdeveloped coun-
tries the drop in infant mortality was a result primarily
of measures introduced by the state and society (the cre-
ation of a health care system, new medications, long
maternity leave and the like). Family life, the care of the
child and for his environment, changed gradually, and
with a substantial lag. Government health care programs
(women's clinics, childbirth centers, polyclinics and hos-
pitals) were intended primarily to preserve the health of
Thus, advances against the second and third
the child. 31
groups of primary causes of deaths among infants over-
took efforts on the first. Today the structure of infant
mortality in the USSR differs from Western experience
in a higher proportion of illnesses of the first category.
In the West such diseases as pneumonia seldom lead to
 Approved For Release 2007/0
death, while in the Soviet Union they account for a sig-
nificant share of infant deaths. 32
This discrepancy grows still larger as a result of
efforts against early childhood diseases in recent dec.
ades in the West. Whereas in 1950 about 1.1% of new-
borns died in the first day of birth defects, underdevel-
opment and other prenatal causes in the US, in 1981 a
similar share (1.2%) died during the course of the first
year. There was a sharp drop in the mortality of infants
from all types of netic illnesses. 3
In weden, where mortality today is two times lower
than in the US, the decline in deaths from birth defects
has been greater still."
Unfortunately, in the majority of instances, preserving the lives of infants suffering from the effects of gen-
etic defect and childbirth trauma does not always result
in total cure, and only a fraction are assured a normal
future life. Society, therefore, supports a growing num-
r of y cappe individ-
uah,'s This situation can graduall y ea o a in
the Leneral vitality of the population. The threat of gen-
etic diseaseu especially serious.
There are more than a thousand known genetic de-
fects which can be transmitted by either father, mother,
or both. A number of these conditions have been passed
down through many previous generations; others have
appeared relatively recently, as a result of mutual alter-
ations caused by unfavorable environmental circum-
stances, radiation, chemical mutagens, etc. 36 These dis-
eases can be divided into three primary groups: chrom-
osomal dificiencies, genetic blood defects, and metabol-
ic disorders. Some types of genetic illness appear during
pregnancy and can lead to spontaneous abortion 37
while others appear as abnormal development of the or-
ganism after birth, sometimes well into maturity. Ac-
cording to available data, genetic deficiencies affect no
less than 5% of newborns, and the number is growing. 3 s
By mentioning all these examples I do not pretend to
discovery of, or even research into, a complex modern
phenomenon. I merely note its existence. By analogy
with the struggle against exogenous disease, we could
call this process the second demogrpahic revolution. It
presents mankind with complex moral problems which I
will not argue here: human life is precious and the saving
of an individual child is a blessing. Eugenic selection
practiced by the ancient Greeks is,not only impossible
but is, by outward appearances, beyond the comprehen-
sion of our civilization. We must find others means of
resolving this issue which comes ever closer to modem
man, first in the developed countries, later in the devel-
oping world and the USSR.
The problem appears less serious in the Soviet Union
than in the West because of higher levels of infant mor-
tality (two times higher than in America, four times
higher than in Sweden). But, as noted above, the USSR
Is undertaking serious efforts to decrease mortality due
to birth defects and early childhood diseases.
Thus, the determined assault on infant mortality in
the Western countries developed over recent decades has
cut mortality primarily from genetic deficiency. It is
possible that this process could lead to some decline in
the overall vitality of each succeeding generation. Some
deterioration in the genetic fund of the population could
also result. The Soviet Union must also confront these is-
;ues, albeit with a lag.
Trends in Mortality Following the Revolution
As we have already seen, mortality in Russia re-
mained at a very high level. The drop at the turn of the
century was slight and affected primarily infants and the
younger age groups (Table 8). In several age categories
for males there was even some growth in death rates.
The First World War similarly had little effect. Mor-
tality over the period 1914-1917 remained at the pre-
war level, falling only slightly as a result of a decline in
the birth rate. (Remember that childhood mortality at
the time comprised a high proportion of population loss-
es.) I iii-LI
The civil war/that followed changed completely the
demographic situation in the country. Famine, typhus
epidemics and Spanish influenza 19 carried off many mil-
lions. 40 The country emerged from the war exhausted,
depleted, weakened, and (paradoxically) having a sharp-
ly reduced death rate. This surprising fact is demonstrat-
ed in Table 8. Virtually all ate groups in 1926-19' e
monstrated greater robustness (by 20-30Io). How could
this happen?
bril-
For Soviet authors there is nothing strange here:
liant successes in medicine and social welfare on the part
of the Soviet state This conclusion however does not
(ALI
ns hospital expansions and the like) were carried out
1926 and 1939. A glance at Table 8 leaves one
betwe
with a fee ' g
these efforts
virtually iden
once and not
census of 19
cy. For e
.55,091
females t
and 72,9
Den
ized
exp
f bewilderment of how little effect all
d (mortality rates in 1926 and 1939 were
cal). The drop in mortality occurred all at
in 1926, but somewhat earlier. The urban
3 showed an improvement in life expectan-
ple, in Leningrad, of 100,000 males,
reached age 20 in 1910-1911, 69,673 had
20 in 1923, and 69,770 in 1926-1927. For
e corresponding figures are 59,926; 73;033;
g the miraculous effects of the newly organ-
et institutions, we are forced to search for other
hold up under scrutiny. All the fundamental measures
undertaken (training thousands of doctors, creation of a
network of medical and childcare facilities, mass innocu-
 Approved For Release 2007/0
.10
1923 and succeeding years. Out of demographic catac-
lysm the population emerged renewed, and this is no
m:taphor. The sharp decline in mortality in 1923-1926
is more readily explained by the preceding catastrophe.
Naturally, the popular notion that mass epidemics and
famine weakens a population is legitimate. But it should
be added that, statistically, disease carried off the weak.
er population, or those "who should have died" during
the post-war years, but because of a deterioration in the
living conditions, they perished prematurely. In addi-
tion, heightened immunity generally follows massive ep-
idemics - most significant with many childhood dis-
eases.
Finally, it should not be forgotten that a complete re-
structuring of the system for compiling mortality rates
tce pp 11 during the period. Civil registration replaced
paish records. It is not impossible that a discrepancy
could arise between church records and those of a state
official concerning the birth of a living or stillborn in.
fant. Moreover, the population did not immediately ad-
apt itself to the civil procedures for recording deaths,
seeing nothing particularly significant in the require-
ment. Death rates from a variety of social causes also
dropped (such as alcoholism, venereal disease, etc.). 42
All of these factors (greater losses among a weakened
population, greater immunity, poor registration) were
temporary in nature and should have gradually disap-
peared. Mortality should have begun to increase some-
what. This was not the case (Table 8), apparently due to
die Tiroad health and social measures undertaken in the
1930s, due to population movements to the cities where
death rates were substantially lower than in the country-
jji t the time.-The famine of 1932-1933 and the braes
of rural population during deportations, for some areas
could have accounted for a greater "natural" selection.
