Russia has one of the world's highest alcohol-related death rates. In fact, if you look at deaths from alcohol use disorders in Europe, there is a clear East-West gradient. Death rates are higher in the East, and lower in the West (source):
What causes this difference in death rates? The obvious culprit is alcohol consumption (duh!). But when you look at alcohol consumption per capita, it is actually slightly higher in Western Europe than in Eastern Europe:
What gives? Is there something different in the way that people are drinking in Eastern Europe from Western Europe that explains higher death rates in the East than the West, even though there is more drinking in the East?
That is what I initially hoped I would learn from this 2018 article by Gintare Malisauskaite and Alexander Klein (both University of Kent), published in the Journal of Comparative Economics (ungated version here). They look at the role of exposure to Communism on alcohol consumption (but not alcohol-related mortality). Their premise may be a little bit faulty though, since they start from a suggestion that drinking is higher in the East, when the data above show the opposite (charitably, I guess we could say this fact is contested).
Malisauskaite and Klein use data on around 36,000 people from the European Health Interview Survey (EHIS), collected between 2006 and 2009. The number of countries included is somewhat limited:
Due to the availability of alcohol consumption data, countries included in our estimations were: Cyprus, Greece, Malta (Western) and Bulgaria, Czech Republic, Hungary, Poland, Romania, Slovenia, Slovakia (Eastern).
Do Cyprus, Greece, and Malta count as Western Europe? I guess, maybe? Personally, I'd probably refer to them as Mediterranean or Southern Europe (as I did in the title to this post), rather than Western Europe. Looking at the map of alcohol consumption, those three countries definitely have lower alcohol consumption than Western Europe, and Eastern Europe as well. The big drinking Western European countries (Germany, Ireland, and France) are all excluded. That might be the basis for Malisauskaite and Klein's initial claim of higher drinking in Eastern Europe.
Anyway, Malisauskaite and Klein look at the relationship between alcohol consumption (and binge drinking) and exposure to Communism. They measure exposure to Communism in two ways:
...one indicating whether an individual lived in the Eastern Bloc between age 18 and 25, the other the number of years lived in a communist regime.
Looking at men and women separately, they find that:
...both variables capturing exposure increase the probability that women consume alcohol more frequently. In the case of men, the number of years spent under communism has a sizeable significant effect. Overall, however, the effect of communism on alcohol consumption frequency is larger for women. Binge drinking, on the other hand, shows interesting gender differences: communist regimes have no effect on women's binge drinking behaviour, but affect men. Binge drinking results for men suggest that exposure during formative years could play a more important role than number of years spent in the regime.
The effects are pretty small. For example, growing up in a Communist country increases the probability of drinking every day by 0.4 percent for both women and men. Certainly, that's not enough to explain much of the mortality gap, even setting aside the unusual comparison group. I'm not sure that this research really adds much to our understanding of these differences, especially since, as Malisauskaite and Klein acknowledge in their conclusion:
...we cannot pinpoint the exact reason why or the way in which experiencing communist regimes could have influenced drinking norms...
So, we really don't know how much exposure to Communism contributes to drinking. A more appealing approach would be to look within, rather than between, countries. For example, research could compare Germans on either side of the border, before and after the fall of the Berlin Wall. That abstracts somewhat from underlying cultural differences, although there are other differences between East and West Germany that would be difficult to control for. It's not perfect, but the results might be more defendable. If only those data were available.
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