Inequalities in Healthy Life Expectancy in Eastern Europe

Compared to the large body of research on mortality differentials between East Central Europe and the former Soviet Union, little attention has been paid to how overall population health status differs between these two country groups. This article investigates disparities in population health, measured by healthy life expectancy (HLE) between ages 20 and 74, for 23 Eastern European countries in 2008. There are substantial disparities in partial HLE between East Central Europe and the former Soviet Union, amounting to differences of 10 years on average for men and women. In addition, factors reflecting the malfunction of existing social structure are inversely associated with partial HLE. Accordingly, populations in countries where corruption, restriction of freedom, and violence are prevalent spend fewer years in good health.     

经济转轨以前俄罗斯人口贫困状况及原因

人口贫困是一个内涵十分广泛和深刻的社会历史范畴,究其实质而言,这是一种能力贫困。中国和俄罗斯等转轨国家在改革前存在许多共同的特征,更为重要的是,社会主义制度不是建立在高度发达的资本主义社会基础之上,这就注定了贫困与反贫困问题必然要成为这些国家面临的共同课题。所不同的是,苏联和当代俄罗斯的人口贫困主要表现为收入贫困,中国则主要是知识贫困。苏联时期人口贫困的主要原因有经济绩效的递减趋势、国家经济发展战略的错误、所有制结构的单一、收入分配机制中的平均主义。     

The impact of income inequality on self-rated general health: Evidence from a cross-national study

Previous studies report a strong negative association between income inequality and population health at the aggregate level. However, it is still in hot debate whether this ecological association indicates a genuine, causal effect of income inequality on health, as asserted by the Wilkinson hypothesis, or it simply reflects a nonlinear effect of individual income on health, as suggested by the absolute income hypothesis. Drawing data from the 2005 round of the World Values Survey, I analyze the relationship between individual income, income inequality, and self-rated general health in a multilevel framework. Results show no independent detrimental effect of country income inequality on individual self-rated general health. In contrast, self-rated general health is strongly associated with absolute material conditions both at the individual and at the country level. Therefore, this study gives more evidence to the absolute income hypothesis, i.e., the strong ecological association between income inequality and population health is more likely a reflection of the nonlinear effect of individual income on health rather than a genuine effect of income inequality.     

Welfare State Development,Individual Deprivations and Income Inequality: A Cross-Country Analysis in Latin America and the Caribbean

Several scholars have confirmed the role that the welfare state (WS) plays in reducing poverty, promoting equality and ensuring the common wellbeing. One of the limitations of the scholarship has been the conceptualization and operationalization of the WS and poverty as one-dimensional variables. The purpose of this paper is to examine the relationship between welfare state development, single-dimensions deprivations and income inequality in Latin America and the Caribbean, before and after controlling for demographic and cyclical factors. The WS is operationalized as a one-dimensional variable, but also taking into account its multidimensional nature. Three individual deprivations suffered by people on poverty and two income inequality indicators are used as dependent variables. Three pooled time-series cross-section regression analyses with panel-corrected standard errors models were carried out on 18 countries in the region around 2000, 2005 and 2010. This paper shows that the development of social-welfare programs and institutions seems to be an effective way of tackling individual deprivations suffered by people on poverty in the region. On the other hand, the WS development didn’t appear to be effective to reduce income inequality. The outcomes of welfare institutions appear to be the pivotal dimension to reduce income inequality and income deprivations in the region.     

The Seeming Paradox of Increasing Mortality in a Highly Industrialized Nation: The Example of the Soviet Union

A discussion of the surprising phenomenon of declining life expectancy in a highly developed country such as the Soviet Union during the 1970s shows that this result was probably due only in a small part to ‘true’ causal changes in the conditions of living. At least equally important is the weaknesses of the measure of life expectancy by itself. The logical difference between period and cohort measurement is one part of the explanation. Another important factor is the adverse selection of risks by war, which makes international and intertemporal comparisons less valuable. Factors like population redistribution or changes in the registration also contribute to the explanation. Thus; life expectancy (in particular period life expectancy) should not, without closer consideration, be accepted as a reliable indicator of human welfare under such circumstances.     