Considering all these factors, variations between moral-
ity tables for 1939 and 1926 appear small. 43
Thus, the mortality rate before the revolution was
significant and was declining, except infant mortality,
very slowly. During the civil war many millions of peo-
ide perished, first of all the weak and 111. This increased
the statistical viability of those who survived. As a result,
mortality rates in all age cohorts dropped greatly in
1,923-26.
During the succeeding pre-war years, shifts in mortal-
ity were insignificant despite sweeping health are and
social programs. It is possible that the stability was due
to the effect of two conflicting trends: a return of the
death rate to previous "normal" levels, and a decline in
mortality as a result of better mediralcare.
Prior to the Second World War, life expectancy in age
ipoups over 40 was close to the level in the West.
Almost immediately after the war, in 1946-50, the
mortality rate reached the level of that of the developed
rsations and further decline in the rate during subsequent
?
years took place mainly because of a decrease in infant
mortality. The rate of the latter 80 per thousand in
1950, at:d became only 41 in 1958.
Unfortunately, there are no reliable data on infant
mortality in 1946. It is known that as a result of sulfa
drugs, it decreased somewhat in 194445 compared to
1943,44 which was 80% higher than in the last pre-war
year, 1940. But new drugs and medical care at the end
of the war were mostly for the urban population. There-
fore, it might be assumed that actual infant mortality in
1946 was close to the pre-war rate. This is supported by
the data on infant mortality in Leningrad: it was 119 per
thousand in 1946, in contrast to 144 per thousand in
1939.4 s One should not think that high infant mortal-
ity in 1946 was a consequence of the weakening of the
Leningrad population during the blockade. The author
from whom our data is obtained emphasizes that all bas-
ic measurements of newborn in 1946 were of pre-war
proportions. 46 Because of the central position of Len-
ingrad, and the blockade in the immediate past, it re-
ceived a larger share of the new drugs in comparison
with rural areas. Therefore, applying the decline in in-
fant mortality in Leningrad in 1939-46 to the whole
country, we would not exaggerate the result. From what
has been said, it follows that the infant mortality rate in
1946 was approximately 140 per thousand.
Hence, although the overall mortality rate for the
whole population was relatively low in 1946, infant mor-
tality remained rather high. Let us try to eliminate in-
fant mortality from the computation (Table 9). We ob-
serve that the mortality rate of those 1 year old and old-
er in 1946 was virtually stable and in 1958 was insignif-
icantly lower -17%. Apparently this decline was distrib-
uted unevenly among age cohorts, and the biggest drop
was in the 1-5-year age group. (A process analogous to
infant mortality should have taken place within this
group.) Taking this fact into account, one may assert
that mortality by age Soups in 1958-59 reflects the level
of mortality achieved in 1946, except for those 0-4 years
old. The level is shown in Table 8. Compared with that
of 1938-39, infant mortality was 5-7 % lower in 1958-
59; mortality of middle-aged cohorts was half the prev-
ious level; and that of the elderly (over 50 years old) was
2/3 the previous level.
This huge jump was the second, and for most of the
age cohorts, the last significant decline in mortality of
the Soviet population. 4 7
Thus, in the middle of the century, the Soviet mortal-
ity rate declined sharply. For the elderly cohorts, it was
caused by brutal selection during the war, and therefore
coincides with its ending. For children, the decline in
mortality had been taking place gradually from the end
of the 1940s till the beginning of the 1960s, and fol-
lowed the introduction of sulfa drugs and anti-
biotics.
Approved For Release 2007/03/05: CIA-R?P83TOO966ROOOlnnn6.0017 7
 Tendencies of Change in Mortality of the Soviet
population in the 1960s and 1970s
Changes in mortality have been already considered in
the literature. Up to the middle of the 1960s, mortality
continued to decline (Table 10), and then mortality the senior cohorts grows slowly. The changes
mortal-
ity of males and females are substantially different. For
A-00 the tendency is down; for those over 30,
ten
V
ea
nt
the growth is stabilized with small fluctuations.48 Mor-
tality of those 45-49 years old, that is, born during the
civil war, has increased considerably. Mortality of fe-
males continued to decline (Table 10).
A noticeable rise in mortality of those over 30 began
in the middle of the 1960s. People of these cohorts were
born before 1928 and more or less sustained the selec-
tion of high infant mortality, of the last war, and, some
of them, of the civil war. But during the following 15
years, the machinery of this selection began to weaken.
The "normal," natural level of mortality, which would
have existed if these cohorts had not endured the catas-
trophes of the previous period, started to restore itself.
Soviet medicine in the 1960s and 1970s did not have
enough revolutionary developments (something compar-
able to the introduction of antibiotics) which could
make us for this restoration of mortality. Various mea-
sures merely smoothed this growth. 49
Growth in male and female mortality is taking place
with different intensities, but one should not forget that
male and female losses were also very different during
the previous period. The difference in male and female
mortality became bigger throughout the twentieth cen-
tury, and by the end of the 1970s was of huge magnit-
de Today the difference in age at death is almost 11
Children and youth - up to 20 years of age - have
not passed through the catastrophic war period, and the
tendency of their mortality reflects real medical a
and social conditions of the Soviet populace. During
the last two decades, mortality of this generation de-
clined noticeably (for females more, males less). A large
put of the decline corresponds to the first half of the
1960s when medicines came into widespread use. b The
consequent period is characterized by a highly
mortality rate, with small fluctuations (Table 10).
High infant mortality gives heightened viability for a
certain period to children of subsequent cohorts. There-
fore, child mortality (1-9 years) in the USSR is not high
compared with that of other countries.
Thus, during the 1970s, there was smooth growth of
mortality in all those age cohorts which had passed
through the severe selection of the catastrophic years.
The normal level was restored, and this coincides with
given medical and social conditions. Child mortality de-
clined or stayed at a stable level. Infant mortality has in-
creased somewhat recently.
1. Infant mortality in the USSR has always been at a
rather high level - not less than 3% of newborns. During
the last 15 years, stabilization of infant mortality, and
even some growth - especially in Asian - is observed.
