L'espérance de vie le montre: la Russie optimise, les USA dépriment

Otto Kolbl, Jan. 2, 2016, 21:27 GMT

How do the people feel about the future of their country? For recent years, various opinion polls on this topic are available, but they often get conflicting results. Statistics about life expectancy can tell us much more than opinion polls. When an optimistic mood prevails, life expectancy goes up; when the outlook is gloomy, life expectancy goes down. This might sound somewhat crude, but we will see that for the countries in Eastern Europe, the evolution of life expectancy over the last six decades provides an extremely interestin insight. It might come only as a half surprise that in recent years, the most upbeat country is Russia, and the country with the most persistent collective depression is the USA.

Statistics are not just numbers

The chart below shows the evolution of life expectancy for a couple of Eastern European countries as well as France and the United States from 1950 to 2013. It is striking to see that some countries, especially Russia, show strong variations over time, whereas others, like Serbia, tend to evolve in a much more steady way. Especially if we compare the evolution of life expectancy with economic development and historical events, we can get a better understanding of what happened in these countries from a human point of view. Both charts below are interactive; by clicking the buttons or the data points, you can add other countries, change the period and get detailed information about the data sources.

In the long term, life expectancy is strongly related to economic development; the same is true for infant mortality. However, in the short term, this link is not necessarily so strong. It is therefore interesting to compare life expectancy to the evolution of GDP, in this case purchasing power parity GDP per capita, which is considered to be the best indicator of the standard of living:

Post-war USSR: a spirit of optimism

Let us start chronologically, with the case of Russia after World War II. Between 1946 and 1964, Russia went through the period of fastest increase in life expectancy in its history. It should be noted that Joseph Stalin was still in power until 1953. This might surprise many, but all the data used here comes from international organizations like UN organs (UNPD), the World Bank, the IMF etc. and from recognized Western academics like Angus Maddison's team. This is definitely not some kind of "communist propaganda data".

From 1953 on, Nikita Khrushchev progressively introduced some degree of liberalization. The fact that the rise in life expectancy slowed during this time is certainly not due to his policies, but rather to the fact that life expectancy in the Soviet Union came close to life expectancy in the most industrialized Western countries.

However, Khrushchev's policies were not that popular among many senior members of the Communist Party and did not lead to faster economic growth. He was deposed in 1964 and replaced by Leonid Brezhnew who undid many of Khrushchev's reforms and imposed a more conservative policy. Until 1973, this did not have any impact on economic development: between 1950 and 1973, the Soviet Union maintained an almost constant yearly growth rate of 3.3%, ranking between the postwar booms of the US (2.5%) and France (4.0%). However, as soon as Brezhnev came to power in 1964, the rise of life expectancy slowed down abruptly or stopped altogether in the European Soviet Republics of the USSR (Russia, Ukraine and Lithuania shown on the chart above; for the other republics, click "Select countries").

The Soviet model reaches its limits

It is as if the people felt that there was no more dynamism in the Soviet regime and that economic growth was maintained only by inertia. They were right: from 1973 on, growth slowed down before it came almost to a halt in the 1980s (1978-1989 average yearly growth rate: 0.7%). The Soviet Union went through a long icy winter.

In Russia, life expectancy even started to decrease from 1974 on, when it became obvious that the doom-and-gloom mood which prevailed since 1964 was actually justified. The evolution which follows tells us a lot about the hopes of the Russian people. In 1980, when Brezhnev's health progressively deteriorated, there was a glimmer of hope and life expectancy started to rise again. After 1982, when the Communist Party had settled for Yuri Andropov and then Konstantin Chernenko, two conservative apparatchiks, life expectancy dropped again.

When Mikhail Gorbachev came to power in 1985, this triggered a huge wave of euphoria, not only in Russia, but also in the other European Soviet Republics. In Russia, life expectancy grew from 67.2 to 69.4 years between 1974 and 1976; after that, euphoria was over and life expectancy stagnated before it started to drop again (since 1988), even before the communist regimes broke down, causing a total melt-down of the economy and social services (since 1989 or 1990). It is quite obvious that the Russian people realized that not much good would come out of Gorbachev a long time before at least some Western experts understood it.

