ABSTRACT
One of the most significant developments in world health in the latetwentieth century is the decline in life expectancy in the former Soviet Union and Eastern Europe. This situation is without precedent in modern history. Nowhere else has health worsened so seriously in peace-time among industrialized nations. Ironically, these countries sponsored a communist ideology of socioeconomic equality that theoretically should have promoted health for all. However, the reverse occurred, and life expectancy for many people has been declining for over three decades. This is a surprising development. The likelihood that an entire group of industrialized societies under a stable administrative system would experience such a prolonged deterioration in public health was completely unexpected (Eberstadt 1994:217). Not only is this circumstance a health disaster for the individuals and societies involved, but it also represents an intriguing puzzle to be solved since a full explanation about why this happened has not been forthcoming (Eberstadt 1994; Makara 1994).
