Demographic crisis in Russia
Demographic crisis in Russia
demographic trends in Russia have caused widespread public concern. Russia is
experiencing unusually high death rates from nonnatural causes, many related to
alcoholism. Life expectancy, especially among working-age males, has dropped
precipitously. The Russian fertility rate has declined to among the world's
lowest, while its abortion rate is the highest. As a result, for the first time
in Russian history, the annual number of deaths has exceeded the number of
births. Compounding these challenges, the population is aging rapidly--a trend
that will accelerate over the next two decades--and immigration continues to
increase, posing thorny political and social problems for a nation historically
accustomed to a net outflow of people.
These events are widely seen as posing a national crisis for Russia.
Civic leaders and the general public are especially concerned about the effects
these trends may have on the progress of reform--for example, how a shrinking
working-age population will support a growing number of elderly citizens.
Opponents of reform have exploited these trends for political purposes. They
have depicted these events as direct outcomes of reform and even as a
conspiracy aimed at destroying the Russian state.
analysts are eager to learn more about the causes and consequences of these
trends so that they can define appropriate policy options as the reform process
continues. The underlying causes of these phenomena had previously not been
studied in great depth. Policymakers in the former Soviet Union had no interest
in policy informed by research; therefore, social and behavioral analyses of
demographic trends were shunned in favor of descriptive, often historical, work.
More recently, scholars using newly available information have begun to delve
into the roots of Russian demographic changes and the long-term patterns
To shed light on
these issues, RAND and the Center for Demography and Human Ecology of the
Russian Academy of Sciences invited a group of Russian demographers to present
the results of their research. The aggregate picture that emerged from this
groundbreaking work is more complicated than the "crisis" language
suggests. Some of the demographic trends currently affecting Russia are the
continuation of long-term patterns. Others are by-products of recent events,
although not necessarily the reforms of the 1990s. Still others are harder to
explain and have probably been exacerbated by the reforms and the current
"Depopulation" of Russia?
Russia's population entered a period of negative growth--that is, the number of
deaths exceeded the number of births combined with the number of immigrants.
This was a first in the peacetime history of Russia.
population decline has been met with increasing concern in some Russian
circles. The Russian mass media have overflowed with alarming articles on
population issues. Based on popular, nonprofessional interpretations of
available vital statistics, some are calling "to save Russia from
depopulation." As a result, the general public has been misled about
population issues. The average citizen is likely to draw a direct connection
between the current economic slump and a demographic crisis.
view ignores long-term trends in fertility. As in many Western industrialized
nations, Russia's fertility rate has fallen over the course of the 20th century
from a relatively high level to a low one. In 1920, the average Russian woman
was expected to give birth to about 7.5 children in her lifetime; in 1994, that
number had fallen to 1.4. This demographic transition is characteristic of
industrial and industrializing nations and is usually associated with greater
numbers of women joining the work force and increased divorce and cohabitation,
all of which tend to reduce family size and drive down fertility rates. Similar
patterns have emerged in the United States and other Western countries.
Russia's fertility patterns have followed their own unique path over the past
two decades. In addition to the decline in births, the age patterns of
childbearing have been changing. In many Western countries, the peak
childbearing age for women has grown older and now falls between 25 and 29; by
contrast, the peak age in Russia has become younger, occurring between ages
20-24. Furthermore, by 1991, fertility between ages 15-19 exceeded that in the
age groups over 30 and rivaled that of the 25-29 age group.
towards fertility at younger ages is reflected in marriage patterns. Between
1960 and 1995, the average marrying age of women in Russia fell by 4.2 years,
from 26.2 to 22.0. This trend sharply distinguishes Russia from other
industrialized nations, where the tendency is for women to postpone marriage
this shift toward earlier childbearing and the low fertility rate has been
Russia's high rate of abortion. The incidence of abortion in Russia is the
world's highest. In 1992, there were 225 abortions per 100 births, far
exceeding the second highest rate--Romania's--which was 157 per 100 births.
