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This book addresses fundamental issues about the last decades of Tsarist Russia, contributing significantly to current debates about how far and how successfully modernisation was being implemented by the Tsarist regime. It focuses on successive outbreaks of cholera in the city of Saratov on the Volga, in particular contrasting the outbreak of 1892 - widely regarded at the time as a national fiasco and a transformative episode for the Russian Empire - with the cholera epidemics of 1904-1910 when - despite completely new scientific discoveries and administrative arrangements - Russia suffered another national outbreak of the disease. The book sets these outbreaks fully in their social, economic, political and cultural context, and explains why a medical and social disaster - which had long since been overcome in other parts of Europe - continued much later in Russia. It explores autocratic government, urban renewal, public health, and disaster management, including the management of widespread public hysteria and social unrest. The book further analyses the assimilation of Western medical knowledge, and the resulting institutional and epistemological changes. Overall, it demonstrates that Russia's medical history was inseparably linked to the nature of the tsarist regime itself in its confrontation with modernity.

Of the many interwar connections between Germany and Russia, one of the most unusual - and least explored - is medicine and public health. Between 1922 and 1932, with high-level political support and government funding, Soviet and German physicians and public health specialists collaborated in joint research expeditions, published joint articles, launched a bi-lingual journal, and established joint research institutions. Surprisingly, students of Soviet-German relations have all but ignored this medical collaboration; while historians of science have treated it as political history, an exercise in cultural diplomacy designed to mitigate the impact of the post-war exclusion of both nations from the international science. The contributors to this volume, who come from Germany, Russia, Britain, the United States and Canada, depart from the traditional approach to the subject. Drawing on previously inaccessible archival materials, the authors move beyond politics to examine the impact of this collaboration on scientific activity. Contributors analyze aspects of the German-Russian collaboration often overlooked by students of cross-national science, including the choice of 'friends' across borders, the activities of scientific entrepreneurs, the tensions between bi-lateral and international science, and the migration of scientists. Treating Soviet-German medical relations as an instance of trans-national science lays bare its unique features. Ultimately,Doing Medicine Togetherraises new and important questions about the vaunted 'special' relation between Soviet Russia and Weimar Germany.

While many transnational histories of the nuclear arms race have been written, Kate Brown provides the first definitive account of the great plutonium disasters of the United States and the Soviet Union. She draws on official records and dozens of interviews to tell the extraordinary stories of Richland, Washington and Ozersk, Russia--the first two cities in the world to produce plutonium. To contain secrets, American and Soviet leaders created plutopias--communities of nuclear families living in highly-subsidized, limited-access atomic cities. Plutopia was successful because in its zoned-off isolation it appeared to deliver the promises of the American dream and Soviet communism; in reality, it concealed disasters that remain highly unstable and threatening today.

Under Stalin's leadership, the Soviet government carried out a massive number of deportations, incarcerations, and executions. Paradoxically, at the very moment that Soviet authorities were killing thousands of individuals, they were also engaged in an enormous pronatalist campaign to boost the population. Even as the number of repressions grew exponentially, Communist Party leaders enacted sweeping social welfare and public health measures to safeguard people's well-being. Extensive state surveillance of the population went hand in hand with literacy campaigns, political education, and efforts to instill in people an appreciation of high culture. InCultivating the Masses, David L. Hoffmann examines the Party leadership's pursuit of these seemingly contradictory policies in order to grasp fully the character of the Stalinist regime, a regime intent on transforming the socioeconomic order and the very nature of its citizens. To analyze Soviet social policies, Hoffmann places them in an international comparative context. He explains Soviet technologies of social intervention as one particular constellation of modern state practices. These practices developed in conjunction with the ambitions of nineteenth-century European reformers to refashion society, and they subsequently prompted welfare programs, public health initiatives, and reproductive regulations in countries around the world. The mobilizational demands of World War I impelled political leaders to expand even further their efforts at population management, via economic controls, surveillance, propaganda, and state violence. Born at this moment of total war, the Soviet system institutionalized these wartime methods as permanent features of governance. Party leaders, whose dictatorship included no checks on state power, in turn attached interventionist practices to their ideological goal of building socialism.

