System disintegration, social disintegration and health in the former Soviet Union
Social Sciences University of Aberdeen aberdeen, UK
Social Sciences University of aberdeen Aberdeen, UK
The collapse of the former Soviet Union was marked by a rise in mortality and morbidity with the rise in mortality amongst men in mid-life due to cardiovascular disease being especially striking. Epidemiological and sociological explanations have focused on lifestyles which included heavy smoking, drinking, lack of exercise and poor diets as the primary causes while acknowledging that stress, the decline of the public health services and the rise in poverty are also likely contributory causes. Less attention has been given to exploring the causes of increased morbidity which has been especially noticeable in women. In this paper we test three hypotheses: that the decline in health in the former Soviet Union was due to poverty; was due to health lifestyles, and; to system and social disintegration. We do so utilizing data from a survey carried out in eight post-Soviet countries: Russia, Belarus, Ukraine, Moldova, Armenia, Georgia, Kazakhstan and Kyrgyzstan. We found contrary to common opinion, smoking and drinking were not strongly correlated with subjective health and nor was diet. Poverty was an important factor however, but most important of all was social disintegration and a sense of disempowerment and control over daily life. We conclude that under circumstances of rapid social change, the breakdown in social integration and, malaise and anomie becomes more important than the usual determinants of poor health. We develop this explanation in terms of a theory of system and social disintegration arguing that subjective health can be used as an indictor of the effects of social and economic change.