low point since 1959, and in 1990 expectation of life at birth had substantially recovered from its earlier decline. We also look at data for Russia for 1992.

In the next section we discuss recent mortality trends in Russia and in Latvia. The situation in Russia has been an object of great concern. Latvia is also interesting because of the high level of economic development and the high quality of data. Most of the reported mortality levels and trends in Russia and Latvia probably reflect the actual mortality situation. We have not had data to use in making comparisons of regions below the level of the whole republic.14 However, other scholars have done this for provinces within Russia (Shkolnikov and Vassin, 1994; Velkoff, 1992; Velkoff and Miller, 1995). Recent data for the Baltic states, Russia, Ukraine, and Belarus are generally trustworthy, especially at the working ages. Data for other regions of the NIS, especially for Central Asia, Kazakstan, and Azerbaijan, are more problematic.15

Our discussion of Russia and Latvia is followed by an examination of the mortality situation in the four Central Asian states (Kyrgyz, Tajikistan, Turkmenistan, and Uzbekistan), plus Azerbaijan and Kazakstan. The health problems and high mortality in these areas deserve special attention, but we show that there are also serious problems with the mortality data from these areas that make the assessment of real trends in mortality highly problematic. Although recent mortality data are more accurate than those from earlier periods, we think that in many areas, even recent data portray a mortality situation substantially better than that which has actually occurred. We show the implausibility of the data through internal comparisons; comparisons with patterns in Russia and Latvia; and comparisons with the situation elsewhere in the world, especially in Sweden and among Uighurs, a traditionally Sunni Moslem, Turkic ethnic group in Xinjiang in northwest China.

Mortality Trends in Russia and Latvia

Mortality patterns in Russia have, of course, been the subject of great interest. Yet the study of Russian mortality has been hindered until recently by the lack of detailed published data. Although life tables were published for many other republics of the Soviet Union, life tables for Russia for the post-World War II period were not published until 1988 (for the years 1970-1971 and later). Hence, as the divergence between mortality trends in the Soviet Union as a whole and those in other developed countries became especially evident in the early 1970s (Vallin and Chesnais, 1974), it remained virtually impossible for scholars to identify the regional (republic) components of the Soviet trends, including Russia's contribution.

However, after examining age-specific death rates and expectation of life at birth for the Soviet Union as a whole and for individual republics, Dutton (1979) speculated correctly that poor survival of men in the Soviet-era Russian Federation was responsible for a large portion of the high mortality of men and for

The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement