Social Issues: Health, Wealth, Poverty, and Crime

Social geography” looks at many aspects of people's daily lives as expressed in their engagement with and movements through space. It encompasses both traditional customs and modern developments. At the outset, it is important to note that social issues can be understood both objectively (as, for example, when one looks at statistics on health or crime) and subjectively (when one perceives things in a certain way, based on his or her cultural upbringing, information received from peers or the mass media, and personal biases). Take the media impact, for example. The former Soviet Union (FSU) is frequently portrayed in the Western media as a rough place plagued by crime, drug use, violence, and corruption. To an American or Western European these days, the very word “Russia” conjures up images of roaming street gangs, ubiquitous disease, corrupt autocratic leaders, and hopeless human misery. Consider this, however: If your only image of New York City was formed by TV reports of gang wars in Queens, would you consider spending any time there? Reality is usually multifaceted, and this truth is nowhere as obvious as in the geography of social issues—be it health, disease, wealth, poverty, crime, or any other issue.

This chapter focuses primarily on the objective patterns of three main social issues in Northern Eurasia today. For an understanding of how the FSU got to this point in regard to these issues, see the chapter on Yeltsin's and Putin's reforms. If you travel through the region, or when you read the travel accounts of others, you will have a chance to form a more personal view of the social situation there. There are also many research articles available written by scholars who have lived and observed social issues in the FSU, some of which are listed at the end of this chapter. Although many different social patterns in the countries of the FSU could be discussed, this chapter looks only (because of space limitations) at three major ones: health, income distribution (and associated unemployment and gender issues), and crime.

The Soviet Health System

The Soviet Union had what was arguably one of the best health care systems in the world. Surprised? If you have seen Michael Moore's film Sicko, you may not be: Moore depicts Cuba as an example of a socialist state with a free, universal health care system that has produced impressive results. This is something many Americans and even some Europeans have a hard time imagining. First, if all this is free, then who is paying the bill? Also, if all of this is universal, how are priorities set? Who gets treated first or most, for example? Is the quality of care adequate? Do people need to wait in a long line to see a doctor? Do the doctors make a decent living? Are the nurses caring and well trained? Do the patients have a choice of doctors or clinics? How is all of this possible?

During the Soviet period, the socialist government owned and ran everything, including the entire health care system. The right to free health care was listed as one of the fundamental human rights in the constitution. The state paid for it, because it made political, economic, and social sense to do so. Sick workers do not work well; sick teachers do not teach well; sick soldiers do not fight well. Instead of forcing people to choose among clinics or doctors based on their income, insurance policies, or personal taste, the system simply provided all with basic care through either their place of residence or their employment. By and large, the care was decent. A Soviet worker who came down with flu, for example, just needed to dial the local clinic's phone in the morning and stay in bed; the physician on call would come and visit the worker at home, usually later that same day. Physicians were accustomed to spending about half of their workday making house calls. Typically, with a common illness, one could receive a doctor-approved excuse from work, while keeping 100% of pay for 7 days. If something more serious was detected, the doctor could prescribe home rest for 2–3 weeks, or send the person to the hospital.

As far as the choice of clinics was concerned, one could go only to the local polyclinic with multiple doctors of various specialties right in one's neighborhood (rather like a health maintenance organization [HMO] in the United States today), or get treated at the factory or institute clinic. Some highly specialized treatments (e.g., laser eye surgery, pioneered by the famous Feodorov Clinic in Moscow in the 1970s) had long waiting lists, but were available on a referral basis for free. Life-threatening diseases would be treated right away, however. The Soviet doctors received free education, so they had no student loans to pay back, but they were expected to work long hours for relatively low pay at the clinics to which they were assigned. Transfers and promotions were rare. An average doctor's salary was comparable to that of many qualified factory workers, about 200–250 rubles per month for a good specialist; nurses received about half that. Many world-class surgeons in the best national hospitals in Moscow or Kiev would work for a small fraction of the possible pay in the West, but their jobs were guaranteed and there were no threats of litigation. The quality of their work was very high, although medical equipment and drugs (with few exceptions) were less advanced than in the West. In reference to the poor quality of after-surgery care in many hospitals, the common late Soviet joke was that the doctors would save your life, but the nurses would kill you. Relatives of patients undergoing major surgery would typically bring a small gift to the surgeon (a bottle of good brandy or a box of chocolates was common). Of course, the party elite had their own clinics, sanatoria, doctors, and the very best equipment, purchased for hard currency in the West.

By the end of the Soviet period, the U.S.S.R. had the highest ratio of doctors to patients in the world, about 1 physician per 233 people (the United States has about 1 per 435 today). Eighty-six percent of the medical staff were female: The Soviet system encouraged women to consider medical careers early on, and the prevailing culture favored that idea too, because of the stereotype that women are more compassionate and better suited for caregiving than men (Hughes, 2005). The predominance of women was also related in part to the relatively low wages Soviet medical specialists received in exchange for a lot of very hard work. Surgeons were usually male, but family physicians and nurses were overwhelmingly female.

The Soviet Union also had one of the longest average hospital stays in the world, because home care was viewed as inherently inferior, while hospital beds were free. A typical hospitalization would last for 2–3 weeks, and frequently over a month. Another common feature was an emphasis on prophylaxis: Vaccination rates were among the highest in the world, and every child and adult was expected to have a physical checkup and a dental exam at least once per year. All of this did not make the U.S.S.R. the healthiest place on the planet; environmental pollution, stress, poor working conditions, and high alcoholism rates all took their toll. The average Sоviet lifespan in 1990 was 69.5 years—well below the U.S. rate of 75 years in 1990, but respectably in the upper third of the world, and well above the expectancies in most African, Asian, or Latin American countries.

Post-Soviet Declines in Health Care and Health

Since the fall of the Soviet Union, there has been a major decline in health care availability. The results in Russia have included a huge slump in life expectancy; an increase in most diseases; the reemergence of previously suppressed diseases such as tuberculosis (TB), polio, and diphtheria, due to a decline in vaccinations; a surge in HIV/AIDS; and many other indicators suggesting a full-blown crisis.

The main reason for this was pure economics. The health care system went through a major restructuring on short notice, with support from the state abruptly declining to a fraction of its former amount due to rising inflation rates and to unwillingness or inability to pay more. Other factors included emigration of some of the best doctors to Western countries, restructuring of the Soviet pharmaceutical and medical industries, and disruptions in the production of medical drugs and equipment. Thus, although the post-Soviet states remained committed in theory to free, universal health care, in reality there were increasingly fewer doctors, fewer supplies, less equipment, and fewer opportunities to provide the level of care needed. With inflation at over 20% per year for much of the 1990s, and without comparable pay raises, state-paid doctors' salaries dropped from being in the upper third of all salaries in the country to the bottom 10%. A janitor at a local McDonald's was making more money in the late 1990s than a doctor at a local health clinic. Private clinics emerged to compensate in part for the decline in state care; however, they were only able to provide care to the wealthiest 15–20% of the population.

Although infant mortality has been steadily improving in most recent years in Russia, adult mortality has not. In fact, after reaching an alltime high rate of about 15.7/1,000 per year in 1994 (up from only 11.3 in 1985), it decreased only modestly to 13.6 by 1998 before rising again after the default of 1998. The current adult mortality level in Russia is 15/1,000, which is comparable to that in such countries as Mali, Tanzania, or South Africa. By comparison, the U.S. mortality rate is 8/1,000, the U.K. rate is 9, and the Croatian rate is 12. Haiti has 10, the highest rate in the Americas. Only 12 countries in the world (most in sub-Saharan Africa, but also Ukraine) had higher mortality rates in 2008 than Russia. Within Russia, the highest mortality rates are found north of Moscow (e.g., Ivanovo, Pskov, and Tver Oblasts), mostly due to the older populations there. The lowest mortality is found in the demographically young republics of the northern Caucasus, where large families are more common. Mortality rates in the countryside are about 8% higher than in the urban areas, thus placing Russian rural mortality on a par with the rate in Sierra Leone, the world's worst.

In a recent study (Vishnevsky, 2006), 12 factors were identified out of a possible 175 that were primarily responsible for increased mortality rates between the Soviet period (1965–1984) and years 2000–2003 in Russia. The top ones were heart attacks and strokes; alcohol-related liver poisoning and stomach cancer; and lung cancer, TB, and pneumonia. Some additional causes were accidents, high blood pressure, and neurological diseases. Clearly, a lot of these are directly related to a decline in health care and/or environmental quality.