Abortion has become Russia's main method of birth control. Abortions are easily
obtained free of charge at virtually all clinics, while contraceptives have
been unavailable. Despite the procedure's prevalence, it frequently poses
health risks for Russian women because it is often performed without proper
hygiene or anesthesia. Abortion has also played a role in concentrating women's
reproductive activity in early years. Women try to achieve their desired number
of children at a young age and then abort subsequent pregnancies without fear
of secondary sterility, which often results from frequent abortions. Only in
recent years, as the availability of effective contraceptives has increased and
the negative effects of abortion have been openly reported by the media, has
the number of abortions begun to decline.
Like the trend
in fertility, Russia's current net immigration inflow perpetuates trends that
emerged earlier, in this case during the late 1960s and 1970s. The size of this
inflow increased dramatically after the collapse of the Soviet Union but
appears to have subsided somewhat. While Russia currently lacks the
infrastructure and experience to deal with immigrants on a large scale,
immigration is sometimes weighed as an option for offsetting the natural
population picture need not be viewed as a short-term crisis. A more plausible
explanation is that fertility patterns are resuming their long-term trend after
a temporary increase in the 1980s that stemmed from government policies aimed
at inducing families to have more children. These measures included paid
maternity leave and extra benefits in housing and services for families with
three children or more. The effect of these measures was to shorten the
interval between births. The current pattern suggests that the older timing is
reasserting itself. Economic hard times may have further influenced this pattern.
Although a two-child family is still the norm, economic difficulties may force
postponement of the second child.
"Graying" of the Russian Population
The decline in
fertility is contributing to a rapid aging of the Russian population. Between 1959
and 1990, the number of persons aged 60 and over doubled. As a result, at the
beginning of the 1990s, the proportion of the population aged 60 or over
reached 16 percent. This figure will reach 20 percent by 2015. By that year,
nearly one of out of every three people over 60 will be 75 or older.
The trends of
population growth and aging in Russia have been profoundly affected by
catastrophic events, such as the two world wars, the civil war of 1917-1922,
and famines in the early 1920s and '30s. These catastrophes have distorted the
population pyramid--the typical age distribution and balance between male and
female in the population. For example, huge losses during World War II have
caused Russia to have the lowest overall male-to-female ratio in the world,
especially among the elderly. The irregularities of this pyramid will continue
to have an impact on the number of births and the rate of population growth and
aging for several decades. This pattern affects such vital spheres as school
enrollment, employment, and retirement.
determinant of the current age structure in Russia has been the declining
fertility rate, which is reducing the number of young people in the population.
In the past, the prevailing age structure compensated for the long-term trend
toward lower fertility. The average age of the population was relatively young,
and many women were of childbearing age. Beginning in the 1990s, however, this
is no longer the case. The age structure is now such that it will promote a
population decrease rather than an increase. Continued low fertility will only
accelerate this effect.
Epidemiological Situation: Deteriorating Russian Health
Perhaps the only
genuine crisis aspect of current Russian demographic trends appears in
increased rates of mortality, which have been especially dramatic among
working-age men. In 1992, there was a sharp increase in deaths from nonnatural
causes. By 1994, mortality rates for males between ages 15 and 64 were about
twice as high as they had been in 1986. Rising alcoholism and related
conditions have figured prominently in this trend. In the mid-1980s, an
anti-alcohol campaign championed by Mikhail Gorbachev was responsible for a
brief reversal in the mortality trend, but the increase resumed after the campaign
was abandoned in the late 1980s.
increase in mortality rates, life expectancy in Russia has dropped. However,
like the fertility trend, the current pattern is not new. In the mid-1960s,
after decades of increase, life expectancy began to decline. This trend was
reversed briefly in the mid-1980s due, many believe, to the success of the
anti-alcohol campaign between 1985 and 1987. However, by 1993, life expectancy
fell again. Russia now has the lowest life expectancy for males in a developed
country (58 years) and the largest disparity in the world between male and
female life expectancy (13.5 years).