It is quite impressive to what extent life expectancy in Russia during this whole period was influenced not so much by material factors, but almost exclusively by the hopes and broken dreams of the Russian people. This contrasts with infant mortality which shows a regular decline over the whole period, with the exception of two short periods of temporary increase 1972-1977 and 1991-1995.

A relatively smooth transition in countries close to Western Europe

If we look at the situation in other Eastern European countries, the pattern is often quite different. After fast growth during the 1950s and some ups and downs during the 1960s, Slovenia has had a steady rise in life expectancy from 1969 to 2013, with only two phases of stagnation at the beginning of the 1980s and of the 1990s. Serbia had a fast rise during the 1950s and 1960s, followed by a slower rise which was only interrupted by a decade of stagnation during the 1990s, when Serbia tried to prevent the break-up of ex-Yugoslavia by every possible means, including the use of military force.

The other countries close to Western Europe like Poland, the Czech Republic, Slovakia and Hungary followed another pattern. All these countries saw a fast rise in life expectancy until the 1960s or 1970s. At that time, some Eastern European countries or Soviet Republics (Czech Republic, Slovakia, Bulgaria, Lithuania and Latvia) even overtook both France and the US in terms of life expectancy, despite significantly lower GDP levels. Ukraine, Belarus, Poland, Montenegro and Estonia overtook the US, but not France. This shows that to a certain extent, a high life expectancy can be achieved by an efficient social policy as long as the people believe in a bright future. It is amazing to see that some Eastern European communist regimes achieved this for some time to a larger extent than the economically much more advanced Western multi-party democracies.

However, from the 1960s or early 1970s on, all these countries entered some kind of collective depression. For example, whereas economic growth continued in Poland until 1978, the peak in life expectancy was reached in 1974. In 1981, one year after the founding of the Solidarnosc worker union, the peak value was reached again, despite an economic situation which had seriously deteriorated since the beginning of an economic crisis in 1979. However, martial law imposed at the end 1981 put an end to the hope. After that, the Poles had to wait until 1993 to enjoy a higher life expectancy than in 1974. This pattern was repeated with some slight variations across most of Eastern Europe. The most extreme example is certainly Lithuania, which had to wait until 2008 to significantly exceed the life expectancy of 1964.

After the breakdown of the communist regimes in 1990, all these countries went through an economic crisis; Western experts call it a "correction". The extent and duration of the crisis in each country was determined to a large extent by the geographical proximity to the industrialized countries in Western Europe, which were in need of cheap labor to delocalize their production. Poland, the Czech Republic, Slovakia, Slovenia and to some extent Hungary were the main beneficiaries of this process. In these countries, life expectancy started to rise again at the very beginning of the 1990s, at the same time or even before economic growth set in.

The collapse of the Soviet Union: from gloom to boom

For the successor states of the USSR, it was an entirely different story, as the comparison of GDP decrease in percent shows. As a comparison, during the financial crisis starting in 2008, GDP in France, the US, Germany and Great Britain decreased between 3.8% and 5.9% between pre-crisis peak and lowest value. In the economic crisis following the collapse of their communist regimes after 1989, the GDP drop in the three countries which were least affected was 14.7% in Poland, 17.6% in Hungary and 21.0% in Slovenia. The Great Depression in 1929 was of course of still another magnitude. At that time, GDP decreased by 30.8% in the US, 25.5% in Italy and 17.8% in Germany; the other countries were less affected. Now let us compare this to the breakdown of the economy in the wake of the collapse of the USSR: GDP drop was 46.7% in average for the whole (former) USSR, 45.3% in Lithuania, 46.3% in Russia, 58.9% in Ukraine and 65.8% in Moldova.

