Category Archives: Public Health

Demography And Leaping To Conclusions

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But first, a note about those two articles published here this morning: As I hope many (if not all) of you guessed, it was a scheduling accident. In particular, as regards the piece “Russia’s Economy Is Now Europe’s Largest,” this is what I expected to see once the World Bank released its PPP-adjusted GNI figures for 2012 (it always does this in April, but for whatever reason it has been late this year). Russia is already very close to Germany as of 2011, and due to a planned harmonization of its GDP counting methodology with international standards – i.e. the introduction of imputed rent - it is projected to automatically increase by 5% in addition to its normal growth. Hence the title: It’s something that’s likely to happen, hence I wrote that title with “see data” for text and scheduled it for publication on April 30th, on the assumption that the World Bank will have released its new data by then and I’d have time to write the actual post. But the World Bank dallied and I forgot about the scheduled publication date.

Now, onto the demography. In contrast to the first 3 months of 2012, when both mortality and birth rates saw big improvements, they have now gone into reverse for the same period in 2013. Namely, births have decreased by 0.8%, deaths have also risen by 0.8%, and the rate of natural decrease widened from 35,000 in 2012 to 43,000 in 2013. Mark Adomanis notes that this is a “pretty worrying development,” with “2013 is shaping up to be the year in which Russia’s streak of improving demography comes to an end.”

That is true enough if current trends continue. The operative word being “if.” But as I cautioned in my last post, extrapolating from a month or even a few months is a risky proposition, given the sharp seasonal swings in mortality. This is particularly true for extrapolations from winter months, in which there is an additional strong independent factor in the form of the influenza/pneumonia situation (which, on average, is worse during colder winters) and climatic factors (e.g. all else equal, Russians tend to drink more during colder winters). Now we know that this year’s has been exceptionally severe in Russia, so let’s look at the detailed breakdown for causes of mortality: -3% for infectious diseases, -1% for cancers and heart/CVD diseases, +18% for pulmonary diseases (e.g. pneumonia), no change in digestive tract diseases, -5% for deaths from external causes (but a +1% rise in alcohol poisonings), and +14% in deaths from sundry causes.

Now on the surface this now looks quite a lot better. Despite a harsh winter, deaths from heart disease (the biggest killer in Russia) continued to decline, as did deaths from external causes (which disproportionately affect the young and thus have an especially negative impact on life expectancy). The additional 3,000 increase in deaths from pulmonary diseases will have mostly accrued to elderly deaths from pneumonia, most likely due to the season swings typical of its epidemiology. The major, overriding question is this: What are “deaths from sundry causes” (прочие причины смерти)? I don’t know. But we can speculate. In old age, it is frequently unclear which of a panoply of ailments finally do someone in. And harsh winters are associated with mortality rises, especially among the elderly. Perhaps a large part of that 7,000 rise in deaths from “sundry causes” were simply a result of more elderly dying due to general winter causes and not being precisely classified.

In any case, I submit that three months is too short a time period to make any meaningful conclusions as to the final trajectory for the year. Again, I refer to Sergey Zhuravlev’s graph as a graphic demonstration of why that is so. Russia’s improvements in mortality are not a steady process, to the contrary they look like a series of intermittent sharp declines followed by steady periods of up to a year’s duration.

Then there is the decline in birth rates. To be fair, it is increasingly unrealistic to expect further rises in crude birth rates, because the “echo effect” is real (if often overstated, because of a failure to adjust for birth postponement/rising age of mother at childbirth). Russia’s total fertility rate started plummeting around 1991; the girls born then are now in their early 20′s. The average age of the mother at childbirth is now about 27 and rising, and up by 2 years since the 1990′s. Nonetheless, despite that counteracting effect, the fact is that the demographic “chasm” of the 1990′s continues to gain on women at their peak fertility (even if the age of peak fertility continues to increase) and it is a deep chasm, with women of the age of 5-19 making up just 61% of women of the age of 20-34 in 2012. So as there will be accumulating downwards pressure from changes in the age structure until the late 2020′s/early 2030′s we can now expect crude birth rates to start consistently falling from year to year.