The increase in TB is particularly alarming, because TB is a highly preventable disease. Bacterial in origin, it occurs largely in individuals who live in chronically poor conditions, lacking vitamins, adequate nutrition, water, or exercise. Although it can be highly contagious, many individuals who come into contact with a TB-infected individual do not get infected right away, if they practice proper hygiene. TB was common in 19th-century Europe among the urban poor who lived in damp basements, worked under dreadful conditions in large factories, and were chronically malnourished. In the Soviet Union, widespread vaccination against TB, better hygiene, and preventive screenings had all but eradicated it by 1960, with a significant exception being the massive prison populations. Unfortunately, the release of thousands of infected inmates under Gorbachev, coupled with a sharp drop in vaccinations, rapidly led to an increase of TB throughout Russia. Worst of all, a new, highly drug-resistant form of TB emerged that is now accounting for over 20% of all new cases. Russia currently ranks 12th among 22 countries with high TB burden worldwide; about 166,000 new cases are reported every year. The TB infection rate is double that of the late Soviet period. Improved surveillance and detection made possible by aid programs from international agencies in the 1990s, especially in the prison system, have made some headway toward reducing the spread of new infections. Nevertheless, TB continues to spread in many places, such as hospitals and day care centers; it can even be contracted by sharing a compartment with an infected person on a long-distance train.

Another infection that scares a lot of people is, of course, HIV. Virtually absent from the Soviet Union, it spread in the countries of the FSU via various channels in the late 1980s. The first HIV cases were found among foreign students from Africa; the first case in the Russian population was detected in 1987. Hundreds of people became infected in regional hospitals via blood transfusions tainted with HIV-positive blood. Soviet hospitals at the time were not equipped with disposable syringes; instead, they relied on autoclave sterilization, which was not sometimes done according to proper standards and allowed some transmission of HIV via dirty needles. Also, no rapid tests were available at the time to check all of the incoming donated blood. By the mid-1990s, disposable supplies and modern, more accurate tests ensured a much higher level of safety in blood transfusions.

Despite these measures, HIV infection in Russia has increased explosively via direct person-to-person transmission—from fewer than 20,000 total cases in 1996 to 448,000 in 2008, according to the Russian Ministry of Health. Unofficial estimates by Western specialists suggest a much higher level, approaching 1.5 million infected persons in 2008. Ukraine is thought to have an even higher rate of infection (about 1.6%, relative to Russia's 1.1%). The main channels of infection are now heterosexual (25%) and homosexual (4%) contacts; transmission from pregnant mother to baby (6%); and, by far the biggest one, the sharing of needles among intravenous drug users (65% of all new cases in 2008). The incidence rate in Russia is still low compared to that of South Africa or Botswana, but it is expected to grow rapidly (Baker & Glasser, 2005). It is already about 10 times the rate of an average European country. Most other FSU states have infection rates ranging between 0.1 and 0.3%, with the exceptions of Estonia (1.3%) and Ukraine (see above). According to the Population Reference Bureau, the world's average HIV infection rate in 2008 was 0.8%, with the U.S. rate at 0.6%, Senegal's at 1.0%, Haiti's at 2.2%, Kenya's at 7.4%, and rates in some southern African nations approaching 25%.

The highest numbers of HIV-infected individuals in Russia are observed in a few big cities: Moscow, St. Petersburg, Yekaterinburg, Samara, Irkutsk, Chelyabinsk, Orenburg, Tyumen, Kemerovo, and Saratov. Such cities tend to have high rates of drug use and prostitution. HIV is not uniformly spread among these cities however. Irkutsk, for example, has an unusually high rate that has to do with the early pattern of spread there among intravenous drug users; some other comparably sized cities have much lower infection rates. The most alarming recent trend is the rapid increase of infection via heterosexual contacts among persons who do not use drugs. More relaxed attitudes toward casual sex among young Russian adults play a big role in the spread of all sexually transmitted diseases, including AIDS. As might be expected, HIV's impact is greatest among the young population, with 80% of Russia's infected persons being between the ages of 15 and 30. More than 40% of new reported HIV infections in 2005 were among women, and the majority of those are thought to have acquired the virus through unprotected sex with an infected male partner, not through unsterilized drug injections (Joint United Nations Programme on AIDS, 2006). Since 2005, approximately 95% of all infected persons in Russia have been receiving antiviral drugs. Nevertheless, the number of new cases grew by 20% in 2008, suggesting that prophylaxis is lacking. Russian scientists are participating in efforts to develop an HIV vaccine. The national and especially local governments in Russia have made some attempts to improve financing of the health care system in recent years. The right to health care is guaranteed by Russia's new constitution. Article 41.1 says:

Everyone shall have the right to health protection and medical aid. Medical aid in state and municipal health establishments shall be rendered to individuals gratis, at the expense of the corresponding budget, insurance contributions, and other proceeds.