Failing Health-Care System
The increase in
deaths from preventable causes points to problems in Russia's health-care
system. Again, these problems are not a recent phenomenon. They have
accumulated over many years. One characteristic of the Soviet period was a lack
of incentives to improve medical services. When changes in the health of the
population occurred--such as a decrease of infectious disease and a rise in
"civilized" ills, such as alcoholism, smoking, traffic accidents, and
pollution, in the mid-1960s--the health-care system failed to adapt
appropriately. Excessive reliance on ideology led to ineffectual goals and an
emphasis on activities that addressed neither the medical problems at hand, the
level of national development, existing medical capabilities, nor public
demand. In the 1980s, the system finally made attempts to cope with the
changing health environment, but the strategy was poorly implemented and lacked
necessary investments in facilities and equipment.
problems were not created by the current socioeconomic crisis, they have been
aggravated by the breakdown of the old social system. In the Soviet era,
virtually all health care was provided free by the state, whose system
emphasized the quantity of medical personnel and facilities, overlooking the
quality of services, and pursued goals set on the basis of political ambitions
rather than on objective medical needs and economic capabilities.
As the command
economy crumbled, the public-health sector plunged into a financial crisis. The
system found itself in an emerging market environment without the capacity to
function successfully in it. Left without proper funding, health-care
facilities were forced to abandon new construction, renovation, and other basic
investments. Cost cutting necessitated switching to cheaper technologies, which
proved insufficient to maintain needed levels of care. Available funds were
frequently diverted to current needs. As a result, the health status of the
Russian population is deteriorating, and diseases long thought to be eliminated
or controlled--such as diphtheria--are now spreading again.
effective health-care system in its current form presents a near-impossible
task. Many important medical research centers, especially at the federal level,
have been left without proper financial support. Progress in all spheres of
health care is under great stress. Faced with this situation, the Russian
government has attempted to reform the health-care sector through
privatization, marketing services in state-owned facilities, and promoting the
private medical sector. One of the main goals of reform is to establish
compulsory health insurance financed through taxes and operated by both the
state and the private sector. However, the reform has yet to produce noticeable
results. Russians are used to receiving free health care and many are unwilling
and frequently unable to pay for health services.
serious health-care problems exist that extra spending alone will not address.
There are no clearly defined federal and local health-protection policies, no
effective programs for monitoring outcomes, and no openly declared systems of
control and delegation of responsibilities for state and public health
institutions. Moreover, the incidence of destructive behaviors, such as
violence and alcohol consumption, has increased. Heavy tobacco use contributes
to a high rate of mortality from lung cancer, which occurs 60 percent more
frequently in Russia than in the United States. Without attention to these
problems, additional funding for health care per se is likely to have little
Toward the Future: Policy Outlook
economic crisis significantly limits the Russian government's ability to deal
with demographic trends through policy intervention. In particular, the
problems of the elderly will be difficult to manage. The retired population is
growing, while the financial resources the state devotes to the elderly
dwindle. With the declining real value of pensions and the rising costs of
health care, the elderly are among the most economically disadvantaged and
vulnerable social groups in Russia. The problems that appear most amenable to
policy intervention are those related to the health-care system. Thoroughly
crafted health-care reform components are essential; an ill-designed benefit
package, hasty decentralization, and overreliance on the private sector will
only aggravate the situation. At the same time, promoting healthier lifestyles
among Russians--reduced smoking and alcohol consumption, better diets--could
improve health substantially.
Russia's demographics should help dispel the popular notion of a demographic
crisis. The continuation of several long-term patterns, such as declining
fertility and historically high mortality, accounts for many of the current
trends. While it is undoubtedly true that economic conditions have aggravated
current problems, there is no strong evidence linking these problems with
recent economic and political reforms. Some of the most dramatic changes appear
to be compensatory effects following the abandonment of previous policies: for
example, the retreat from pronatalist and anti-alcohol initiatives of the
1980s. In fact, it has been suggested that whatever crisis features are present
in Russia's current situation might be attributable to a delay in reforms--for
example, delay in reforming the health-care system. This delay hampers the
adaptation of social institutions to the new realities of economic and family
behavior in Russia. Furthermore, the most recent data suggest that the
mortality and life-expectancy situation has begun to improve.
demographic realities in Russia are not fundamentally different from those
facing most industrial nations--a decreasing population, aging, shifts in
family composition. Since it is impossible for Russia to avoid these changes,
the challenge lies in addressing them effectively. Toward that end, a great
deal of further research is required to disentangle the effects of earlier
policies, current reforms, and other factors in explaining Russia's demographic
patterns. Although they may not add up to a crisis, these trends will continue
to pose difficult challenges for those deciding the direction of Russian policy
Alexander V. Myskin, gr. 301