Alexi Gugushvili

Mortality in Transition: Study Protocol of the PrivMort Project, a multilevel convenience cohort study

BackgroundPrevious research using routine data identified rapid mass privatisation as an important driver of mortality crisis following the collapse of Communism in Central and Eastern Europe. However, existing studies on the mortality crisis relying on individual level or routine data cannot assess both distal (societal) and proximal (individual) causes of mortality simultaneously. The aim of the PrivMort Project is to overcome these limitations and to investigate the role of societal factors (particularly rapid mass privatisation) and individual-level factors (e.g. alcohol consumption) in the mortality changes in post-communist countries.MethodsThe PrivMort conducts large-sample surveys in Russia, Belarus and Hungary. The approach is unique in comparing towns that have undergone rapid privatisation of their key industrial enterprises with those that experienced more gradual forms of privatisation, employing a multi-level retrospective cohort design that combines data on the industrial characteristics of the towns, socio-economic descriptions of the communities, settlement-level data, individual socio-economic characteristics, and individuals’ health behaviour. It then incorporates data on mortality of different types of relatives of survey respondents, employing a retrospective demographic approach, which enables linkage of historical patterns of mortality to exposures, based on experiences of family members. By May 2016, 63,073 respondents provided information on themselves and 205,607 relatives, of whom 102,971 had died. The settlement-level dataset contains information on 539 settlements and 12,082 enterprises in these settlements in Russia, 96 settlements and 271 enterprises in Belarus, and 52 settlement and 148 enterprises in Hungary.DiscussionIn addition to reinforcing existing evidence linking smoking, hazardous drinking and unemployment to mortality, the PrivMort dataset will investigate the variation in transition experiences for individual respondents and their families across settlements characterized by differing contextual factors, including industrial characteristics, simultaneously providing information about how excess mortality is distributed across settlements with various privatization strategies.

The effect of rapid privatisation on mortality in mono-industrial towns in post-Soviet Russia: a retrospective cohort study

Summary Background Population-level data suggest that economic disruptions in the early 1990s increased working-age male mortality in post-Soviet countries. This study uses individual-level data, using an indirect estimation method, to test the hypothesis that fast privatisation increased mortality in Russia. Methods In this retrospective cohort study, we surveyed surviving relatives of individuals who lived through the post-communist transition to retrieve demographic and socioeconomic characteristics of their parents, siblings, and male partners. The survey was done within the framework of the European Research Council (ERC) project PrivMort (The Impact of Privatization on the Mortality Crisis in Eastern Europe). We surveyed relatives in 20 mono-industrial towns in the European part of Russia (ie, the landmass to the west of the Urals). We compared ten fast-privatised and ten slow-privatised towns selected using propensity score matching. In the selected towns, population surveys were done in which respondents provided information about vital status, sociodemographic and socioeconomic characteristics and health-related behaviours of their parents, two eldest siblings (if eligible), and first husbands or long-term partners. We calculated indirect age-standardised mortality rates in fast and slow privatised towns and then, in multivariate analyses, calculated Poisson proportional incidence rate ratios to estimate the effect of rapid privatisation on all-cause mortality risk. Findings Between November, 2014, and March, 2015, 21 494 households were identified in 20 towns. Overall, 13 932 valid interviews were done (with information collected for 38 339 relatives [21 634 men and 16 705 women]). Fast privatisation was strongly associated with higher working-age male mortality rates both between 1992 and 1998 (age-standardised mortality ratio in men aged 20–69 years in fast vs slow privatised towns: 1·13, SMR 0·83, 95% CI 0·77–0·88 vs 0·73, 0·69–0·77, respectively) and from 1999 to 2006 (1·15, 0·91, 0·86–0·97 vs 0·79, 0·75–0·84). After adjusting for age, marital status, material deprivation history, smoking, drinking and socioeconomic status, working-age men in fast-privatised towns experienced 13% higher mortality than in slow-privatised towns (95% CI 1–26). Interpretation The rapid pace of privatisation was a significant factor in the marked increase in working-age male mortality in post-Soviet Russia. By providing compelling evidence in support of the health benefits of a slower pace of privatisation, this study can assist policy makers in making informed decisions about the speed and scope of government interventions. Funding The European Research Council.

Stalin is dead, long live Stalin? Testing socialization, structural, ideological, nationalist, and gender hypotheses

Recently, there has been a renewed focus on analyzing post-Soviet memory, including the rekindling of debate on contemporary perspectives of Josef Stalin. Most notably, the publication of The Stalin Puzzle has helped bring attention to the persistence of positive accounts and admiration, along with ambivalent and contested images, of the former dictator of the Soviet Union. Using survey data and multivariate statistical methods, we test five broad hypotheses – socialization, structural, ideological, nationalist, and gender – to ascertain what factors might shape peoples attitudes toward Stalin in Georgia. Our analysis reveals that elderly, poor men from rural areas have the most positive associations of Stalin, whereas young, wealthier women from cities, those who are open to privatization, and perceive Russia as Georgias biggest threat judge Stalin negatively. Counterintuitively, non-Georgian minorities show higher esteem for Stalin than Georgians. We envision that the effects of cohort replacement, economic development, and urbanization will decrease positive perceptions of Stalin in years to come.

Self-interest, Perceptions of Transition and Welfare Preferences in the New Eastern Europe and the South Caucasus

This article studies public welfare preferences in Armenia, Azerbaijan, Belarus, Georgia, Moldova and Ukraine. Generalised ordered logistic regression models and predicted probabilities are employed to analyse comparable attitudinal survey data. The results vary considerably among the countries, but age is the most important covariate of welfare preferences, followed by individuals’ socio-economic characteristics. The findings also indicate that popular perceptions of transition, notably in Ukraine and Moldova, are most strongly linked to preferences concerning the states involvement in reducing the gap between the rich and the poor rather than to preferences regarding the main welfare state programmes such as pensions and healthcare.

