Opinion: Belarusan state is adding to high death rate by keeping price of alcohol and tobacco low

Authoritarian regimes have no interest in promoting human development because they do not need to maintain the support of a majority of the electorate to win elections, Volha Charnysh writes.

Over the past two decades, the Belarusan population declined by nearly seven percent. By 2050, demographers are predicting an over 30% decline.

The shrinking pool of Belarusans is in part driven by a high death rate. While Belarus has converged with Western Europe in terms of fertility, it ranks well behind the developed and even developing world on mortality measures.

Premature death is much likelier among men in Belarus than in neighbouring EU states–the probability is 1.7 times higher than in Poland, and 2.5 times higher than in the Czech Republic.

The Belarusan government has sought to address the demography problem by stimulating the birth rate. Ambitious plans such as rewarding the birth of the third or subsequent children with a $10,000 USD allowance were debated at 21 August meeting on state support for families with children.

Minsk has done nothing to combat high mortality, however. In fact, the authorities are contributing to the high death rate by keeping the price of alcohol and tobacco low.

Out of Pace with the rest of the world

Over the last six decades, life expectancy has been rising across the globe. For a long time, Eastern Europe was no exception – that is, until the Berlin Wall fell in 1989.

After 1989, life expectancy continued to rise in the post-Communist states that were on track for the EU membership. In post-Soviet states, by contrast, life expectancy gains were reversed. Russia experienced the starkest reversal, with male life expectancy falling by 6 years between 1990 and 1994.

In Belarus, life expectancy also declined, albeit at a slower pace. Belarus today has the dubious distinction of ranking 140th in the world in life expectancy and 15th in mortality.

The situation is particularly bad for Belarusan men. The country’s male life expectancy was higher than the global average in the 1960s. Today it is two years below the world average.

Why Are Belarusan dying?

A leading cause of death in Soviet times, coronary heart disease, has risen in post-Soviet Belarus due to unhealthy lifestyles and eroding healthcare systems. According to the 2012 edition of the European Cardiovascular Disease Statistics, coronary heart disease accounts for 36% of deaths among Belarusan men, ranking Belarus a narrow second behind Ukraine (38%) in the post-Soviet space.

Risk factors for coronary heart disease include smoking, alcoholism, and obesity. Belarusans indulge in all of these unhealthy activities. In 2014, the World Health Organisation ranked Belarus first in the world in alcohol consumption. The country has the highest share of young cigarette smokers in the post-Soviet space. Belarus also leads Europe in the share of obese and overweight women.

About half of Belarusans who die prematurely have been smoking, drinking, or both. An average middle-aged Belarusan has anywhere between 3 to 7 chronic diseases, according to a study by Belarus’s Republican Centre for Cardiology.

Dying from the Soviet past?

At first glance, the dramatic decline in life expectancy seems to have started with the collapse of the Soviet Union. Belarusans started drinking - and dying - in greater numbers in response to political, social and economic changes of the early 1990s.

At the same time, contemporary mortality trends exhibit many features that were already present in the 1980s. In particular, coronary heart disease was a prevalent cause of death already in Soviet times. Alcoholism was a serious enough problem for Mikhail Gorbachev to launch a campaign against alcohol abuse. Following the Soviet collapse, unhealthy behaviors became even more widespread while the health care systems weakened, producing a demographic crisis.

The Belarusan government delayed market reforms even as other post-Soviet states began experimenting with liberalisation. Initially, Belarus experienced a more moderate rise in death rates than its neighbours. At the end of the day, however, Belarus’ gradualism seems to have prolonged the decline in death rates.

How Belarusan policies increase the death rate

The Belarusan government recognises the country’s demographic problem. Its policies have had divergent effects on the country’s demographic situation, however. On the one hand, President Alyaksandr Lukashenka has consistently emphasised the need to increase birth rates.

On 21 August he stated that “two children are mandatory, but having three or four children needs stimulation” and promised to redirect money from “unjustified benefits” to support large families.

On the other hand, the Belarusan government keeps alcohol and cigarette prices low. State-led campaigns to combat alcoholism have been inconsistent and limited. Because alcohol is very cheap in Belarus, losers of the current economic and political situation drown their sorrows in a bottle of vodka instead of going to the square to protest.

Does Belarus need democracy to Live longer and healthier?

In 1999 Nobel Prize winning economist Amartya Sen famously remarked that “[n]o famine has ever taken place in the history of the world in a functioning democracy.” Indeed, a growing number of studies show that democracies are more likely to adopt inclusive health care policies and improve the socio-economic wellbeing of their populations.

Authoritarian regimes, on the other hand, have no interest in promoting human development because they do not need to maintain the support of a majority of the electorate to win elections.

Perhaps it is not surprising that the Belarusan state has focused on increasing birth rates instead of extending life expectancy. First, it is much harder to reduce death rates by reforming the health care system and improving life standards than it is to dole out money for families with children. Second, high death rates mean less public spending to care for the elderly.

What is more, raising alcohol prices is a highly unpopular measure. Supporting families, by contrast, creates the impression that the state truly cares about its people.

In a recent article in the New York Review of books, Russian-American pundit Masha Gessen asked why Russians are dying “at ages, and of causes never seen in any other country that is not, by any standard definition, at war.” She concludes that Russians are dying “for lack of hope.”

Even though Russia’s demographic situation is now somewhat less dire than Gessen admitted in the article, her main observation could apply to many other post-Soviet states. Lack of hope – for a better economic and political future – might have something to do with why Belarusans are drinking – and dying, too.

Originally published at BelarusDigest