Nations or groups of nations can occasionally serve as natural experiments allowing us to see how certain factors that influence population health can change over time. For instance, available evidence suggests that Russia was much less healthy than the United States in 1900 but had mostly caught up in mortality outcomes by 1960, when progress languished. After the breakup of the Soviet Union in 1991 and the adoption of capitalist elements, mortality increased substantially in those nations and has not yet returned to the lower levels enjoyed previously (Walberg, et al, 1998). The vulnerable populations varied in different parts of the former Soviet Union as did the specific diseases responsible for the observed increase in mortality. The increase itself, however, is not in question. This suggests that a disease focus may not be the best way to address health in nations. This week, you examine the Russian experience and see how the dynamic is reflected in two other large eastern hemisphere nations, India and China.
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