Probably in part this can be explained by improvements
in recording mortality. The lack of reduction in infant
mortality over the long term is a specific peculiarity of
the USSR in contrast to other countries. Another world
record of the USSR is its number of abortions - about
5 million a year. The Third World's achievement in dem-
ography is, indisputably, the gap in life expectancy of fe-
males and males (the lifespan of males is 62 years, and of
females, 73 years).
2. In life expectancy and infant mortality, the Soviet
Union has never been among developed countries, but
was between them and the underdeveloped countries.
Nowadays the lag behind the industrial world has in-
creased somewhat, but it is not catastrophic. - about
10% of newborns' life expectancy, and 1-2% of that of
the elder cohorts.
3. The specific peculiarity of the country has always
been the high life expectancy of the oldest cohorts. It is
explained by high infant mortality, which serves as a cru-
el selector of the viable individuals. An analogous picture
can be observed when comparing different ethnic and so-
cial populations in various countries.
4. High infant mortality does not serve as a guarantee a-
gainst the growth of inherited diseases and genetic de-
fects. These phenomena are threatening the USSR, but
possibly less so that the West.
W .
years. In most of the developed countries, the gap is 6-7
years, and in the developing countries, it is 2-3 years.
In the USSR the inequality of the axes in life expec-
tancy is to a large extent social in character. For exam.
pie, in cohorts of 2040-year-olds, where mortality is re-
latively low, it is determined by social, rather than med-
ical, factors (occupational injuries, alcoholism, crime);
thus, male and female mortality rates have opposite ten-
dencies. The former is growing, the latter is falling or is
stable. This, without a doubt, indicates that certain so-
cial conditions in the country are unfavorable.
That growth in mortality of these age cohorts has, to
a significant extent, a social character is supported also
by the fact that this tendency is more evident in rural
rather thin urban areas. In the countryside, mortality
cit-
of all age cohorts of 50 and under is higher
ies, and is growing faster. Many authors think that the
introduction of modern techniques, and especially chem-
icals (fertilizers), into rural life plays a substantial role. It
leads to growth of occupational hazards and gradual poi-
soning of the human organism throughout the environ-
ment. 5 ? 10
Approved For Release 2007/03/05: CIA-R?P83T00966R000100060017-7
 . ?
:;. Changes in the basic tendencies of mortality of the
Soviet populace in the century were determined by
powerful, non-accidental selection, when the country
was passing through terrible social and military catas-
trophe. Life expectancy increased by quantum jumps
immediately after the civil war in 1923-26, and after
World War U in 1946.
Hunger and disease carried off many millions in the
civil war, and made the generations which underwent
these terrible experiences more viable. The situation re-
peated itself during World War H.
The generations sifted by these catastrophes were
smaller numerically, but were distinguished by the mid-
dle of the 1950s by their greater viability. This tempor.
ary and peculiar situation gave the impression, in the
USSR and in the West, of high life expectancy of the
Soviet populace, in comparison with that of the Western
countries.
6. Gradual removal of the "margin of saftey," which
sprang up during the catastrophes, led to the growth of
mortality in the 1960s and 1970s. More precisely, it led
to the restoration of the "natural" level of mortality.
This process is going on unevenly in rural and urban ar-
eas, with males and females, and among different ethnic
groups in the Soviet Union. It is going on under com-
plex, contradictory conditions, so that side by side with
various measures of the health care system, social and
living conditions of Soviet citizens are worsening.
Mortality in the USSR in the Year 2000
The mortality rate of elderly people during the rest of
this century and part of the next will grow. This is main-
ti because the normal level of mortality, which was artif-
iiially reduced by catastrophes, will be restored. Anoth-
er even more lasting tendency will be the gradual re-
placement of the generations which went through the
severe selection of infant mortality by the generations
which did not endure it in their childhood. This process
will lead to the leveling off of low mortality of the elder
cohorts in rural areas, and of Muslims, to the level of
mortality of city dwellers and of Slavs. (Actually, in
more remote territories, the present rate will rise above
that of those who have better medical and social condi-
ti;ons.)
This apparently is already going 'on,,or is just about to
start, and will continue for 3040 years until the "selec-
ted" generations give way to the younger ones, born af-
ter World War U under conditions of generally sharply
reduced child mortality. It seems that the country's pres-
ent infant mortality rate, 3-4% of newborns, is not such
a powerful selection factor of more viable infants, and
its impact will not affect the general mortality rate for
many decades.
The middle-aged cohorts' mortality, which is deter-
mined to a great extent by social reasons, will emerge
from the press of selection earlier than the elder cohorts.
For them, this process will be completed, seemingly,
during the next decade. After this, the life expectancy of
these cohorts will be determined'by economic and polit-
ical conditions. I would like to hope that these condi-
tions will be favorable. Most likely, the mortality of
these groups will stabilize at a somewhat higher level
than now, and at the beginning of the next century will
start to decline little by little. Gradual change in the eth-
nic structure of these cohorts - the growth of the num-
bers of Muslims - will be an unfavorable circumstance in
this regard.
Infant mortality, to all appearances, has stopped
growing and will soon stabilize, then will start to de-
crease. The ground for such an assertion is a world-wide
tendency - and the USSR, so far, has rather steadily re-
peated, although with a lag, all the basic movements of
the West. No substantial medical discoveries of measures
will be needed to reduce the impact of mortality from
external causes (such as influenza - pneumonia). This
will happen step by step because of the general rise in
the culture of the population, and raising of the more
remote territories to a level existing already in some re-
gions. In the same direction, reduction of the birthrate
in the country as a whole and in its various parts will
work, also. An infant mortality rate of about 15 per
thousand seems probable to the end of the century.
On the whole, life expectancy of the population will
increase a little (to 70-71 years), and for a long time will
be at the same level. That of the West, meanwhile, will
cross the threshold of 75-76 years, and life expectancy
of some countries of Asia and South America will come
close to the Soviet level.
The latter will be, at the same time, at the threshold
of the new century and of the second demographic rev-
olution.
At approximately the same time, by the very end of
this millenium will occur another important demograph-
ic event - stabilization of world population. Birth and
death rates will level off, then the number of people will
gradually decrease. Probably this will be of great inter-
est: newspapers will print articles about a demographic
catastrophe; but maybe this problem will not be consid-
ered of serious interest.
11 consider here only one aspect of the issue: the general trends
in mortality in the USSR in peacetime. The cataclysms of 1918-
22, 1932-38, and 1939-53 which resulted in massive losses of
population deserve independent study, to which I expect to re-
turn at another time.