The Russian Cross Becomes A Hexagon

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One of the standard memes about Russia’s demographic trajectory was the “Russian Cross.” While at the literal level it described the shape of the country’s birth rate and death rate trajectories, a major reason why it entered the discourse was surely because it also evoked the foreboding of the grave.

russian-cross

But this period now appears to have come to a definitive end. Russia’s population ceased falling around at about 2009; in the past year, it has increased by over 400,000 thanks to net immigration.

Meanwhile, against all general expectations, the birth rates and death rates have essentially equalized. Whereas in 2011 natural decrease was still at a substantial 131,000, preliminary figures indicate that it has subsided to a mere 2,573 for this year. It could just as easily turn positive once the figures are revised. For all intents and purposes, the “Russian Cross” has become the “Russian Hexagon.”

russian-hexagon

This is a momentous landmark in many ways.

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Russia’s Demography Continues To Improve Rapidly In First 3 Months Of 2012

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In my previous demography post, I argued that for all intents and purposes, Russia’s “demographic crisis” can be reasonably argued to have ended. Population growth is now consistently positive since 2009, and as of last year, the country’s natural decrease was a mere 131,000. This is a massive improvement over the 500,000-1,000,000 annual natural decrease seen in 1993-2006.

The latest figures continue to beat all expectations (even my relatively optimistic ones) in the first three months of this year. The crude birth rate has risen by 6.5% over the same period last year, implying a c.8% rise in the total fertility rate (slightly higher since the ratio of women of childbearing age is now falling). Projecting it for the rest of the year – a risky assumption, granted, but this is back of the envelope stuff anyway – would give a TFR of about 1.73 for 2012 (from c.1.60 in 2011). This would make it broadly comparable to the Netherlands (1.79), Iran (1.70), Canada (1.67), and Estonia (1.62); below the US, France, the UK, and Scandinavia (1.8-2.0); and above Germany, the Med, Japan, South Korea, Poland, China, and the Christian ex-USSR (1.2-1.5). It is time to stop thinking of Russia as a low-fertility country; it is firmly in the middle of the pack among industrialized countries. It is particularly noteworthy that whereas Russia is frequently described as the sick man of the BRIC’s (in demographic terms), it is now probably closer to Brazil (1.86) than it is to China (c.1.4-1.5).

The numbers of deaths fell by 3.3%, and this is a trend that is likely to persist as excise taxes on alcohol and tobacco are raised at  a more rapid pace now that the elections are done with. As a result, the natural population loss in the first quarter this year is now only 35,000 relative to 79,000 last year. There is now a distinct chance that natural population growth will actually be positive this year – linearly extrapolating from this quarter (which is of course an unreliable method, but whatever) would give 1,793,828*1.065 births and 1,925,036*0.967 deaths = 1,920,426 – 1,861,509 = c.60k increase - although I’d still give it less than even odds. As graphs are worth many words…

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Is Khodorkovsky A Political Prisoner? Read The ECHR Judgments Before Quacking

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It’s one thing if Western journalists and Yukos PR henchmen – if there is indeed any difference – shill for all they’re worth about the travails of Khodorkovsky, the former oligarch doing time for fleecing the Russian Treasury to the tune of billions of dollars, charges he sooner boasts about than denies when given the opportunity to address Russians on national TV. It’s quite another when many ordinary Russians begin to lap up their lies, with a disturbing 10% describing him as a political prisoner in a recent VCIOM poll, and opinions are split 50/50 on a Presidential pardon. Congrats to the PR team, I guess.

Fortunately, at least some court systems still keep their judgments partitioned from the demands of self-interested businesspeople, their PR hacks, libertarians who believe that money should be able to buy a Not Guilty verdict, liberals operating under the delusion MBK is a popular and legitimate political opponent of Putin, etc. According to four (by my count) judgments to date, the European Court of Human Rights (ECHR) is one such institution. The Yukos team managed to get their cases heard at Europe’s highest court of appeal, and they decided that – barring a few administrative irregularities, for which Khodorkovsky was awarded a paltry $35,000 – there was no proof for any of his allegations that the case was politically motivated. This is despite the fact that the ECHR can in no sense be having a Russian government-friendly stance, given the numbers of judgments that have gone against it there.

