Does Alcohol Matter? Public Health in Russia and the Baltic Countries Before, During, and after the Transition

Abstract

Since the mid-1980s public health in Russia and the Baltic countries has shown vast fluctuations. After a notable improvement during the second half of the 1980s, the early 1990s saw a dramatic deterioration with soaring mortality rates. This article describes some particularities of this rise and fall in public health, primarily concerning age, gender and cause of death, which have been remarkably similar in all four countries. The article identifies three phases in the development in alcohol policy and alcohol consumption, and in public health as such, during the past 15 years. There are many questions and few definite answers concerning the driving forces behind the recent public health turbulence, but developments are frequently related to two important events: the anti-alcohol campaign during the 1980s, and the economic and political transition following the breakup of the Soviet Union. Although the public health crisis is a result of unique historical experiences, there are general lessons to be learned, and the similarity in trends is noteworthy. Moreover, internationalization will enhance a certain convergence in consumption patterns and policy responses in the future, although local provisions will ensure a certain diversity in policies.