Field M G
Russian Research Center, Harvard University, Cambridge, MA 02138, USA.
Soc Sci Med. 1995 Dec;41(11):1469-78. doi: 10.1016/0277-9536(95)00060-k.
Observers of the Soviet health and demographic scene have noted that many of the phenomena (particularly mortality) were unprecedented in 'peace time.' In fact, the Cold War (or Third World War) was 'war time,' although not in the conventional military sense (it was ideological, political and economic warfare). The health crisis in the former Soviet Union is partly the result of that lost conflict by the Soviet side due to its inability to match the West in defense outlays and to provide for the needs of the civilian sector. Health conditions began to deteriorate in the late sixties, and were exacerbated by the collapse of the Soviet Empire in late 1991. These were reflected in increasing mortality and morbidity, decreasing natality, a deteriorating health service, and an environment ruined by the heedless drive toward industrialization and militarization. This resulted in a 'systemic' breakdown of the Soviet system, not only its health care structure. The situation of the former Soviet Union is that of a country that has suffered a humiliating national defeat with all the consequences of a 'post-war' situation, including inflation, anomie and social polarization. The health crisis is likely to get worse, and will not be resolved until a viable political, economic and social order is established. Today's deteriorating health and demographic situation will create 'echo' problems in the decade to come.
观察苏联健康与人口状况的人士指出,许多现象(尤其是死亡率)在“和平时期”是前所未有的。事实上,冷战(或第三次世界大战)就是“战争时期”,尽管并非传统军事意义上的战争(而是意识形态、政治和经济战争)。前苏联的健康危机部分是由于苏联一方在那场失败的冲突中无力在国防开支上与西方抗衡,也无法满足民用部门的需求。健康状况在60年代后期开始恶化,并因1991年末苏联帝国的崩溃而加剧。这些表现为死亡率和发病率上升、出生率下降、医疗服务恶化,以及因盲目追求工业化和军事化而遭到破坏的环境。这导致了苏联体系的“系统性”崩溃,不仅是其医疗保健结构。前苏联的情况就像是一个遭受了屈辱性国家失败的国家,有着“战后”局面的所有后果,包括通货膨胀、社会失范和社会两极分化。健康危机可能会恶化,并且在建立起可行的政治、经济和社会秩序之前都无法得到解决。如今不断恶化的健康与人口状况将在未来十年引发“连锁反应”问题。