2 Nick Eberstadt, -?he Health Crisis in the USSR," The New
York Review of Books, February 19, 1981.
Approved For Release 2007/03/05: CIA-RDP83T00966R000100060017-7
 Table 1
PROBABILITY OF DEATH WITHIN A YEAR
(per 1.000)
1896-1897
1968-1971
M
F
M
F
0
298
259
27.8
21.8
5
20.4
20.2
0.94
0.69
10
6.84
6.48
0.67
97
0
0.45
15
4.57
5.29
.
08
2
0
75
20
6.63
6.7
.
.
1
25
7.47
7.91
2.91
.
0.9
30
7.89
8.62
3.89
1.19
67
35
9.31
9.94
4.91
1.
8
40
11.2
11.2
636
2.1
26
45
8
14
13.4
8.42
3.
50
.
18.8
16.5
11.3
.76
4
79
55
25.4
23.9
16.2
6.
81
60
32.6
33.1
23.2
9.
7
65
48.7
50.3
34.9
26.
70
67.7
66.6
48.6
50.4
75
7.9
5.2
1
73.6
92.7
4
80
112
12
107
12
Life
Expectancy
(In yew) 31
33 64 74
Sources: Tsentral'noe Stati:ticheakoe Upravlenie Pr'
Sovete Ministrov SSSR, Itogy vsesoyuznoi
perepis( rtaseleniia 1959 dodo (Results of
the USSR Population Census of 1959),
Moscow, 1962, p. 258.
TtSU SSSR, Naselen ye SSSR 1973; Star
isticheskii sbornik (Population of the
USSR in 1973; A Statistical Cot tpilation),
Moscow, Statistika, 1975, p. 139.
Vestnik Statistiki (Herald of Statistics),
Moscow, 1974, No. 2,,p. 95.
S Christopher Davis and Murray Feshbach, Rising Infant Mortd-
try In the USSR in the 1970s, The US Bureau of Census, Series
=
P45, No. 74, Sept. 1980.
a in the Comecon handbook, the figure for infant mortality in
the USSR was originally displaced at first by an elipsis
years the entry for the Soviet Union was omitted altogether. (See
Statittieheskly Ezhegodnik Soon-Chlenov Soveta Ekonomiches-
koi Vuirnopotnothchi for 1975-80, sections "Infant mortality"
and "Average life expectancy.") (Statistics Yearbook Comecon
1975.80)
S The lack of data appears still more threatening beause of the
history of such grave silences in the USSR Demographic statis-
tip on particular, data on births, deaths, and population) dis-
appeared from print at the start of the 30s. The Soviet Union is
certainly not alone among the Socialist countries in discontinur
ins publication when the data begins to look unpleasant. The
Comecon Yearbooks present a rather curious picture. Bulgaria
provides life expectancy figures for three-year intervals but up-
dates the information only when it demonstrates progress. The
1977 issue presents data for 1969-71. Cuba has not altered its
data since 1970. Soviet data were frozen in 1971-72. But the
record belongs to Mongolia. Having achieved a life expectancy
of 65 years in 1964 5, they have not seen fit to part in cAll ompany
y
with good news and to have simply repeated the figure
oessive yearbooks-
6 Nick Eberstadt, "Replies," The New York Review of Books,
Nov. 5,1981.
T Rashin, A.G., NaselenieR lossitl to to 1let 913), 1811-1913 mosooW. 1~e
Population of Russia from
32.
a Mironov, B.N.. In Brachnost', Rozhd~ilnN Rusm ostd
r Rossii i SSSR (Marriage, Birth, and
the USSR), Moscow, 1977, pp. 93-104-
9 "Under our criminal code, persons found guilty of criminal
abortion are subject to loss of all civil rights, and exile to the
remotest regions of Siberia 0. EntsikloPedfehetkii slovar' Brok-
quza i Efrona (Encyclopaedia), under "Vykidysh" (miscar-
riage), vol. VIla,1892, p. S 11.
10 Grigorovich, D.V., Izbrannye Proizvedenlia (Selected writings),
Moscow, 1959.p. 87.
U Zhbankov, D.N., in Vrach,1889, No. 13, p. 309.
s Shinprev. A.1., in Afeditsinskaia Beseda, 1889, No. 9, p. 25.
D Pervda Vseobshd aia Perepit' Naseleenna Rhossiskoot In per
1897 (First General Census of Popula
pine in 1897), 89 vois (1899-1905).
M Compiled from census data.
is Novesetskii, S.A.. Smertnost' i prodolzhite/'Host' zhizni v
Rostli (Alortdiry and Expectation of Life in Russia), Petrograd,
1916. P. 179.
M Bednyl, M.S., Plodolzhitel'nost' zhizni v Gorodakh i Seiakh
(Life Expectancy in Cities and the Countryside). Moscow Stat-
i dka, 1976, p. 40.41. The recording of deaths in the country-
side was not good, which could distort the data.
 ?
DSFANT MORTALITY RATE, USSR AND BY RF?URUC: Nit TO 1976
(Number of deasbe per I00 fire births)
tars a Vestea mobs d. 30.2
29.5
25.3
36.2
29.3
30.2
31.9
33.6
35.6
ala* Republics
omit
35.0
25.0
23.0
21.0..
22.0
22.0
23.0
31.0
NA
taeWu
19.6
19.4
17.3
16.2
17.4
17.4
NA
NA
NA
Selertmia
30.0
NA
19.0
16.0
16.0
17.0
17A
NA
NA
Rakic Republics
3210aie
19.3
16.9
17.9
17A
13.9
15.9
17.6
NA
NA
I9111
19.0
19.0
15.0
16.0
16.0
16.0
19.0
NA
NA
r5tlttaaai
19.9
30.7
19.3
14.9
17.4
0.1
19.4
NA
NA
Teaeeautaafaa Republics
Arawda
26.0
NA
NA
NA
NA
NA
NA
NA
NA
Aatbaydtdtat
39.0
NA
NA
NA
NA
NA
NA
NA
NA
Gaor$ta
39.7
NA
NA
NA
NA
NA
NA
NA
NA
Custrwl Aa6a Republics sad K...bh
99tathstaa
26.5
NA
NA
NA
NA
NA
NA
KA
NA
K}ptiya
NA
NA
NA
NA
NA
NA
NA
NA
NA
T iaan
NA
NA
NA
NA
NA
NA
NA
NA
NA
UWakstan
NA
NA
NA
NA
NA
NA
NA
NA
NA
No-Repananl R
ak.t
T
N ?,
NA
NA
NA
NA
NA
NA
NA
NA
NaIaria
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA - not awaabk ? F~nmaI.d.
e? infant maubty taus for Tarksadsaa and Maldave more .eeet been pwb idiee. Rata fm all clot 13 tapablio AN
a1diab1e for otdy 2 yen dating the period 1958.1976. For than 2 yam 1960 and 1967, an adaute for tae two top
IhOM in aor.birad form, war lade by a retinal method.
