During the Cold War, life expectancy in Russia was only slightly lower than in the United States. But as the decades of political and military tension between Moscow and Washington wore on, a real—and widening—mortality gap emerged. The gap narrowed in the 1980s with Mikhail Gorbachev’s policy of perestroika(and its attendant focus on public health). But following the Soviet collapse, Russian life expectancy again plummeted, dropping some 6.6 years for men and 3.3 years for women between 1989 and 1994. ¹⁵

While the mortality rates of most other countries affected by the USSR’s crack-up have largely stabilized, Russian life expectancy has remained low. In 2004, Russia ranked 122nd in the world in life expectancy, placing it in the bottom third of all nations and far outside the norm for industrialized ones. ¹⁶By 2011, that number had plunged some twenty-two places, to 144th. ¹⁷The average life expectancy for Russian citizens is now seventy years, putting them behind the citizens of Peru and Tonga (average life expectancy: seventy-one) and only slightly ahead of those in countries such as Tuvalu, Mongolia, and North Korea. ¹⁸

Russian males have been particularly hard-hit. On average, they can expect to live just sixty years—less than their counterparts born in Botswana, Madagascar, and Yemen. The life expectancy of Russian males is, generally, a decade and a half shorter than those in other industrialized nations. ¹⁹

The situation for Russian women is slightly better. Females there can expect to live until they are seventy-three, roughly the same age as women in neighboring Kazakhstan or in Saudi Arabia and Indonesia. ²⁰But, like Russian men, Russian women have nothing resembling the life expectancy of their counterparts in the West.

Russia’s plummeting life expectancy is counterintuitive. “The Russian experience grates against conventional wisdom about the progress of global health and social standards over the last century,” Nicholas Eberstadt and Apoorva Shah of the American Enterprise Institute have written. “It is unprecedented for a well-educated, modern European society to mimic mortality rates of a Third World country.” ²¹And yet, that is exactly what Russia has done.

The causes are many, from poor healthcare to rampant alcoholism, particularly among Russian men. Russian scientists estimate that one in five male deaths in Russia today is alcohol-related. ²²And while alcoholism is a problem across Russian society, the country’s youth are disproportionately affected. Alcoholism among Russian youth contributes to a death rate at age thirty-five that is seven times that found in the European Union, according to Yuri Krupnov, director of Moscow’s Institute of Demography, Migration and Regional Development. ²³

Russia’s drinking problem may be contributing to its decline, but it’s not the only factor. Russia is coming apart at a more fundamental level.

COLLAPSE OF THE RUSSIAN FAMILY

During the early part of the Cold War, the harsh realities of life under Communist rule kept families unified and tightly knit. Communal apartments, colloquially known as komunalki, were typical, as was having multiple generations of one family living under the same roof. In 1958, divorces in the USSR were virtually nonexistent—just 0.9 per one thousand citizens. ²⁴By the end of the 1970s, that rate had risen slightly to 3.6 per one thousand. ²⁵But Soviet-era restrictions on individual mobility, coupled with widespread economic hardship, helped keep most families together.

By contrast, the past two decades of freewheeling capitalism and post-Communist disorder have coincided with a collapse of the Russian family. According to the UN’s 2011 Demographic Yearbook, Russia now has the highest divorce rate in the world, with half of all unions ending in divorce (and 60 percent of those dissolving within the first decade). ²⁶

This does not mean that Russians are not procreating. Far from it, as the abortion rate (discussed below) indicates. It suggests, rather, that nuclear families with multiple children are quickly becoming an endangered species in Russia.

A CULTURE OF ABORTION

Under Communist rule, abortion was the only practical method of birth control available to Soviet citizens, and it was employed extensively. In 1964, there were 278 abortions for every one hundred live births in the USSR, a rate that far outpaced those in the West. ²⁷Russia’s abortion rate remained high through the 1970s and 1980s, with the number of abortions exceeding 4.5 million annually. ²⁸

Russia’s abortion rate gradually began to decline as Soviet authorities—and then Russian ones—became more conscious of the negative effects of abortion, and more restrictive in its authorization. In 2006, for the first time, the trend reversed, with ninety-five abortions for every hundred live births. ²⁹

But this progress is relative. Russia still has the highest abortion rate in the world. In 2010, 1,186,000 abortions were performed in Russia—that’s three hundred abortions every hour. ³⁰It also means that close to one percent of the country’s population is being aborted every year—literally killing chances for positive population growth in the process.

But the official estimates may not capture the true extent of Russia’s abortion culture. According to Igor Beloborodov of Moscow’s Institute of Demographic Studies, the actual number of annual abortions performed in Russia is as much as double the official figure—some 2 to 2.5 million in all—owing to “a vast layer of private clinics” that carry out the procedure in parallel to official hospitals and facilities. ³¹If Beloborodov’s tally is accurate, then the true cost of Russia’s abortion culture is the annual termination of close to 2 percent of the Russian Federation’s potential population. In a real sense, Russians are aborting their future.

AN AIDS EPIDEMIC

HIV/AIDS first appeared in Russia later than it did in other parts of the world, in part because of a lack of mobility and travel among the captive population of the Soviet Union during the Cold War. Russia registered its first cases of HIV/AIDS in 1987—half a decade after the disease became prevalent in the West. ³²

Once AIDS did arrive in post-Soviet Russia, however, it spread quickly. By the end of the 1990s, documented cases of AIDS in the Russian Federation stood at approximately twenty thousand. Less than a decade later, Russian experts began calling their country’s encounter with HIV an epidemic. “We have an estimate of up to 1.2 million to 1.3 million infected with HIV,” Vadim Pokrovsky, head of the Russian government’s AIDS center, told reporters in May 2007. ³³“Not only is the number of Russians infected with HIV rising but there is an increase in the rate at which the epidemic is spreading, so [there is] a rise in the number of newly infected.” ³⁴

Blood infected by HIV, the virus that causes AIDS, spreads easily when people share equipment to use drugs. Some 2.5 million Russians are estimated to be addicted to drugs today, with heroin as the overwhelming drug of choice. ³⁵According to the UN Office of Drugs and Crime, Russian consumption accounts for more than a fifth of all heroin consumed globally every year. This trend has contributed greatly to the spread of AIDS in Russia. According to a 2012 briefing paper compiled by the International AIDS Society, more than one third of the country’s users of injectable drugs have HIV. ³⁶

Over the past decade, AIDS-related deaths in Eastern Europe and Central Asia have skyrocketed, increasing elevenfold since 2001. Russia and Ukraine cumulatively accounted for roughly 90 percent of the ninety thousand AIDS deaths in the region in 2010. ³⁷That statistic stands out even more when compared with the rest of the world, where AIDS deaths have fallen by more than a fifth since their peak in 2005. ³⁸In other words, while the rest of the world is beginning to win the battle against AIDS, the Russian Federation is increasingly succumbing to it.