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Russia’s Mortality From Vices On The Decline

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Sometimes a single picture is worth a thousand words. This is one.

Though Russia remains a highly dangerous country by developed country standards, it has improved immeasurably in the past decade. Fewer Russians today die from alcohol poisonings, homicides, suicides, and even – despite a near doubling of car ownership rates – transport accidents that they did in the 1990′s to early 2000′s. Indeed, most of these “non-natural deaths” indicators are back to the levels of the late 1980′s, coinciding with Gorbachev’s anti-alcohol campaign.

The importance of this decline shouldn’t be understated. Though they only account for a small proportion of total deaths, they tend to happen at earlier ages and thus have a significant impact on the workforce and overall life expectancy. Furthermore, the fact that the pace of improvements actually speeded up during the crisis indicates that Russia is becoming a “normal country” in the sense that health improvement trends have decoupled from economic fluctuations.

Translation: Sergey Zhuravlev – The Reversal Of The “Russian Cross”

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Sergey Zhuravlev is a Russian economist who runs a wonky but eminently readable and very useful, interesting blog and writes for Expert (author profile), which I may add is an excellent publication. You have met him previously on my blog as the inventor of a clever – if, in my opinion, flawed – argument that the 2011 Duma elections were marred by 5%-6% fraud, but were clean in Moscow; and if you read the Russia blogs, you may also have come across Mark Adomanis’ translation of one his articles about Russian regional inequality. Now I am presenting a translation of his Feb 13 article on what I called as the end of Russia’s demographic crisis: The Reversal of the Russian Cross. In my opinion, it has a few weaknesses; in particular, he is too cavalier about dismissing the “alcohol hypothesis” about post-Soviet Russia’s “supermortality”. But overall it is a brilliant and deeply informative survey of the origins of the Russian Cross – the crossover of the births and deaths graphs in 1992 – as well as of its recent reversal, to the extent that natural population decline is now almost stabilized and the overall population is able to grow due to net migrants.

The Reversal Of The Russian Cross

Last year our country’s population increased, for the first time in 20 years. Although positive growth in aggregate was only enabled by immigration from the Near Abroad, existing trends in rising fertility and falling mortality were maintained.

If we are to go by Rosstat’s figures, in the past year Russia’s population – for the first time in virtually the entire twenty years of Russia’s existence as a sovereign state – increased, exceeding 143 million people. The maximum population size was reached in 1992, at 148.56 millions, and has since decreased at a practically monotone rate. That said, it should be added that small population growth was previously observed in 1994 and 2009, and that the population fall in 2010 was, most likely, explained by cumulative errors over the period since the 2002 Census, and by the abnormal mortality during that summer’s heatwave [AK: There were c.56,000 excess deaths during the anomalous 2010 heatwave, which is basically equivalent to population decline of 48,300. Furthermore, the 2010 Census showed there to be 143.9 million Russians, which was one million higher than projections based on the 2002 Census; this implied that during the period, net immigration was underestimated by more than 100,000 per year. So its likely that even despite the heatwave, Russia's population still eked out an increase in 2010].

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Making Sense Of Russia’s Arms Binge

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In the wake of Putin’s article on national security for Rossiyskaya Gazeta, there has been renewed interest in Russia’s ambitious military modernization plans for the next decade. I am not a specialist in this (unlike Dmitry Gorenberg and Mark Galeotti, whom I highly recommend), but I do think I can bring much-needed facts and good sources to the discussion.

1. This is not a new development. In fact, the massive rearmament program was revealed back in 2010 (I wrote about it then). Russia’s armed forces were neglected in during the 1990′s and early 2000′s, and enjoyed only modest funding until now; relative to Soviet levels, they are now far degraded. The main goal is to create a mobile, professional army equipped with modern, high-tech gear by 2020.

2. To recap. With oil prices high and Russia’s fiscal situation secure, it IS affordable; it’s not like the old USSR (or today’s US for that matter) spending money it doesn’t have. I also don’t necessarily buy the argument that most of the additional funds will be swallowed up by corruption or inefficiency. Massive new procurement can create temporary bottlenecks, which raises prices, but on the other hand it also allows for economies of scale. The real question is whether Russia absolutely needs to retain the hallowed One Million Man Army, which would appear far too big for the modest anti-insurgency or local wars it may be called to fight in the Caucasus or Central Asia. (There is no possibility of matching NATO or Chinese conventional strength in principle, so that consideration is a moot point).