This table doe not idude iadaect data free tae literature. It In knows. for auple, t t infant aenabty among
Malts is 1973.74 wee 2% dwa Naar than smaa Ukrainians. 33
COMPUTATION OF INFANT MORTALITY
RATES IN THE USSR
Share of the newborn Infant mortality rates
Year children, percent
USSR RSFSR West East USSR RSFSR West East
1959
100
53
27
20
40.6
41
36
46
1%0
100
52
26
22
35.3
37
31
36
1%5
100
47
26
27
27.2
27
21
34
1970
100
45
27
28
24.7
23
18
34
1971
100
45
27
28
22,9
21
16
33
1972
100
45
27
28
24.7
.23
17
35
1973
100
45
26
29
26.4
22
17
42
1974
100
45
26
29
27.9
23
18
44
1.975
100
45
26
29
29.4
24
18
48
1.976
100
45
25
30
31.1
24
18
53
West - includes the Ukraine, Belorussia, the Baltic republics,
Idoldavia, and Georgia. East - includes Central Asia, Barakh-
iAan, Armenia, and %%zerbsydzhan. This division follows that of
Davis and Feshbach. In addition to materials cited by these auth-
ors, I have used TsSU SSSR, Naseknlye SSSR 1973; Statlnich-
i*y sbornik (Population of the USSR iii 1973; A Statistical
Compilation). Moscow, Statistika, 1975, pp. 69-83 on birth rates
in different regions
17 " ... Science has provided the wealthier classes with dozens
of means of aborting a fetus ... The evil is already widespread,
spreads daily even more widely, and soon will encompass all
women of the upper classes." Tolstoy, LN., Collected Works,
Moscow, vol. 25, 1937, p. 408.
ra The differences between numbers of males and females first
appeared during the cataclysms of revolution, war, and Stalin-
ism when males perished in greater numbers.
10 Compiled from census data.
20 Soviet medical statistics do not include births earlier than 28
weeks following conception, less than 1 kilogram in weight or 35
centimeters in length, if the newborn dies within 7 days of birth.
Davis and Feshbach studied data of the US National Institutes of
Health for 1960 (when infant mortality stood at 25.1 per 1000
and births numbered 4.258 million, approximating the levels in
the USSR in 1968) and determined that the group excluded
from Soviet statistics on live births amounted to 14.4% of infant
deaths in the US (0.36% of newborns). Davis and Feshbach ad-
justed data for 1959-1976 proportional to the infant mortality
sate.
The number of such births is presumably more closely related
to birth rates than to infant death rates. In this caw the adjust-
ment to the Soviet figures would be 0.36% per year which would
produce a variance from Davis and Feshbach of 10 to 20%.
Adjusting Soviet data on numbers of deaths among prema-
ture newborns from US statistics (due to a lack of such statistics
from the USSR) can be somewhat risky. There are significant
differences between the two countries in the composition of in-
fant mortality rates and abortion rates; relationships among first,
second, and third births for individual mothers; maternal health;
and obstetrical science. The discrepancies can have a substantial
effect on differences in pre-term birth rates.
 INFANT MORTALITY
AND LIFE EXPECTANCY
Table 4
AN EVALUATION OF DEATH RATES AMONG
NEWBORNS IN THE USSR WITH ADJUSTMENTS
Year
According to Soviet Methodology- -According
West-
USSR
cortecnons for
am meth-
(official)
(est.)
incompleteness of data
odology,
East USSR
USSR
1
2
3
4
5
6
1959
40.6
46
61
44
48
1960
35.3
36
48
38
42
1965
27.2
34
45
30
34
1970
24.7
34
45
28
32
1971
22.9
33
44
26
30
1972
24.7
35
46
28
32
1973
26.4
42
47
28
32
1974
27.9
44
48
29
33
1975
29.4
48
49
30
34
1976
31.1
53
53
31
35
Infant deaths
Life expectancy
per 1000 births
(yew)
Country
(numbers. we rounded)
1%0
1970
1977
1960
1970
1977
Industrial
Countries,
28
17
12
69
72
73
incl.: Sweden
17
11
8
72
74
75
US
26
20
15
70
71
73
W. Ger.
34
24
17
69
70
72
South Europe
56
37
32
65
69
70
incl.: Greece
40
30
23
68
71
73
Yugoslav.
88
56
35
62
68
69
Portugal
78
58
39
62
68
69
Soc. Countries
47
31
23
67
70
70
Hungary
48
36
26
67
69
70
Rumania
76
49
31
64
69
70
USSR
42
32
35
68
70
68
Istin America
95
71
58
56
61
64
Far East
60
50
41
53
58
61
Mid. East
46
51
54
S. Asia
43
47
49
Africa
40
44
47
This table has been compiled from World Tables, the second edi-
tion (1980). Published for the World Bank by the Johns Hopkins
University Press. Some of the data cited is less than precise, but
it gives rather accurate impressions of the global demographic
situation. Only the data for the USSR is adjusted.