Intergenerational objective and subjective mobility and attitudes towards income differences: evidence from transition societies

This article explores the association between intergenerational social mobility and attitudes towards income differences in post-socialist societies. I hypothesise that based on the psychological mechanism of self-serving bias in causal attribution, those who experience upward social mobility are more likely to support greater income differences, and that subjective intergenerational mobility has stronger association with attitudes towards income differences than objective mobility because individuals filter their objective environment in order to derive their subjective perceptions of the world and their own experiences. The described hypotheses are tested with two cross-national data sets – European Values Studies and Life in Transition Survey. The derived findings are robust to alternative statistical specifications and indicate that individuals who perceive themselves as subjectively mobile have significantly different attitudes towards income differences in comparison to non-mobile groups, but that this effect does not manifest among objectively mobile individuals.

Economic Liberalization and Intergenerational Mobility in Occupational Status

One of the most important components of post-socialist transition has been economic liberalization. This article inquiries into how the latter is associated with intergenerational mobility in occupational status. Using European Values Studies (EVS) data from the nationally representative samples for a large number of post-socialist societies, the European Bank for Reconstruction and Development (EBRD) index of economic liberalization, and multilevel mixed-effects linear regressions, I test the “meritocracy as functional imperative” perspective which implies that life chances depend on the efficiency considerations of liberalized economy. The derived results are robust to alternative model and variable specifications and suggest that economic liberalization explains cross-national differences in intergenerational status reproduction, and is better suited for macro-sociological models of mobility in occupational status than other conventional contextual explanations such as economic development and income inequality

Unconditional love? Exploring hometown effect in Stalin's birthplace

This article explores the impact of spatial location – place – on peoples attitudes by examining whether support for Stalin is concentrated in his birthplace: Gori, Georgia. Using a variety of multivariate statistical methods, including propensity score-matching, we examine a recent survey indicating high levels of admiration for Stalin in his home country. We explore two main questions: First, is there a “hometown effect” – do people in Gori love Stalin unconditionally because they came from the same place? Second, is Gori so exceptional from the rest of Georgia? We conclude that there is indeed a stronger level of support for Stalin in Gori, but when shifting scales and looking within the category, we find that the highest admiration stems from the towns rural outskirts.

Political democracy, economic liberalization, and macro-sociological models of intergenerational mobility

Building on the previously investigated macro-sociological models which analyze the consequences of economic development, income inequality, and international migration on social mobility, this article studies the specific contextual covariates of intergenerational reproduction of occupational status in post-communist societies. It is theorized that social mobility is higher in societies with democratic political regimes and less liberalized economies. The outlined hypotheses are tested by using micro- and macro-level datasets for 21 post-communist societies which are fitted into multilevel mixed-effects linear regressions. The derived findings suggest that factors specific to transition societies, conventional macro-level variables, and the legacy of the Soviet Union explain variation in intergenerational social mobility, but the results vary depending which birth cohorts survey participants belong to and whether or not they stem from advantaged or disadvantaged social origins. These findings are robust to various alternative data, sample, and method specifications.

Intergenerational Mobility in Relative Educational Attainment and Health-Related Behaviours

Research on intergenerational social mobility and health-related behaviours yields mixed findings. Depending on the direction of mobility and the type of mechanisms involved, we can expect positive or negative association between intergenerational mobility and health-related behaviours. Using data from a retrospective cohort study, conducted in more than 100 towns across Belarus, Hungary and Russia, we fit multilevel mixed-effects Poisson regressions with two measures of health-related behaviours: binge drinking and smoking. The main explanatory variable, intergenerational educational mobility is operationalised in terms of relative intergenerational educational trajectories based on the prevalence of specified qualifications in parental and offspring generations. In each country the associations between intergenerational educational mobility, binge drinking and smoking was examined with incidence rate ratios and predicted probabilities, using multiply imputed dataset for missing data and controlling for important confounders of health-related behaviours. We find that intergenerational mobility in relative educational attainment has varying association with binge drinking and smoking and the strength and direction of these effects depend on the country of analysis, the mode of mobility, the gender of respondents and the type of health-related behaviour. Along with accumulation and Falling from Grace hypotheses of the consequences of intergenerational mobility, our findings suggest that upward educational mobility in certain instances might be linked to improved health-related behaviours.

Parental transmission of smoking among middle-aged and older populations in Russia and Belarus

ObjectivesThe very high rates of smoking among men and the rapid changes among women in the Post-Soviet countries mean that this region offers an opportunity to understand better the intergenerational role of parental influences on smoking.MethodsIn this study, we exploit a unique data set, the PrivMort cohort study conducted in 30 Russian and 20 Belarusian towns in 2014–2015, which collects information on behaviours of middle-aged and older individuals and their parents, including smoking. We explored the associations between smoking by parents and their offspring using multiply imputed data sets and multilevel mixed-effect Poisson regressions.ResultsAdjusting for a wide array of social origin, socio-demographic, and socio-economic variables, our analysis suggests that sons of regularly smoking fathers have prevalence ratios of 1.35 [95% confidence intervals (CI) 1.21–1.50] and 1.39 (CI 1.23–1.58) of smoking, while the figures for daughters of regularly smoking mothers are 1.91 (CI 1.40–2.61) and 2.30 (CI 1.61–3.28), respectively, in Russia and Belarus.ConclusionsIntergenerational paternal and maternal influences on smoking should be taken into account in studies seeking to monitor the rates of smoking and the impact of tobacco control programmes.