A number of indices exist to calculate lifespan variation, each with different underlying properties. Here, we present new formulae for the response of seven of these indices to changes in the underlying mortality schedule (life disparity, Gini coefficient, standard deviation, variance, Theil's index, mean logarithmic deviation, and interquartile range). We derive each of these indices from an absorbing Markov chain formulation of the life table, and use matrix calculus to obtain the sensitivity and the elasticity (i.e., the proportional sensitivity) to changes in age-specific mortality. Using empirical French and Russian male data, we compare the underlying sensitivities to mortality change under different mortality regimes to determine the conditions under which the indices might differ in their conclusions about the magnitude of lifespan variation. Finally, we demonstrate how the sensitivities can be used to decompose temporal changes in the indices into contributions of age-specific mortality changes. The result is an easily computable method for calculating the properties of this important class of longevity indices.

At the beginning of the 20th century, medicine as an academic discipline and a vocational training was quite similar in Russia and in western Europe. Most professors in Russian medical faculties had some international training. Pirogov, Sechenov, Mechnikoff, and Pavlov, just to name a few, were not only exceptional scientists but typical with their international training and research experience. Yet medicine as a service to the public was underdeveloped.

I examine the legacies of Soviet public health policy and the socialist health care system and trace how the Soviet past figures in contemporary Russian policymaking and debates about drug use, HIV, and abortion. Drug policies and mainstream views of HIV reflect continuities with key aspects of Soviet-era policies, although political leaders do not acknowledge these continuities in justifying their policies. In abortion policy, by contrast, which is highly debated in the public realm, advocates represent themselves as differing from Soviet-era policies to justify their positions. Yet abortion activists’ views of the past differ tremendously, reminding us that the Soviet past is symbolically productive for arguments about Russia’s present and future. I describe key aspects of the Soviet approach to health and compare how current drug policy (and the related management of HIV/AIDS) and abortion policies are discursively shaped in relation to the Soviet historical and cultural legacy.

Between the two world wars, Russia was transformed from a country with the highest mortality and morbidity rates in Europe, the lowest (relative to population size) number of physicians and other health professionals, and an embryonic pharmaceutical industry into one of the world's leading centers of medicine and public health, arousing admiration, envy, or censure throughout the world. HEALTH PROTECTION The Bolsheviks created a unique state system of zdravookhranenie (health protection) that integrated into a unified whole everything related to health: * medical practices and institutions, * health research and development, * epidemiological surveillance, * prophylactic measures, * manufacturing and distribution of pharmaceuticals and medical equipment, * specialized education and training, * sanitary infrastructure, and * propaganda. In \"A Revolutionary Attack on Tobacco,\" Starks (p. 1711) details the Narkomzdrav approach to tobacco as a health hazard and the agency's pioneering efforts to curb its use on a national scale by means of vigorous antismoking campaigns and special smoking-cessation programs.

Tuberculosis (TB) mortality declined in the northern hemisphere over the last 200 years, but peaked during the Russian (1889) and the Spanish (1918) influenza pandemics. We studied the impact of these two pandemics on TB mortality. We retrieved historic data from mortality registers for the city of Bern and countrywide for Switzerland. We used Poisson regression models to quantify the excess pulmonary TB (PTB) mortality attributable to influenza. Yearly PTB mortality rates increased during both influenza pandemics. Monthly influenza and PTB mortality rates peaked during winter and early spring. In Bern, for an increase of 100 influenza deaths (per 100,000 population) monthly PTB mortality rates increased by a factor of 1.5 (95%Cl 1.4-1.6, p<0.001) during the Russian, and 3.6 (95%Cl 0.7-18.0, p = 0.13) during the Spanish pandemic. Nationally, the factor was 2.0 (95%Cl 1.8-2.2, p<0.001) and 1.5 (95%Cl 1.1-1.9, p = 0.004), respectively. We did not observe any excess cancer or extrapulmonary TB mortality (as a negative control) during the influenza pandemics. We demonstrate excess PTB mortality during historic influenza pandemics in Switzerland, which supports a role for influenza vaccination in PTB patients in high TB incidence countries.

The Russian health system retains the main characteristics of the Semashko model of medical care, as it was delivered in the Soviet Union.1,2 This model grants all citizens the right to free medical care, and its proclamation in 1918 marked the first example of universal coverage in the world. An extensive network of public medical facilities was created to ensure this right to medical care, but in actual fact, access to medical care was not equal for all citizens. Employees of priority industries, residents of large cities, and officials were treated in medical institutions with the best equipment and staff.