Age
AVERAGE ADDITIONAL LIFE EXPECTANCY FOR VARIOUS AGE GROUPS
1897 1900 1927 1929 1939 1939 1958 1958 1971 1971 1975 1978
.Russia USA USSR USA USSR USA USSR USA USSR USA USSR USA
32
49
44
61
47 64 69
69 70 71
68
73
65
49
51
54
56
56 59 63
62 62 63
61
55
41
43
45
47
47 49 54
52 53 54
52
46
34
35
38
39
39 41 45
43 44 44
43
36
27
28
30
30
31 32 36
34 35 35
34
6
28
20
21
23
23
24 24 27
25 26 26
2
19
14
15
16
16
17 16 19
17 19 19
18
13
10
7
10
10
110 10 130
11 12 12
12
7
8
7
5
6
6
7 6 8
7 7 7
6
4
5
4
5 4 6
5 5 5
5
%
Sources: TsSu SSSR, Naaeleniye MR 1973; Statistidiuky sborrrik (Population of the USSR in 1973; A Statistical
Compilation), Moscow, Statistika, 1975, p. 139. Vita, Statistics of the United States, Vol. 11, Section 5, "Life Tables,"
US Department of Health and Human Services, Public Health Service. Data rounded to whole numbers Data cited is
for the given years, and for the surrounding period (e.g., 1986-1978, 1969 71 p. 178. The figures are lower: 10 years in
? Nerodonaselenie stmt mire (Population of the World), Moscow,
1939, 11 in 1958. Apparently the author (M.S. Bedny) considers the mortality tables for 1939 and 1959 insufficiently
precise in the higher age groups
 UFE EXPECTANCY OF AMERICANS
(years)
Age
0
40
70
85
Males
Females
1978
1900
1978
1900
70.2
48.2
77.8
51.1 65.0
32.5
73.6
35.0
33.6
27.7
39.9
29.2 30.4
23.1
37.0
24.4
11.1
9.0
14.8
9.6 11.6
9.3
14.8
9.6
5.3
3.8
6.7
4.1 7.8
4.0
9.9
5.1
Pitd Statistics of the United States, Vol. 11, Section 5, "life Tables," US Department of Health and Human Services,
Public Health Service, 1978, pp. 5-13.
21 Davis and Feshbach cite Western research on abortions in the
USSR. According to these data, 16.5 million abortions were per-
formed in 1966, or 6 abortions per woman. The data appear to
be weakly supported and somewhat inflated. Abortion statistics
in the USSR are kept secret, but among informed medical spe-
,dalists in Moscow, abortion in recent times have stabilized at
about 5 million annually. A. Smirnov, in an interview with West-
iarn journalists stated that the number of abortions closely ap-
proximates the number of births, which corresponds to our own
data. (Ouristian Science Monitor, June 4, 1981.)
It should be kept in mind that 5 million would be a record in
iboth absolute and relative terms, a record held for many years
sow by the Soviet Union. (By comparison, the US recorded
:1.157 million abortions in 1978.) The World Almanac and Book
of Facts 1982, N.Y., 1982, p. 961.
:22 Taentml'noe Statisticheskoe Upravlenie (fsSU) put Sovete
1Yinistrov Uzbekskoi SSR. Narodnoye KhozisistvO Uzbekskof
:3SR v 1974 godu; statisticheskii ezhegodnik (The National Ec-
onomy of the Uzbekistan SSR in 1974; A Statistical Yearbook).
Tashkent, 1975, p. 12.
The Christian Science Monitor, June 4. 1981.
as The population's standard of living cannot be considered par-
ticularly stable. Some factors have evidently taken a turn for the
worse, affecting the rise in mortality in the process Among them
tare changes in working and living conditions; a lowering of phys-
i.tal demands and the consequent weakening of the human organ-
ism ; changes in nutrition (increasing.use of preservatives and
Food additives, deterioration of variety and quality of food prod-
acts, occasional overeating); environmental pollution (air, soil,
water); increasing use of chemicals in agriculture; more intense
working conditions (automation, exposure to harmful chemicals,
greater psychological stress, injuries on the job); increasing num-
bers of women in the industrial labor force; degradation in
health among older generations as a result of higher survival rates
MORTALITY BY AGE COHORTS
(per thousand)
Age 1896-
1907-
1926?
1938-
1958-
.1897
-1908
-1927
-1939
-1959
0-1 375
290
174
167
41
0-4 133
119
78.9
75.8
11.9
5-9 12.9
10.7
7.3
5.5
1.1
10-14 5.4
5.4
3.1
2.6
0.8
15-19 5.8
5.7
3.7
3.4
1.3
20-24 7.6
7.6
5.5
4.4
1.8
25-29 8.2
8.3
6.1
4.7
2.2
30-34 8.7
8.6
6.3
5.4
2.6
35-39 10.3
10.3
7.5
6.8
3.1
40-44 11.8
11.7
9.0
8.1
4.0
45-49 15.7
15.6
10.9
10.2
5.4
50-54 18.5
18.3
14.0
13.8
7.9
55-59 29.5
29.0
18.1
17.1
11.2
60-64 34.5
34.0
24.7
24.5
17.1
65-69 61.6
62.0
36.5
35.0
25.2
Over
70 89.0
90.0
79.5
78.9
63.8
uulab~ottP- 32.4
28.4
20.3
17.4
7.4
in prior years among weaker children; weakening of social strut- Sources: Narodonaselenfyy Siren Mire (Population of the World,(
ttures (alcoholism, crime). Moscow, 1978, p. 176. Smertnost' i Prodolzhitel'nost' Zhizni
Some researchers have pointed to the growth in the incidence Nasdeniya SSSR, 1926.1927, Tablitsy Smertnosti (Mortality
of diseases and cancer as current trends (S. Kazenov in Prodol- and Longevity of the Population of the USSR, Life Tables, 1926-
shitel'nott' Zhizni [Expectation of Life], Moscow, 1974, p.34.) 1927, Moscow, 1930.
Approved For Release 2007/03/05: CIA-R?P83T00966R000100060017-7
 MORTALITY RATE OF THOSE 1 YEAR AND OLDER, MILLIONS
average for Died, total younger
the year Born of those than 1 year
except
newborns
Mortality
older rate of those
than 1 year 1 year old and
older, %
1958
201
5.240
1.490
0.212
1.278
0.64
1950
175
4.805
1.745
0.395
1.350
0.77
1946
1660
4.022
1.836
0.563
1.273
0.77
1940
489
6.096
3520
1.148
2.372
1.26
Sount: Woaeleniye SSSR 1973 (Popuiorion of the USSR in 1973), Moscow, 1975, pp. 7.69,141.
? Calculated from 1950 using birthrates for 1946-49 (published in Zhenshehiny Y SSSR (Women in the
USSRJ, Moscow. 1975, p. 101) and with average mortality dudag 1946-50 of 1%.
GRANGE IN YO1tTALrrY RAM 1960.1980
1958.1959
1964.1965
1971.1972
1974
1979*
AV Y
Ys Fm
IWs
F.
Wla
F.
Yaks
Fan.
Male.
Fan.
0-4 12.6
10.8
7.7
65
75
6A
83
6.8
8.7
7.0
5-9 13
0.9
09
0.7
04
oS
09
03
04
03
10-14 1n
0 7
0.7
03
CA
0.4
0.6
0.4
0.7
0.4
15-19 1.7
1.0
13
0.6
14
0.6
1A
0.6
13
0.6
24 2A
0
13
1
2
lA
2.5
09
25
09
2.7
0.8
-
2
.
