Spatial variations in the Soviet health service.

Abstract

According to the familiar propaganda, the Soviet Union is a of nations and, to quote from the state anthem, a union of indissoluble republics. Arguably, it might also be identified as the last of the great empires, in which one half of the population rules over the numerous ethnic groups making up the other half. These mutually irreconcilable views are relevant to this article, since they both allow for a degree of autonomy in the development of health services in different parts of the USSR. We analysed data on the numbers of doctors, middle grade staff, and hospital beds in each of the 15 Union republics, which are the main divisions of the Union's territorial-administrative rtructure. (In constitutional theory they enjoy the status of sovereign nation states and have the right to secede from the USSR.) The period covered ran from 1950 to 1980, respectively the first and, currently, the last postwar year for which pub? lished data are available.1 During this period no discontinuity or historic break with the past occurred comparable with the inception of the National Health Service in the United Kingdom.