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Read more at 'The Lancet'

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LISA MULLINS: A new study released today makes the link between health and economic change. The study focuses on how the collapse of the Soviet Union led to higher death rates of men in many former Communist countries. The study in the international medical journal “The Lancet” concludes that the rapid privatization of state-run companies was a major factor behind surging death rates. David Stuckler is the lead author of the study. He is now in Oxford, England. So, David, you're not saying communism good, capitalism bad for health?

DAVID STUCKLER: No. I certainly wouldn't want the headline to read “Capitalism Kills.” The point of our study was to build on previous research that had noted that unemployment and hazards of alcohol drinking were key drivers of rises in mortality. But to start thinking about why did some countries face such greater mortality surges than others did?

MULLINS: So what did you find out?

STUCKLER: There was a debate about how should reform proceed. And on one side, there was a group of top economic advisors that said the Soviet Union faced a tremendous political window of opportunity to make the leap over to capitalism, and that their claim was that if reforms were delayed, workers might try to block them and Russia and other soviet countries would end up with an inadequate form of market socialism or state capitalism. Well, on the other side was a camp of graduists who drew experience from China which didn't shatter all of the existing state institutions but instead allowed for a more gradual approach to reform. Privatization on such a large scale was truly unprecedented. Margaret Thatcher of Britain, the so-called “Great Privatizer,” in her 11-year tenure privatized 20, 30 firms. Russia, in the span of 2 years, was facing the challenge of having to privatize 200,000 state-owned firms.

MULLINS: So you specifically looked at the men of these various populations, and it's not just Russia. Give us a broader scope of what you found.

STUCKLER: Within five years after reform started, there were over 3,000,000 avoidable deaths, according to the United Nations. In some countries like Russia, life expectancy plummeted by five years. Whereas in others, such as Slovakia, for example, life expectancy went straight up.

MULLINS: How far can you go in saying what caused these deaths?

STUCKLER: We know that the rise in deaths was driven by heart attacks, strokes, suicides, homicides, largely accidents and alcohol-related mortality such as cirrhosis of the liver.

MULLINS: Could the argument be made that if the process had been done quickly and maybe correctly that these countries could have at least gotten the worst over with and there would be health benefits further on down the line?

STUCKLER: That was exactly the logic – short-term pain, long-term gain. In this study, we tested how painful was that short-term period? And it looks to have been devastating. As far as we can tell, in the data, there has been no sign that the countries that followed the rapid approach have fared any better than the countries that followed a slow route.

MULLINS: You know, right now these days, much of the world is going through a transition economically. There are countries in particular such as China and India and certainly Iraq, that are. Here in the United States there are to a lesser extent but still very palpable changes in the economy and changes in people's lives. Are we able to draw any lessons from the transition that you studied from communism to capitalism?

STUCKLER: I think one of the take home messages to our study is that it reminds us that whenever policies seek to radically re-haul the way a society is organized economically, that it can have very crucial consequences for health. The good news is that the shocks in the state aren't quite the one-two punch we saw in Russia where workers were put in a hard position while at the same time social safety nets were being shattered. I think this study has more implications for developing countries which still have large, state-owned sectors such as China and India, where similar reforms are on the table.

MULLINS: All right. Thank you. Professor David Stuckler, the lead author of a new study in the international medical journal “The Lancet.” The study argues that countries that made a rapid transition from communism to capitalism paid a big price when it came to the health, particularly of their male population. Professor Stuckler, thank you.

STUCKLER: Thanks for having me.

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