UPDATE: Thanks to Cecilia in the comments thread for pointing to this debunking of the Gessen piece, which argues that there has been 'a substantial and long-term improvement in the health of (Russia's) population' in the last fifteen years.
Did you know 'Male life expectancy at age fifteen in Russia compares unfavorably to that in Ethiopia, Gambia, and Somalia'?
Since the Soviet collapse, says Masha Gessen in this wonderful NYRB essay, Russia has suffered the longest peacetime period of depopulation of any country, ever. And nobody really knows why. Is it alcohol? Not really, since Russians drink less than Czechs, Slovaks and Hungarians, whose life expectancy has increased since the end of the Cold War. And it's not as if Russians have the fattiest diets or that health spending is exceptionally low.
So maybe Russians are just dying from a lack of hope. Here's the conclusion of the article:
Another major clue to the psychological nature of the Russian disease is the fact that the two brief breaks in the downward spiral coincided not with periods of greater prosperity but with periods, for lack of a more data-driven description, of greater hope. The Khrushchev era, with its post-Stalin political liberalization and intensive housing construction, inspired Russians to go on living. The Gorbachev period of glasnost and revival inspired them to have babies as well. The hope might have persisted after the Soviet Union collapsed—for a brief moment it seemed that this was when the truly glorious future would materialize—but the upheaval of the 1990s dashed it so quickly and so decisively that death and birth statistics appear to reflect nothing but despair during that decade.
If this is true—if Russians are dying for lack of hope, as they seem to be—then the question that is still looking for its researcher is, Why haven’t Russians experienced hope in the last quarter century? Or, more precisely in light of the grim continuity of Russian death, What happened to Russians over the course of the Soviet century that has rendered them incapable of hope? In The Origins of Totalitarianism Hannah Arendt argues that totalitarian rule is truly possible only in countries that are large enough to be able to afford depopulation. The Soviet Union proved itself to be just such a country on at least three occasions in the twentieth century—teaching its citizens in the process that their lives are worthless. Is it possible that this knowledge has been passed from generation to generation enough times that most Russians are now born with it and this is why they are born with a Bangladesh-level life expectancy? Is it also possible that other post-Soviet states, by breaking off from Moscow, have reclaimed some of their ability to hope, and this is why even Russia’s closest cultural and geographic cousins, such as Belarus and Ukraine, aren’t dying off as fast? If so, Russia is dying of a broken heart—also known as cardiovascular disease.