This time around, the reaction was far more unanimous:
No one paid any attention to Gorbachev's proposal, though everyone
ignored it for different reasons. People who are living in the past
dislike Gorbachev so intensely that they refuse to listen to him
even when he says something eminently reasonable. People who live
for today don't read newspapers, and those who live for tomorrow
don't drink. Yet you were wrong to ignore Gorbachev's proposal,
comrades. Alcoholism is perhaps the single biggest reason for
Russia's high mortality rate. And it really is astronomical: In
terms of life expectancy, Russia ranks 122nd in the world, alongside
North Korea and Guyana.
Economists Elizabeth Brainerd of Williams College
and David Cutler of Harvard recently published a paper outlining
their conclusions after years of research into the causes of
Russia's high mortality rate. The most important factor in declining
life expectancy, they write, is alcohol consumption. Other oft-cited
factors -- the declining standard of living and deterioration of the
public health system -- don't stand up under scrutiny. The public
health system may be falling apart, but the indicators that should
react most dramatically to worsening conditions, such as the number
of mothers who die in childbirth or the use of medications, have
changed little.
But there has been an upsurge in mortality resulting
from so-called "external causes" -- homicide, suicide and accidents.
The situation was bad enough during the Soviet era, when male
mortality from external causes was three times higher than in
Western Europe, and female mortality was twice as high. Since the
collapse of the Soviet Union, however, the situation has become far
worse. The research carried out by Brainerd and Cutler shows that
our passion for alcohol increases our likelihood of death from
external causes by four times. On the whole, Gorbachev is right: We
have a problem, and we need to tackle it.
What lessons can we learn from his anti-alcohol
campaign 20 years ago? That this problem is extremely difficult to
solve "from above." Ideally, the impetus for change should come from
below. In the United States, for example, nearly one-fourth of all
counties are "dry," meaning that even for a beer you have to go
elsewhere. In Chicago, residents can vote to make their individual
neighborhoods dry. Even before President Vladimir Putin's reforms,
local democracy in Russia was in an embryonic state, to put it
mildly, and his push to take us "back to the U.S.S.R." doesn't bode
well for the future. On the other hand, a new, centralized
anti-alcohol campaign would be better than nothing. After all, the
period from 1985 to 1987 did see a dramatic improvement in important
demographic indicators. It's time to take a sober look at the
facts.
Konstantin Sonin, a professor at the New Economic
School/CEFIR, wrote this column for Vedomosti.
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