Non-communicable Disease in Russia: Impacts on Individuals, Families and the State
By Marleyse Borchard
Non-communicable diseases (NCD) such as diabetes, heart disease, cancer and lung disease, are a growing problem throughout the world and have very recently received international attention through a September 2011 UN High-level meeting on Non-communicable Diseases. 63% of all annual deaths globally are due to NCDs. Of the 36 million annual deaths from non communicable disease, one quarter are considered premature and preventable deaths (aged under 60 years). Russia, an upper-middle income country with extremely poor population health, is an example of a country where NCD deaths dramatically accelerate demographic decline and impact both individual lives and society.
Premature deaths from NCDs are not only a human security concern, they are a matter of concern for societies and states as they negatively impact productivity, constrain economic growth, and can lead to social challenges in countries. NCDs bring tremendous economic costs to societies and states through the loss of human capital and productivity due to morbidity and premature death of working age people, as well as through increased health care costs. NCDs erode the future options of societies and states by accelerating demographic decline and by setting up conditions for continuing cycles of poverty and historical health disadvantage for future generations.
While it makes intuitive sense that the health of societies impacts the strength of states, we do not have a conceptual framework linking NCDs to national security. In the past, investigators have successfully argued that infectious disease burden can impact state capacity and is therefore more than a “human security” threat, it is a “national security” threat as well. While NCDs are a growing concern internationally, it is necessary to determine the ways in which the growing NCD burden might impact societies and states. To do this, I ask whether there is evidence of greater non-communicable disease burden causing diminished state capacity in Russia. My research therefore seeks to propose a conceptual framework linking NCDs to state capacity and then to test one or two specific proposed pathways using Russian data. Possible pathways through which NCD burden might impact state capacity could be through the health of conscripts, diminished human resources to diversify the economy, worsening health of the workers, or declining educational outcomes for children.