The Dec. 13 editorial "What Russia Is" argued for remaining engaged with the people of the Russian Federation, even in the face of renewed saber rattling. A particular area worthy of engagement concerns the health of the Russian population.

As the editorial noted, throughout the '90s, the Russian population has been shrinking. Longevity has reached a low of 57 years for males. Most affected by health concerns are adult males in their most productive years. This demographic and public health crisis is unprecedented in a time of peace.

Half of the increased mortality is due to cardiovascular disease -- heart attacks and stroke -- reflecting both unfavorable social habits (smoking, alcohol, obesity, poor diet) and the inadequate identification and treatment of hypertension. Russia also is experiencing an epidemic of tuberculosis, with a prevalence more than 10 times that in the United States. Among Russian prisoners, the reported case rate is 50 times the civilian rate.

Until now U.S. foreign assistance to social safety net matters in Russia has been uneven and, at times, counterproductive. A stable Russia is in the interest of the United States. We need a coherent policy and program for health assistance to Russia to serve both humanitarian and security goals.



Institute for Health Policy Analysis