Such a terrible economic disaster was bound to have a huge impact on life expectancy. What is more, economic hardships came with a breakdown of state institutions and social services as well as an explosion of corruption and organized crime. Lithuania found the way back to economic growth in 1995; the same year, life expectancy started to rise again, after a drop from 71.2 years in 1986 to 68.5 years in 1994.

The case of Ukraine is interesting. This country had to wait until 1999 to resume economic growth. Two years earlier, after a drop from 70.5 years (1987) to 66.9 years, life expectancy started to rise again, probably in anticipation of better days to come. However, after only a short rise, life expectancy stagnated from 1998 to 2008 at around 68 years. The "Orange Revolution" of 2004/2005 did nothing to raise the spirit of the Ukrainians; anyway, in 2010, they brought Viktor Yanukovych to power again, precisely the man who had been the target of the Orange Revolution, but without any enthusiasm. Then, they got rid of him again in 2014, this time in a much more violent context. As the chart above shows, Ukraine is one of the very few countries which are still below the GDP level of 1989. This certainly goes a long way to explain present-day instability.

On the other hand, life expectancy surged between 2008 and 2010. How can we possibly explain this? These are exactly the years of the financial crisis starting in 2008, and Ukraine was one of the countries which was hardest hit (GDP decrease of 14.8%) among all the Eastern European countries. In none of them, the 2008 financial crisis triggered any decrease or even slowdown in the increase of life expectancy. On the contrary, in Lithuania, this crisis also triggered a renewed rise, after a second dip in life expectancy between 2005 and 2007. Maybe crises which are forced on a country from the outside do not entail a collective depression like crises which have got their source within the own society. Instead, they strengthen the fighting spirit and the determination to overcome any hardships which other countries might try to impose on your own.

However, since 2011, the doom-and-gloom mood seems to have extended to almost all of Europe and America. With very few exceptions (like Russia and traditionally stoic Serbia), life expectancy shows a perfectly synchronized bent downwards. This might be linked to a general breakdown of trust in the Western politico-economic system, but in 2008, when the financial crisis broke, there was no negative impact.

Another explanation emerges if we look at life expectancy in France: there is a dent in 2003. Was this linked to the Iraq war? This seems unlikely because no such dent exists in the US. It seems more plausible that it was linked to the extremely hot summer 2003 which has cost tens of thousands of elderly people their lives. 2011 was the beginning of a series of very hot years. The dent in life expectancy from 2011 on is probably not due directly to mortality caused by a warmer climate, but rather to a collective depression: people realized that climate warming was becoming a reality, that it was transforming Europe into a tropical region threatened by malaria and devastating droughts, unless we give up essential aspects of our lifestyle like powerful German cars.

This might provide an explanation why Russians do not feel the heat of climate warming. In many Russian regions, people suffer from high temperatures in summer, but as a whole, climate warming is rather perceived as a process which will transform the country of snow and ice into the only remaining temperate place on earth, with more fertile soil available for agriculture than ever before in history.

However, as a whole, it is not climate warming, but the economic and political outlook which has had the biggest impact on life expectancy; this becomes very clear when we look at the evolution in Russia after the breakdown of the communist regime and the economy from 1989 on. In 1994, as soon as the drop in GDP slowed down, the Russians thought that the worst was over and better days would come soon, but in 1998, there was a new crisis. It might look quite insignificant on the GDP curve and was over within one year, but because it was linked with rising prices for the most basic goods, it had a major impact on the poorest. According to World Bank figures, the percentage of the population living in extreme poverty had reached an absolute peak of 3.6% in 1996, then decreased to 1.1% in 1997, only to increase again to 1.7% in 1998 and 3.4% in 1999.

Even though this crisis was solved quite quickly (in 2002, extreme poverty reached an all-time low with 0.7%), the impact on the mood was tremendous: life expectancy sank from 67.0 years in 1997 to a low of 65.0 years in 2003, four years after the peak of the crisis was over. It is interesting to see that the second dip in life expectancy in Lithuania from 2005 to 2007 is also due to a sudden increase in extreme poverty which does not appear on the GDP curve at all; on the contrary, the economy went through a continuous boom during all these years. This might be a hint to what the people find most depressing: even if their own life improves, seeing increased extreme poverty and misery around them seems to be so depressing to them that life expectancy plunges and remains low even years after poverty has dropped again to a level which is even lower than before the crisis. This should definitely be a strong argument for a sustained fight against poverty.

