The policies pursued by the Soviet Union and its satellites in central and eastern Europe have had profound implications for health. 1 2 By 1990 the probability of people dying before the age of 65 in the Soviet Union was twice that for western Europe, and for the communist countries of central and eastern Europe it was 70% higher compared with western Europe.3

Men were especially susceptible to dying prematurely. Although men in all industrialised countries live shorter lives than women, in the Soviet Union the gap between the sexes was especially large. In 1990 the life expectancy of men living in the Soviet Union was only 64 years—nine years less than in western Europe. Soviet women could expect to live to 74 years—10 years longer than men and only six years less than women in western Europe. The disadvantage in life expectancy relative to western Europe was less for countries of central and eastern Europe, but even there the gap was six years for men and five years for women. The travel writer Colin Thubron, after meeting an old woman in a village in western Siberia, observed for himself the reality that “in her experience, men died young.”4