3
8
2
1
1
3
3
1.0
3.1
0.9
3.7
1.0
25-29 3.0
1
.
.
.
4
4
3
3
1
4
4
1A
44
1A
30-34 3.6
1.7
3.7
1.
.
.
.
35-39 43
2.2
4.6
19
SA
19
19
6.7
2.0
0.44 6
~
5.7
23
73
24
2.6
8.4
2.7
.
45-49 6.1
39
7.5
3.5 9.6 3.7
9.7
3.7
119
4.2
10-54 12.2
SA
119
SA 13~~
139
5.8
15.6
6.1
SS-59 18.2
83
163
7A
19.2
79
19~
223
69
60-64 26.1
129
26.2
12.6
283
12.6
28.7
12.6
32.1
65-69 36.2
213
360
169
40.5
202
409
302
45.2
21.6
e1.70 77A
603
-
-
-
-
90.5
66.7
91.8
79.4
to
7.0
7.6
6.7
9.0
79
93
8.2
10.1
89
8i,~es: Aydo~le a... Y1A (Papal of rr 5 ,9, rroe~. 198, F 172. Yank SNM*i
r/ l'J. W. 1973. Ma 12; 1~M,ea d. er .9m Al hte OM No
dMO
Al vlss raw tY ..W V 1!~
aswAruoro.bmdwwa
?aMmt
 Without doubt such diseases contribute to a Vowing number of
deaths. Where s in 1960 they accounted for 51% of all deaths, in
1970 they contributed 62%. (Yu. P. Lisitsyn, Sotslol'nalo Gigien-
a if Orgonizerslia Zdravookhreneniia (Social Hygeine and Orgeniz-
ation of Health SemilvaJ, Moscow, 1973, p. 182.) The spread of
such diseases is apparently related primarily to changes in popu-
lation structure as well as improved diagnosis. M.V. Kurman (4k-
ra.l'nye rooprory demos i (Actual Questions of Demography)
Moscow, 1976. p. 74.) believes that mortality increases in the
older age groups are due to just these factors, while the rise
among males generally is due primarily to social factors.
_'' It appears that the state as a totalitarian machine has little
interest in eigltifcantiy prolonging the lives of its subjects, par-
ticularly the chronically ill and the elderly. Naturally no one
would publicly support such an inhuman proposition. Neverthe-
less, the country's health care system is oriented more toward
tIe working population. Pensioners as a rule are unwelcome in
hospitals, they have difficulty obtaining scarce drugs or admis-
don to sanatoria. Upon retirement, middle-ranking officials lose
their health are privileges, including access to specialized clinics
hospitals.
21S Mendeleev, D.K., K poznaniiu Rossi! (Tonwrd the Under-
sivriding of Russia), St. Petersburg, 1906. Novosel'sky,
S,A., Smertnost' i Prodolzhitelnost' Zhizni v Ross!! (Mortality
and Expectation of Life in Russia), Petrograd, 1916. A large
number of those who lived longer - and subsequently the low
mortality rate of elderly people - can be explained in part by
filteracy of the population, which often rounded ages upward.
The fact that those in the elder cohorts exaggerate their ages
is evidenced by inaccurate unreliable correlations within these
cohorts. For example, in England in 1901 there were 9,638 peo-
ple over 90 years old, or 3.96% of the number of those over 60.
Those 100 years old and older were 0.06% of all those over 60.
For Russia, these numbers were 15.16% and 1.82%. Smertnost'
i Prodol2hitelnost' Zhizni Naseleniia SSSR, 1926-1927, Tablits),
Smertnosti (Mortality and Longevity of the Population of the
USSR, Life Tables, 1926-1927, Moscow, 1930.
=a Yatnik staristiki (Herald of Statistic), Moscow, 1973, No.
12, p. 79.
29 In the USSR mortality rates still have a U-form. Infant mor-
tality is more or less equal to the mortality of those 65-70 years
old (in the US, 4045 years aid). All consequences of the first
demographic revolution, achieved my modern medicine, devel-
aped in the West and spread around the world, are not quite
clear today. The social structure of mankind turned out to be
unprepared for the tempestuous growth of the population. Lack
of energy, food, and other resources, adequate living space, and
many other problems, became obvious. And while the rich West
has ?often out of these difficulties (actilly,it was not into them
Ijeause the birthrate was reduced in time), the East and the
South have a long, difficult path to travel
10 Differences in matrimony in Eastern and Western Europe had
a great impact on,birth rate and infant mortality. In the eight-
oenth and nineteenth centuries, late marriages were characteristic
in the West, and there were relatively fewer of them. But the
psychological pattern of Eastern Europe demanded early mar-
riages. England is an example of the Western pattern. The pro-
portion of unmarried women in 1900 was: 20-24 years old: 73%;
5-29 years old: 42%; 45.49 years old: 15%. (Hajnal, John in
Glass, D.V. and Everslay, D.E.C. Population in History, London,
1965.) In the European part of Russia, according to the census
of 1897, the proporton of unmarried women was: 20-29: 23%;
40.49 years old: 5% -
It should also be said that the Western European pattern in-
cluded a noticeable reduction in the birth rate as a result of some
measures in the family (Coale, Ansley J. in Fertility and Famfly
Manning, Ann Arbor, 1969.) In Russia, at the beginning of the
century, the birthrate was dose to the biological limits.
31 Workers in and the administrators of maternity hospitals are
interested in reducing indicators of stillbirths. Therefore they try
to restore the breathing of a newborn, if necessary, for a long
time. If it is not done during the first five minutes, brain damage
is highly likely. I am not going to judge what doctors should do
in such cases; I do not know what is being done in the West. But
I simply notice that in the USSR, despite rather high infant mor-
tality, the number of traumas in infants who survive is rather
high.
32 A third of infant mortality in the USSR is due to pneumonia,
but in the US it is only 4% (Davis and Feshbach, Rising Infant...
Sept. 1980.)
33 The correction suggested by Davis and Feshbach demon-
strates how substantially infant mortality went down and what it
consists of. Almost 15% of all newborns who died during their
first year were underdeveloped, were born prematurely, or were
of low birth weight (three times less than normal). After 1960
infant mortality in the US was halved; it seems that the propor-
tion of insufficiently developed infants is now higher among
both those who die during their first year and those who live.
