Moscow, 22 October 2019: The Dialogue of Civilizations Research Institute (DOC) held a workshop titled “Mortality and life expectancy in post-communist countries. What are the lessons for other countries?”, with the aim to identify causes, mechanisms and consequences behind the unprecedented developments of the recent years – the stagnation and even decline of life expectancy in high-income nations. Participants tried to analyse the acute mortality crisis in post-communist societies of Eastern Europe and former Soviet Union in the 1990s, during their transition to the market economy, and to see how it could help understand the unfavourable trends in life expectancy in rich countries.
During the opening remarks Dr. Vladimir Yakunin, Chairman of the Supervisory Board of the Dialogue of Civilizations Research Institute (DOC), focused on three major critical challenges for humanity with regards to economic policies and decisions: the inability to foresee the real impact and influence of economic policies; the need to rethink environmental models given the dangers caused by climate change and environmental pollution; the dehumanisation of the social life. Rising mortality, the stagnation of life expectancy in developed countries, as well as the decline of the birth rate everywhere in the world, should be seen as warning signs. It is important to examine and to understand the reasons behind such processes, especially in comparatively affluent societies. He pointed out the need to understand that a wholesome social atmosphere and social environment are essential for societies and civilisations, and thus, there is an increasing need to develop policies that would internalise the complexity of cultural and social aspects in a more adequate way.
Following the introductory remarks, Professor Vladimir Popov, Research Director in Economics and Political Sciences at the Dialogue of Civilizations Research Institute (DOC) and convener of the DOC´s research project on this topic, explained in his presentation why recessions in some instances do not lead to a general increase in mortality, whereas in other cases recessions cause a marked increase in mortality. Former communist countries with free healthcare, good levels of social protection, and even income distribution always had higher life expectancy compared with non-communist countries at the same level of development. Even in 2000, after the decline of the early 1990s, life expectancy in transition economies was five years higher than per capita GDP would suggest. But in the last decades of the USSR (since 1965 and until the end of the 1980s) life expectancy did not increase due to the loss of social dynamism. In the 1990s, however, there was a sharp decline in life expectancy due to stress associated with the shock therapy transition to the market economy.
Prof. Giovanni Andrea Cornia, Professor of Economics at Department of Economics and Management at the University of Florence based his presentation on his special report covering the themes of the ‘Historical antecedents of mortality crises triggered by potentially favourable political and economic changes’ and ‘Life expectancy during transition to the market economy and liberal democracy of the former socialist countries of Europe (1989-2014). He suggested the taxonomy of causal factors behind the mortality crises that followed potentially positive political and economic reforms which were expected to move certain countries from a low social equilibrium to a higher one. Life expectancy might decrease in times of a lack of social perspective and high competition, on the one side, as well as in times of stagnation with high unemployment and growing income inequalities. The taxonomy of factors responsible for the discrepancy between ex-ante expectations and ex-post outcomes includes, according to Prof. Cornia: unexpected effects of rural-urban migration combined with an inelastic supply of public infrastructure; political reforms carried out in the absence of adequate administrative, legal, and redistributive institutions; the introduction of economic reforms under conditions of incomplete or distorted markets and institutions; and the unchecked contact between socio-economic groups characterised by different disease profiles.
During the second session Prof. Roberto De Vogli, Associate Professor at Department of Development and Social Psychology and Human Rights Centre at the University of Padua and Honorary Senior Lecturer at the Department of Epidemiology and Public Health at the University College London, presented his paper ‘Health in times of socio-economic and political change: lessons from Greece, Italy, United States and United Kingdom’. He considered different hypotheses explaining unfavourable changes in life expectancy in developed countries and argued that globalisation that is not accompanied with special measures to protect disadvantaged groups of the population may lead to a rise in suicides, opioid use, obesity, mental and psychological disorders and other negative consequences.
Dr. Luca Bortolotti, PhD in Development Economics at the School of Social Sciences at the University of Trento and Lecturer at the Department of Economics and Management at the University of Florence, presented his paper written in co-authorship with Yue Teng, PhD in development economics at the University of Trento and the University of Florence, ‘The Path of Economic Growth and Health Status: Evidence from China’. The paper examined the links between economic progress and life expectancy in the provinces of China.
Prof. Li Ling, Mulan Chair Professor of Economics and Doctoral Supervisor at the National School of Development at the Peking University as well as the Chief Advisor on China Health Care Reform at the World Bank and Chief Committee Member of Policy and Management Research at the Ministry of Health of the People’s Republic of China, joining the workshop via video conference from China commented on the relationship of economic growth and health status in China. She argued that in the period of 1979-2003 life expectancy increase proceeded at the lowest pace (from 67 to 71 years) due to the dismantling of the previous free health care system for all and poor financing of health care. The previous period (in 1949-79 life expectancy increased from 35 to 67) and the following period (in 2003-18 life expectancy increased from 71 to 77) were more successful.
Prof. Vladimir Popov gave more detailed cross-regional analysis of the rise in mortality rate in Russia in 1990-2003 and speculated about the lessons which can be learned from the past. On the basis of his paper, entitled ‘Mortality Crisis in Russia Revisited: Evidence from Cross-Regional Comparison’ (MPRA Paper No. 21311, March 2010; CEFIR and NES working paper #157, January 2011), Prof. Popov revealed that it is exactly the role of stress factors in mortality rise that makes the post-Soviet case unique.
Prof. C.P. Chandrasekhar from the Centre for Economic Studies and Planning at the Jawaharlal Nehru University, New Delhi presented the paper written together with Jayati Ghosh, Professor of Economics at the Centre for Economic Studies and Planning, School of Social Sciences, at the Jawaharlal Nehru University, in New Delhi, India: ‘Policy reform from the early 1990s and changes in health status in India (1991-2016)’.
Sebastian Vollmer, Professor of Development Economics, Department of Economics & Centre for Modern Indian Studies (CeMIS) at the University of Göttingen , presented a paper written in co-authorship with Nana Khetsuriani, Research Assistant, Department of Economics & Centre for Modern Indian Studies (CeMIS) at the University of Göttingen, and Paulina Kellersmann, Student Assistant, Department of Economics & Centre for Modern Indian Studies (CeMIS) at the University of Göttingen: ‘Mortality patterns in post-Soviet Georgia’. He compared different statistical estimates of the dynamics of mortality and life expectancy in Georgia.