Local and regional governments still run free clinics that anyone can use (although a state insurance card is now required). They also subsidize medical drug expenses for seniors and the poor. The exact quality and level of care, of course, depend on geography. The wealthiest regions, including Moscow and Tyumen, will have considerably better care, more modern equipment, more diverse clinic choices, and higher subsidies. Some of the poorest and/or most remote regions have a very low quality of care indeed (Tyva, Altay, most of the northern Caucasus, and many underperforming regions in European Russia).

Another big change since 1991 is the appearance of private clinics. Some now function similarly to the U.S. HMOs, trying to do everything in house except major surgeries, while requiring annual payments in advance. Others provide on-the-spot care for cash. The cost of visiting a private clinic varies dramatically from region to region. At the time of this writing, the average clinic visit to a physician in Moscow costs $25–$30. This does not include any lab work or drug costs, which may be considerable. Patients will be charged a smaller fee for return visits, but a treatment that requires antibiotics and a few blood or urine tests may cost a total of $100–$200. This may sound like a bargain to U.S. residents, but bear in mind that the average salary in Moscow is still below $1,000 per month. One unquestionable improvement over the Soviet system is the elimination of long queues at the clinics. Most are now open from 9 A.M. to 9 P.M., 7 days a week. The same is true for the dental clinics, among which there is a considerable amount of competition. Whereas a U.S. patient has to wait sometimes more than 2 weeks to get into a dentist's chair, one can call a local clinic in Russia and get in within 2–3 hours, including on weekends! The cost of private dental care in Russia is currently about 20% of the U.S. level, with essentially the same level of care, Western-made fillings and prosthetics, and adequate pain control. The main difference is in the cost of dentists' labor, which is considerably lower in Russia. A recent increase in medical and dental malpractice suits may change this for the worse in the near future, however.

A final interesting aspect of health care in the FSU is the wide availability of alternative care, including acupuncture, herbal medicine, and homeopathy. All are very popular, as they also are in the West. The Altay Mountains of central Siberia produce a large share of medical supplements and herbs. Traditional Chinese and Tibetan practitioners can be easily found in major cities. Also, there are many unregulated herbalists and shadowy psychics, who advertise their services on TV, in press, and online. As in the West, many are little more than charlatans, so buyers must beware.

Income and Wealth Distribution

In 2007, the Forbes magazine list of dollar billionaires listed 53 billionaires from Russia, out of a total of 946 worldwide. Only the United States and Germany had more. However, Russia's mostly young, self-made tycoons are catching up to Germany's often aging heirs and heiresses. Russia was two people shy of Germany's total, but the Russian oligarchs were worth a collective $282 billion in 2007, $37 billion more than Germany's richest. It is worth remembering that Forbes does not include government officials or royals on its list, to avoid political trouble; if one were to include wealth controlled by people from Putin's circle or by some regional governors, a few more billionaires would undoubtedly be added. The majority of Russian billionaires live in Russia, with a few important exceptions. The richest in 2007, Roman Abramovich (worth $18.7 billion), widely believed to be the personal banker of the Yeltsin family during the late 1990s, now lives in England after having cashed in most of his Russia-held assets in 2000. Boris Berezovsky, worth a paltry $1.1 billion, likewise makes his home in the United Kingdom, where he is enjoying the British government's protection against the arrest warrants repeatedly issued by the Russian chief prosecutor's office.

The next nine Russian “sharks” on the Forbes list made their fortunes in the 1990s, mostly in steel and nonferrous metals, petroleum, telecommunications, and banking. Some participated in the infamous auctions that allowed quick privatization of the most lucrative state assets for a fraction of the real price. Some of the smaller and more recent “fish” on the list made their fortunes in real estate, construction, information technologies, and retail. A few of these are more modest, and even religious people, known for their philanthropic work. All in all, Russia's position in the top three countries with billionaires is remarkable, given that it was only the 9th largest world economy in 2007 after adjustment for purchasing power parity (PPP). France, in 7th place, had an economy about 10% larger than Russia's, but only 15 billionaires. This, of course, indicates a highly uneven post-Soviet distribution of wealth. Ukraine had 7 billionaires on the Forbes list, and Kazakhstan had five. The main sources of wealth for those people were steel and coal, as well as oil and banking, and (most importantly) personal connections to the ruling elites of those republics.