34 Inherited defects and infant disease took, in 1920, 2.92% of
all newborns in Sweden; today mortality from all causes is 0.8%
(Preston, S., Keyfits, N., Schoen, R., Causes of Death. Life
Tables for Nation Populations, New York, 1972, pp. 652-58).
Certainly a number of diseases of various types (for example,
septic diseases) decreased, but on the other hand, analysts note
that the pathology of pregnancy and labor is increasing. This
seemingly is linked to the growth of the proportion of first chil-
dren among newborns and with the growth and intensity of
pathogenic factors. These, in turn, are determined by the devel-
opment of modern technology, changes in the professional sta-
ture of working women, expanding overuse of strong medicines
(antibiotics, soporifics, smoking, narcotics, alcoholism, pol-
lution, radioactivity, age of mothers, etc. (Shaburov, K. Yu. in
prodolzhirel'nost' Zhizni: Analiz i Modelirovaniye, Moscow,
1979, p. 36.)
Jas In the course of this discussion one strange misconception
appeared. Davis and Feshbach and, after them, Eberstadt, wrote
about the growth of inherited diseases in the USSR, quoting a
samizdat book by B. Komarov (Komarov, Boris (pseud.), Unich?
tozheniye prirody: obostryeniye ekologicheskogo krizisa v
SSSR [The Destruction of Nature: The Intensification of the Ec-
ological Crisis in the USSR] Posev-Verlag, Frankfurt/Main,
1978.)
Komarov took these data from a well-known Soviet genetic
specialist academician Dubinin. He had no Soviet data (there was
almost no such research in the USSR, and if there was any, the
results are kept secret). Dubinin writes that according to the in-
formation of Western scientists, the number of children affected
by this problem was published in the scientific magazine Protec-
tion of Nature. On this magazine is stamped "For office use on-
ly." The fact of the restriction says a lot by itself.)
 3s Nowadays there are not only negative, but also positive tand-
encies in the spread of inherited diseases. In particular, higher
migration decreased the number of marriages among relatives,
which had led to more genetic diseases. Still, re a rchers note
that the decline in the birth rate has cancelled the positive effect
of migration, and in a number of rural loalities, the proportion
of marriages among cousins is high. (Sutler, I. in Fertility and.
Family Planning, Ann Arbor, 1969, p. 293.)
a e,`15-2096 f the number of pregnancies diagnosed. More-
over, 5_0 0 these abortions go unnoticed during the earliest
stage (Lektsii po Meditsinskol Genedke (Lectures on Medical
Genetics), Moscow, 1974, p. 160.)
39 Narodonaseleniye Stalin Mire (Population of the World),
Moscow, 1978, P. 184; Friedland, I.G., Gigiena Zhenskogo
Duda (Hygiene of Women's Labor), Leningrad, 1975, p. 16.
39 Spanish flu led to a jump in the mortality rate in the world:
for example, to a record decline in fife expectancy in the United
States for 12 years in 1918. But, certainly, in the hungry coun-
tryside, without a health are system, its effect was much more
terrible.
40 Population losses in catastrophic periods deserve serious inde-
pendent consideration. By moving the 1926 census results back
to 1913, one can estimate the losses to be about 10 million.
Heavy losses of females of various ages prove that it was mainly
sanitary losses.
41 Kaminskii, LS., Meditsinskaia i Demograficheskaia Statfs?
tika (Medical and Demographic Statistics), Moscow, 1974, p.
128. The number of Petrograd-Leningrad inhabitants per doc-
tor was as follows: in 1911 - 700; in 1923 - 875; in 1926 -
400. The professional skills of pre-revolutionary doctors and
those who were taught during the civil war were, of course, rath-
er different By 1926, a lot of hospitals, other health centers,
day nurseries and kindergartens were created, but they could not
provide a significant curative effect.
42 In 1922-13, 35 people in Petrograd per 100,000 population
died from alcoholism, but in 1923, it was 1.6; in 1926, 10.9; and
in 1928, 25.9 (Kaminskii, cited above, p. 134). Losses from oth-
er social causes such as gangsterism increased (Novoselskii, S.A.,
Demogrolia i Statlstika (Demography and Statistics), Moscow,
1978, p. 113).
43 Many authors note that the tables of 1939 pertain to the
whole country (and tables of 1926 to the European part), and
are more precise, and see in this the reason for a small difference.
They suggest that the decline it.. mortality in the European areas
was offset by addition of the data from the Asian territories
where mortality was higher. One should take into account that
outside European Russia, recording of deaihs was done very bad-
ly. This is still true. There is considerable underrecording of mor-
tality In Asian territories, which could lead to some understating
of the rates for 1939.
44 yatestvennoye Dvizheniye Naxleniya Sovsemennogo Mira
(Natural " Movement of site Population of the Contemporary
World), Moscow, 1974.
45 Sifman, R.I. in Prodolzhitel'nost' Zhizni: Analiz I Modeliro
naniye (Life Expectancy: Analysis and Simulation), Moscow,
1979, pp. 50-59.
461bid, P. 251.
47 In 1946, life expectancy of those 5 yeas and older was
about 67 years in the USSR. It was higher than in the US at that
time.
48 The fluctuations in mortality rate are determined partially
by a noticeable heterogeneity of life of various age cohorts. For
example, the group of 20.24-year-olds in 1958-1959 consists of
those born before the war, when infant mortality was signific-
ant; in 1964-65, it consisted of the scanty generation born dur-
ing the war; in 1971-72, it consisted of the first postwar genera-
tion, when infant mortality was rather high; in 1979, it consisted
of the relatively populous post-Stalin generation, with relatively
low infant mortality (having been cured by antibiotics). No
doubt the differences of "life experience" should affect the mor-
tality of these cohorts.
49 One can get the impression from what has been said that the
introduction of modern medical care complexes in the 1950s
and 1960s played no role in the USSR. This is not so. It is pre-
cisely bemuse of medical achievements that the manifold reduc-
tion of child mortality (0-9 years) should be explained. Medical
achievements played a very important role for other age groups
as well, however - It led not to a reduction of the mortality rate,
but it prevented its increase. Mortality would have grown, grad-
ually returning to the 1939 level, without the artificial reduction
in it brought about by modern medical care. Medicine also re-
duced the mortality rate of some age cohorts in 1958-65.
s o Bednyi, M.S., Prodolzhitel'nost' Zhizni Y Gorodakh i Posel-
kakh (Life Expectancy in Cities and the Countryside), Moscow,
1976, p. 49.
Ar)12royed For Release 2007/03/05 - 9668000100060017-7