BBC, 15 January 2009 - The rapid mass privatisation which followed the break up of the Soviet Union fuelled an increase in death rates among men, research suggests. The UK study blames rapidly rising unemployment resulting from the break-neck speed of reform. The researchers said their findings should act as a warning to other nations that are beginning to embrace widespread market reform. The study features online in The Lancet medical journal. (Implications on India and China) The researchers examined death rates among men of working age in the post-communist countries of eastern Europe and the former Soviet Union between 1989 and 2002. They conclude that as many as one million working-age men died due to the economic shock of mass privatisation policies. Following the break up of the old Soviet regime in the early 1990s at least a quarter of large state-owned enterprises were transferred to the private sector in just two years. This programme of mass privatisation was associated with a 12.8% increase in deaths. The latest analysis links this surge in deaths to a 56% increase in unemployment over the same period. However, it found some countries with good social support networks withstood the turmoil better than others. Where 45% or more of the population were members of at least one social organisation, such as a church group or labour union, mass privatisation did not increase mortality. But Russia, Kazakhstan, Latvia, Lithuania and Estonia were worst affected, with a tripling of unemployment and a 42% increase in male death rates between 1991 and 1994. Countries that adopted a slower pace of change, gradually phasing in free-market conditions and developing appropriate institutions, fared much better. The best were Albania, Croatia, Czech Republic, Poland and Slovenia, which experienced only a 2% increase in unemployment - and a 10% fall in male mortality. Caution urged - The authors, led by sociologist David Stuckler, from Oxford University, wrote: "The policy implications are clear. "Great caution should be taken when macroeconomic policies seek radically to overhaul the economy without considering potential effects on the population's health." Researcher Professor Martin McKee, of the London School of Hygiene and Tropical Medicine, said the death rate was already high in the old Soviet Union, as the healthcare system was inadequate, while rates of smoking and alcohol use were high, and diets poor. This was compounded as the unemployment rate began to rise as workers suffered from uncertainty and stress. Not only does stress have a direct effect on health, it is also closely associated with unhealthy lifestyles, such as alcoholism. Together this raises the risk of heart disease and strokes, as well as mental illness. "The workplace also tended to provide what healthcare was available, along with social support," he said. "People got everything from work - and when they lost their jobs all that just went." In an accompanying article, Professor Martin Bobak and Professor Sir Michael Marmot, from University College London, said the findings were relevant today. "Countries in other regions are, and have been, undergoing economic and social transitions. "That the extent and speed of such changes are important is increasingly apparent." However, they stressed that the impact on health also depended on historical and political contexts. [http://news.bbc.co.uk/2/hi/health/7828901.stm] ** ECONOMIES EYEING RAPID PRIVATIZATION AT HIGHER RISK: STUDY Jacob P. Koshy, New Delhi, Jan 2009 http://www.livemint .com/2009/ 01/22223405/ Economies- eyeing-rapid- privati.html Countries that rapidly privatized their enterprises saw unemployment triple and mortality rates rise by as much as 42%. Economies that adopt rapid mass privatization of state-run enterprises may inherit a significant male mortality rate ranging from 8%-12%, says a study that has already triggered a sharp rebuttal from some experts. Though the study, to be published in the forthcoming issue of the international medical journal Lancet, relies on male mortality data from some East European countries and former Soviet republics, the authors warn that the research holds lessons for India, which launched economic reforms about 18 years ago. The study warns implications on China and India. Some experts have criticized the finding sharply The top five countries on the list—Russia, Kazakhstan, Estonia, Latvia and Lithuania—that rapidly privatized their enterprises saw unemployment triple and mortality rates rise by as much as 42%, said the Lancet report published online on 15 January. Countries that transitioned gradually—Albania, Croatia, the Czech Republic, Poland and Slovenia—posted a decrease in mortality rates by 10% and saw only a 2% rise in unemployment. The key factor that accelerated mortality rates was unemployment, followed by stress, a decrease in the quality of health care (which had previously been provided by workplaces), rising social inequalities, social disorganization and increased corruption. While previous studies have theorised about links between the nature of a country’s economy (capitalist or communist) and its effect on the populations’ health, Martin Mckee, co-author of the Lancet research said this is the first time there’s an empirical basis. “We’ve put numbers and for the first time linked mass privatization to mortality rates in these regions.” However, Jeffrey Sachs, professor at Columbia University and one of the architects of the economic reforms initiated by Russia, has challenged the claims set out by the researchers. In a letter published in the online edition of the Financial Times on 19 January, Sachs says, “The paper in question is a confused polemic that will not withstand serious epidemiological scrutiny.” According to him, life expectancy had been falling from the 1960s, prior to the transition, and worsened after “a collapse of a Russian-led empire, mass corruption, and chaotic political and economic conditions”. Although fast developing economies such as India, in the 18th year of its economic reforms programme and China were not studied, Mckee, who is a professor at the London School of Hygiene and Tropical Medicine, said they would be better off adopting a gradual pace of privatization. “The implications of this study are clear for countries such as China and India, which are starting to privatize large, state-owned sectors. The countries which phased in the changes gradually, and developed appropriate institutions aimed at helping workers to adjust, did not see these huge rises in male deaths,” he said. According to the latest statistics from the World Health Organization, India had an overall male mortality rate of 27.5%, significantly lower than those of the worst-performing European countries measured. However there’s a growing wealth of analysis suggesting a spurt in so-called lifestyle diseases, such as cardiovascular ailments and type-2 diabetes that are associated with increased carbohydrate intake—essentially a lack of proper nutrition. “There are no systematic studies, to my knowledge, on the impact of privatization on mortality in India,” said Rajat Kathuria, a researcher at the Indian Council for Research on International Economic Relations. “However, privatisation has been rather slow in India. Montek Singh Ahluwalia (deputy chairman, Planning Commission) authored a recent paper on the pace of privatization in India and emphasized that India was following a so-called gradualism approach. So in that sense, it’s unlikely that we would see that kind of spurt in mortality in India due to privatization.” But though absolute poverty showed a decreasing trend, there was a marked rise in inequality among social classes, said Kathuria, and if that was one of the factors responsible for a high mortality rate, India should be wary, he added.