The new crisis of 1998 shook the trust of the people in their government for many years. This was the result of three decades of false hopes which turned out to be illusions. Nina Kouprianova's article "If You're So Smart, Then Why Are You So Poor? Russia's 1990s Revisited" paints a vivid picture of this period. When Vladimir Putin came to power in 2000, he managed to restore public security and to turn the economy around, but it took him five years until the population trusted him enough to emerge from a depression which had become chronical. Since 2006, life expectancy has risen at an impressive rate. Of course, no Western academic will ever try to calculated the number of lives which were saved in this way.

Life expectancy in the US: from postwar boom over Vietnam gloom to gloomy boom

We might now have a short look at the evolution of life expectancy in the US. The fact that in 1950, life expectancy in the US was higher than in France is quite expected; France was still recovering from the Second World War. The first US dip from 1962 on can be linked to the Vietnam War and the split within the American society which it entailed. It should be noted that in the early 1960s, there were only very few US troops in Vietnam; this dip was therefore not caused by war casualties. In early 1973, direct US involvement in Vietnam was over, but life expectancy recovered only gradually. This shows again that the drop in life expectancy was not caused by casualties, but by some kind of collective depression resulting from a crisis within the society.

The gradual decrease in US life expectancy as compared to France from 1982 on is much larger in scale. It is totally unrelated to actual economic performance or to the reputation of the USA abroad. The Vietnam War has had a devastating impact on the image of America, but in the 1980s, the US looked more and more as gaining the upper hand in the ideological competition with the Soviet Union. From the early 1990s on, a majority of the world population even considered the USA to be the sole winner. Since the early 1980s, the GDP advantage of the US over France was again widening after France had progressively caught up during the previous three decades. So what causes the decline in life expectancy relative to France and other highly industrialized countries?

1981 and Ronald Reagan's presidency are the starting point of a continuous decline of the US healthcare system (see the article Never leave a cowboy in charge of the nursery, or 12,000 babies will die each year). Since that year, the gap in infant mortality between the US and the other industrialized nations constantly increased. This was due at least in part to disastrous neo-liberal health policies, in part also to an evolution in the American society which cared less and less about the lives of the poor and destitute.

The first blowback came during Reagan's second term, when the public opinion realized that even patients with life-threatening emergencies were dumped by unscrupulous hospitals if the patients or their families could not pay the bill. Some measures were taken, but the overall decline was not stopped. By now, infant mortality in the US is more than double the average for countries with the same standard of living, 232% to be precise. Barak Obama promised that he would take care of the problem, but these were only empty words; infant mortality was standing at 194% of average before he came to power.

Infant mortality depends heavily on economic development, but also on many other factors like income inequality and the quality of the healthcare system, especially the accessibility of healthcare for the poor. We can therefore consider that the horrendously high infant mortality in the US is a result of failed policies. However, there is no reason to believe that the same applies to life expectancy. The most plausible explanation for the relative decline of life expectancy in the US is related to psychological factors. The extreme poverty and misery which are so apparent in each American city and the innumerable babies who are no more among us because of a whole series of failed policies have come back to haunt the US citizens.

Is there a way of pushing the US citizens and politicians to care more about their babies and the poor? Probably, and it all depends on Russia. If Vladimir Putin manages to stay in power until 2031 and to preserve the present upbeat mood in Russia, essentially by making sure that steady economic growth is matched by social development, Russia will have overtaken the US in terms of life expectancy. This should be enough for the US to wake up and to realize that a model of development which is obsessed with GDP figures without taking care of babies and the poor is not sustainable, but a gloomy economic boom at best.

This article has also been published on countercurrents.org.