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All of the former Soviet countries have followed the universal tendency for mortality to decline as infectious diseases are brought under control while death rates from degenerative diseases rise. What is exceptional in the former Soviet countries and some of their East European neighbors is that a subsequent increase in mortality from causes other than infectious disease has brought about overall rises in mortality from all causes combined. Another distinctive characteristic of the former Soviet case is the presence of unusually high levels of mortality from accidents and other external causes, which are typically associated with alcoholism (see Shkolnikov and Nemtsov, in this volume). The variations among republics conform broadly to expectations that mortality from infectious, digestive, and respiratory system disease is highest in the less-developed Central Asian republics and lowest in the Baltic countries and Belarus.
The next two sections of this chapter review data and measurement issues, respectively, that are encountered in examining mortality patterns in the NIS countries. Next we present results for mortality levels and cause of death. We then briefly examine mortality trends during the 10-year period, 1979-1989, preceding the breakup of the Soviet Union. The final section presents a discussion of the results.
Statistics on Mortality in the NIS Countries
The statistical agencies of the ex-Soviet countries share a common heritage of standard procedures and definitions imposed by the former State Committee on Statistics (Goskomstat) across the territories that comprised the Soviet Union. Certain distinctive aspects of this system's approach to the collection and measurement of mortality statistics impinge on the present analysis. While we share the cautious outlook of our colleagues in and out of the NIS with regard to the quality of official mortality statistics for these countries, we consider it appropriate to note at the outset that the statistical system of the former Soviet Union ranks above average by world standards and in some respects outperforms our own in the United States.2 This said, we turn to the complications engendered by former Soviet statistical conventions.
One of the most widely recognized idiosyncracies of former Soviet demographic statistics is the unusual set of definitions applied to the components of the infant mortality rate. Infants under 28 centimeters in length and weighing less than 1000 grams who died within the first week of life were excluded from both the numbers of live births and infant deaths according to the long-standing conventions of Soviet vital statistics (Boyarskiy, 1985). In contrast, the standard international definitions of the United Nations and the World Health Organization (WHO) consider as live births infants who exhibit some sign of life upon delivery (United Nations, 1985). Those definitions have the virtue of transpar-