Subjective Welfare, Well-Being, and Self-Reported Food Hypersensitivity in Four European Countries: Implications for European Policy

This study estimates the effects of food hypersensitivity on individuals?? perceived welfare and well-being compared to non-food hypersensitive individuals. Study respondents were recruited in the Netherlands, Poland, Spain and UK. The difference in welfare between food hypersensitive respondents and those asymptomatic to foods was estimated using a subjective welfare approach, including income evaluation. Well-being was measured using the Cantril Ladder-of-Life Scale, and health status using the Self-Perceived Health Scale. The difference in well-being, welfare and health status between participant groups was explained further using a number of background variables. No significant within-country differences in welfare between food hypersensitive respondents and respondents asymptomatic to foods were found. In terms of well-being, adult food hypersensitive respondents and their spouses reported significantly less happiness than respondents and their spouses asymptomatic to foods in the Netherlands and Poland. In Spain, the spouses of the food hypersensitive respondents were significantly less happy than respondents aymptomatic to foods. The well-being of children did not significantly differ between groups. The degree of severity of food hypersensitivity was negatively related to overall health status. In Poland, food hypersensitive respondents reported worse health status compared to asymptomatic respondents. In Spain, the converse was true. Food hypersensitive respondents were generally less happy with their life as a whole than respondents asymptomatic to foods, presumably because they experienced more negative effects, which were not related to perceived health status.     

Socio-Economic Inequalities in Happiness in China and U.S.

Our paper studies the determinants of happiness in China and U.S. and provides a better understanding of the issue of inequalities in happiness beyond income inequality. Based on the two waves of nation-wide survey data on happiness collected by World Values Survey in 1995 and 2007, Probit and ordinary least square methods are used to estimate effects of various factors on happiness. Our findings show that socio-economic inequalities increase inequalities in happiness in China. The poor are the least happy even though the income effect flats out at the high end. Individuals with below high school education attainment are less happy than those with more education. Agricultural workers are the most unhappy and are becoming even more unhappy over time. However, in U.S., there is no systematic difference in happiness across income and education groups and between agricultural and non-agricultural workers. In both countries health is a major factor contributing to happiness. Our study implies that adequate provision of national health care services should be an effective way to improve social welfare. Besides, since the probability of being happy for agricultural workers is still considerably less after controlling for income in China, policies to improve their welfare should not be limited to enhancing current income.     

Welfare measurement in labour supply models with nonlinear budget constraints

This paper is concerned with the measurement of individual welfare in labour supply models which allow for the impact of income taxation and income support schemes on labour supply decisions. The paper is motivated by the concern over the need to have measures which can be interpreted easily, which can be compared with net income, and which can be meaningfully aggregated. To illustrate the issues we use estimates of a discrete choice model of labour supply for United Kingdom lone mothers to compute alternative welfare measures which might be considered as having intuitive appeal to policy-makers. We compute welfare change based on these measures arising from a recent reform of the child support payments system. Received: 25 February 1997/Accepted: 12 March 1998     

Expectancy of life at birth in 36 nationalities of the Soviet Union: 1958-60

Abstract In the 36 nationalities of the Soviet Union the estimated expectancy of life at birth ranged from 50·0 years for Chechens to 71·1 years for Latvians with a median of about 67·5 years for Russians. In essence, the life table function e(0) was generated from the child-woman ratios with the use of intricate equations based on empirical data obtained from official Soviet publications. A modified version of Bourgeois-Pichat's model was used to estimate life expectancies at birth among the 36 nationalities on the basis of their crude death rates and the percentage of population aged 65 years and over. The 1959 U.S.S.R. Census of Population provided information pertaining to the older age groups. The crude death rates were estimated separately with the aid of second-degree polynomials fitted to the crude demographic measures for 109 administrative areas of the Soviet Union for 1960. Information about recent improvements in public health, as well as conjectural evaluations of economic advancement in recent years were examined and related to the past and present level of mortality among the Russian people and the remaining population of minorities.     

The Evolution of Well-Being in Spain (1980–2001): A Regional Analysis

Evaluations of regional welfare conventionally rely on Gross Value Added (GVA) per capita as an indicator of well-being. This paper attempts to re-address the regional welfare issue using alternative indicators to per capita income. With this aim, a database for the Spanish regions (NUTS II) has been constructed for the period 1980–2001 and an augmented version of the United Nations Development Programme (UNDP) Human Development Index (HDI) has been estimated incorporating indicators of health, education and per capita income. The results show that, whereas regional income per capita disparities have remained constant, regional convergence in the Augmented Human Development Index (AHDI) was achieved between 1980 and 2001. None the less, there is no evidence of intra-distributional mobility (leap-frogging) across regions in the AHDI     

A note on suicide in Russia, 1965–1993

Recently, theCentre for Demography and Human Ecology in Moscow in collaboration with theInstitut National d’études Démographiques in Paris undertook a reconstruction of registered deaths in individual republics of the former Soviet Union. The first set of such data, tabulated by sex, age and cause of death, covers the deaths registered in Russia between 1965 and 1993. The present article extracts from the data set information on registered suicide mortality and reviews its trends and age and sex patterns. The link between alcoholism and suicide is strongly suggested.     

Expectancy of life at birth in 36 nationalities of the Soviet Union: 1958-60

In the 36 nationalities of the Soviet Union the estimated expectancy of life at birth ranged from 50·0 years for Chechens to 71·1 years for Latvians with a median of about 67·5 years for Russians.

In essence, the life table function e₀ was generated from the child-woman ratios with the use of intricate equations based on empirical data obtained from official Soviet publications. A modified version of Bourgeois-Pichat's model was used to estimate life expectancies at birth among the 36 nationalities on the basis of their crude death rates and the percentage of population aged 65 years and over. The 1959 U.S.S.R. Census of Population provided information pertaining to the older age groups. The crude death rates were estimated separately with the aid of second-degree polynomials fitted to the crude demographic measures for 109 administrative areas of the Soviet Union for 1960.

Information about recent improvements in public health, as well as conjectural evaluations of economic advancement in recent years were examined and related to the past and present level of mortality among the Russian people and the remaining population of minorities.     

The challenge of world health

2 development specialists have expounded on the demands world health has placed on public health. Striking declines in infant and child mortality occurred with the advent of biomedical and technical interventions in developing countries after World War II. At the same time, these interventions promoted longer lives by curing and/or treating chronic diseases in developed countries. In the 1970s, however, it was apparent that the hospital based, curative approach could not meet health needs and was very costly. In developed countries, biomedical and social sciences showed that chronic diseases did not occur due to modernization but from unhealthy behaviors, diet, and lifestyle. In fact, in 1975, the US Centers for Disease Control announced that unhealthy lifestyles contributed to 50% of all deaths while the medical system was responsible for only 11%. The US and other developed countries then began to promote healthy lifestyles, and in the 1980s, considerable improvements in health occurred, especially among adults. Developing countries which depended on the Western medical model did not experience health gains in the 1970s. Yet developing countries where health systems concentrated on carrying essential services to all people and promoted basic hygiene and sound dietary practices continued to achieve considerable health gains. In 1978, WHO an UNICEF hosted the International Conference on Primary Health Care in Alma Ata, the Soviet Union to hold these developing countries with community based health systems as models of primary health care (PHC). The 1980s witnessed the spread of PHC especially in the form of child survival which focused on oral rehydration therapy and breast feeding. The biomedical and social sciences are needed to move this health policy and program strategy forward. Governments must see to policies that promote healthy people. Political will is needed to make human welfare a high priority.     

The Income and Health Effects of Tribal Casino Gaming on American Indians

The legalization of American Indian casino gaming in the late 1980s allows examination of the relationship between income and health in a quasi-experimental way. Revenue from gaming accrues to individual tribes and has been used both to supplement tribe members’ income and to finance tribal infrastructure. We assembled annual data from 1988–2003 on tribal gaming, health care access (from the Area Resource File), and individual health and socioeconomic characteristics data (from the Behavioral Risk Factors Surveillance System). We use this information within a structural, difference-in-differences framework to study the effect of casino gaming on tribal members’ income, health status, access to health care, and health-related behaviors. Our difference-in-differences framework relies on before-after comparisons among American Indians whose tribe has at some time operated a casino and with-without comparisons between American Indians whose tribe has and those whose tribe has not initiated gaming. Our results provide identified estimates of the positive effect of gaming on American Indian income and on several indicators of American Indian health, health-related behaviors, and access to health care.     