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Russia’s Demographic Crisis Has Ended

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I will have a much longer and detailed post on this in the future, with new projections, but this breaking news (at least as far as it comes with dry demographic statistics) so I can’t refrain from writing a preliminary post on the matter.

For all intents and purposes, Russia’s demographic crisis – the infamous “death spiral” afflicting it for much of the post-Soviet period – is at an end.

Here is a summary of the preliminary data for 2011:

1. The population increased by 189,000. The rate of natural decrease, deaths minus births, is now at a mere 131,000; for comparison, it was consistently within the 700,000 to 1,000,000 range from 1993 to 2006. This was more than balanced by an uptick in net immigration, which rose to 320,000 this year. (This has not stopped the hackish Western media from slobbering on about Russia’s “brain drain” at just the precise moment in time that it finally came to a complete halt).

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Russia Demographic Update VII

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It is now increasingly evident that Russia’s population has settled on a small but decidedly firm upwards growth trend. I have been vindicated.

According to the latest data, in the first eight months of the year births fell by 1.4% (12.5/1000 to 12.3/1000) and deaths fell by 6.2% (from 14.6/1000 to 13.7/1000) relative to the same period last year. The rate of natural population decrease eased from -198,3000 to -128,800. The big fall in the death rate is due to two factors: (1) the continuing secular increase in life expectancy, due to decreasing alcohol consumption and more healthcare spending; (2) specific to 2011, the “high base” effect of the mortality spike during the Great Russian Heatwave last year.

This natural decrease was more than compensated for by 200,255 net migrants during the same period, making for a population increase of 71,500 this year to August. This more than cancels out the population decrease of 48,300 for the whole of 2010, and let it be reminded that it rose by 23,300 in 2009. In other words, in stark contrast to the avalanche of doom-mongering articles that continue to be written in the Western press about “dying Russia” – of which two of the most egregious examples are this and this – the reality is that today in net terms Russia’s population is now larger than it was in 2009.

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Interview with Craig Willy (Letters from Europe)

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After a year long hiatus from interviewing Russia watchers, I decided it was time to get back in the game. As it happens, my attention first fell on a Europe blogger – and not just any incisive, counter-intuitive scribbler whose intellect and analytical acumen is matched only by the number of themes he is prepared to expound upon, but also someone who has experience in politics (work in both the US Congress and the European Parliament), journalism (with the EU policy news site EurActiv), ideological adventurer (started off very neocon, but Iraq War and education fixed that), and a fellow rootless cosmopolitan (having been raised in France and briefly in the US, and studied at the London School of Economics). I am talking of none other than Craig Willy, who writes the irreverent (and informed) Letters from Europe.

Craig Willy: In His Own Words…

What first sparked your interest in blogging and Europe, and how did the twain meet?

I’ve been in love with history, politics, thought and argument since I was maybe 14. I remember very clearly telling a friend at the time that I wanted to “be paid to say my opinion”… Perhaps not the easiest career path and not one I persistently pursued!

Blogs don’t provide money, usually, but they are an absolute liberation for the aspiring writer: costs are zero, middlemen are eliminated, and you can reach every person on the planet who has Internet. How could I not blog? I started my first blog in 2004 and I don’t think I’ve changed the mix of more analytical pieces with humor, including on Euro-nonsense.

I have always been interested in Europe as I was born and raised here (specifically in France and the UK). I have been interested in the EU insofar as it seemed to represent Europeans reclaiming their power in the world and historical agency. It usually fails in this respect and hence I used to find the United States of America – its historical role, politics and foreign policy organizations – much more interesting. I now think all areas of the world are worthy of study. The US is probably over-written about and, being based in Brussels and involved in EU journalism, I can genuinely add value writing about European affairs. If I wrote about the US I would be just another opinion. I also think Europe needs more pan-European writers: it is a very real entity but it has no public space.

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