Some fundamental problems concerning the relationship between population growth and economic development]

The population growth rate is closely related to the quality of economic life, available funds for individual and social consumption, national income to be used for reproduction, and the labor employment situation. Since liberation, socialism has not been able to show its superiority, mainly because of China's large population figure, low economic productivity, low national income, and poor management in the relationship between consumption and accumulation. In order to solve these problems, we need to adequately control the pace of the population growth and match the rate of population growth with the pace of economic development. A way to increase national income is through saving and avoiding unnecessary waste. Social expenditures on education, culture, science, health and medical care, social welfare, and investment in the promotion of people's wisdom should all be increased. Meanwhile, the living standard of the people needs to be raised, and capital accumulation should also be managed so that funds will be available for industrial and economic enterprises. Existing inefficient production enterprises should be properly reorganized so that full employment may be achieved. In this way, the national economy will have more prosperity, and the people will benefit more from the Socialist policy.     

Rising Mortality in Hungary

Although Hungary is not alone in Eastern Europe in experiencing a rising death rate during recent years, this adverse development would seem to have progressed further there than in neighbouring socialist countries, with the possible exception of the Soviet Union. The Hungarian death rate has been rising since the mid-1960s in part because the population was ageing but, more significantly from the health point of view, because of a real increase in mortality among certain sections of the population. The age-specific death rates of males aged 15 and over were all higher in 1980 than in the mid-1960s, the increase being particularly marked for the age group 30–59; moreover, women aged 30–59 are also now beginning to display the same characteristic. In the paper the individual contributions of the various causes of death to these trends are examined and some of the factors that are thought to have enhanced the risk of dying are outlined.     

Income inequality and self-rated health status: Evidence from the european community household panel

We examine the effect of income inequality on individualś self-rated health status in a pooled sample of 11 countries, using longitudinal data from the European Community Household Panel survey. Taking advantage of the longitudinal and cross-national nature of our data, and carefully modeling the self-reported health information, we avoid several of the pitfalls suffered by earlier studies on this topic. We calculate income inequality indices measured at two standard levels of geography (NUTS-0 and NUTS-1) and find consistent evidence that income inequality is negatively related to self-rated health status in the European Union for both men and women, particularly when measured at national level. However, despite its statistical significance, the magnitude of the impact of inequality on health is very small.     

Cultural Connection Predicts Perceptions of Financial Security for Māori

This paper examines the impact of relative income on income satisfaction with given absolute income. We conducted an experiment in China where participants earned three different levels of income according to their relative performance in a task. While the treatment group was informed about their relative income, the control group only knew their own absolute income. We found that while controlling for absolute income and other factors, information about relative income increases the satisfaction of the high-income group and reduces the satisfaction of the low-income group. Relative income may interact with individual characteristics, such as gender, to affect income satisfaction. We also found that relative income treatment significantly increases income satisfaction inequality, primarily by causing social comparisons among different income groups, which has some welfare implications.     

Understanding the “Russian Mortality Paradox” in Central Asia: Evidence from Kyrgyzstan

In the former Soviet republics of central Asia, ethnic Russians have exhibited higher adult mortality than native ethnic groups (e.g., Kazakh, Kyrgyz, Uzbek) in spite of the higher socioeconomic status of ethnic Russians. The mortality disadvantage of ethnic Russians at adult ages appears to have even increased since the breakup of the Soviet Union. The most common explanation for this “Russian mortality paradox,” is that deaths are better reported among ethnic Russians. In this study, we use detailed mortality data from Kyrgyzstan between 1959 and 1999 to evaluate various explanations for the Russian mortality paradox: data artifacts, migration effects, and cultural effects. We find that the most plausible explanation is the cultural hypothesis because the personal behaviors that appear to generate a large part of the observed mortality differences (alcohol consumption, in particular) seem to be closely tied to cultural practices. We examine the implications of this finding for understanding the health crisis in post-Soviet states.     

The Centenarian Question: Old-Age Mortality in the Soviet Union, 1897 to 1970

There is a long history of claims of extraordinary longevity among the populations of the Soviet Union, and the Russian Empire before it, especially in the Caucasus region. Exceptionally high proportions of centenarians have been reported in the censuses, and much publicity has accompanied the announcements of ‘super-centenarians’ living well beyond 150 years. The major question regarding this phenomenon of supposed extraordinary longevity is whether the claims are, indeed, true or, rather, the result of age exaggeration. This paper examines the available Russian and Soviet census and mortality data from 1897 to 1970 in order to assess Soviet claims of extraordinary numbers of centenarians. A detailed analysis of age overstatement in the census data and death registration statistics shows that the long history of longevity claims goes hand in hand with a long history of age overstatement. The extraordinary longevity observed in the Soviet Union is in all likelihood the result of that age overstatement.