Economically speaking, none of the FSU countries are yet giants in terms of personal wealth. According to the CIA World Factbook (see Websites) Russia's gross domestic product (GDP) per capita (adjusted for PPP) for 2007 was merely $14,600—about the same as that of Botswana ($14,700) or Malaysia ($14,400). It did move up from 2006 to 75th place from 82nd among 229 countries, a modest accomplishment. All the FSU countries, except the Baltics, were considerably below this level. The poorest country in Western Europe, Portugal, on the other hand, had had a GDP PPP of $21,800 (in 55th place); the EU average was $32,900; and the United States was at $46,000. With the world's average GDP PPP per capita at $10,000 that year, Russia was barely above the middle mark. Thus, generally speaking, it fits into the category of countries with a slightly higher-than-average income, but not a truly high one. According to the CIA data, about 60% of Russia's labor force in 2007 was occupied in services, 29% in industry, and 11% in agriculture and forestry. In 1940, over 50% of the workforce was still in agriculture, with one-quarter in industry, and only 24% in services. For comparison, over 80% of the U.K. workforce in 2007 was in services, 19% in industry, and less than 2% in agriculture. The official unemployment rate in Russia is quite low (only about 6%), but in reality there is a lot of underemployment and underreporting, especially among undocumented immigrants.

Russia has a very uneven distribution of wealth—similar to that in the United States, but quite unlike those of its European neighbors. Its “Gini index,” which measures inequality of family income, is 41.5 (0 = perfect equality, 100 = perfect inequality). For comparison, one of the most equitable countries in the world, Denmark, has a Gini index of 24; the U.S. index is 45; and Brazil's is 56.7. To describe this situation in another way, the income distribution in both the United States and Russia is very “top-heavy,” with over 30% of all wealth concentrated in the hands of about 6% of the households. In Finland or Denmark, on the other hand, the same one-third of wealth will be distributed over 12% of all households. Of course, being in the top 10% in the United States vs. Russia means different things. The top 5% of all U.S. households in 2006 earned over $160,000 per year. For Russia, these earnings were only $20,000—but the income inequality in Russia is still striking, because the poorest 10% in Russia made under $1,000 per year per household, or only $3 per day.

Before we discuss money farther, we need to bear in mind that in Russia it is customary to express earnings not as hourly or annual rates, but as monthly rates. Soviet salaries were paid out in cash twice per month, and the paid vacation period for white-collar workers was also about 1 month (24 work days; a shorter period for blue-collar workers). Hence a common statement in job advertisements was “Possibility of earning over $2,000 per month,” not “$24,000 per year.” Because of the high inflation over the past 15 years, it has also been common to express salary amounts in dollars or euros, although today they must be paid in rubles (usually to a bank account accessed via a debit bank card). In the 1990s it became fairly common for cash salaries to be paid in U.S. dollars to avoid taxes. In 2001, about 35% of all salaries (amounting to about $60 billion) were not properly declared (so-called black-cash). More transparent tax regulations put forth in the first year of Putin's administration, plus a crackdown on illegal tendering of dollars, reduced the black cash somewhat.

The inequality in income distribution increased greatly after the fall of the Soviet Union. Money did not mean much in the U.S.S.R., because many goods were not available for money at all. Social capital was needed to obtain those scarce, often imported goods (e.g., nice shoes, modern kitchen equipment, caviar) through government distribution channels. Even then, no one, including party officials, was allowed to own planes, yachts, or palaces. Although the state property was managed by the nomenklatura, they could not bequeath state assets to their heirs (except their housing) or publicly flaunt their wealth. All that changed with the advent of the Russian kapitalism. Private wealth appeared suddenly and with vigor. Visits to night clubs and casinos, exotic cars, and regular weekend trips to St. Tropez or Davos suddenly became both attainable and visible for the lucky few. In modern Russia, two former friends who graduated from the same high school in the 1980s may be as different in their levels of income or social positions today as a Hollywood star is different from an undocumented Mexican janitor in Los Angeles—a situation inconceivable even a generation ago.

In fact, the members of the generation who entered perestroika as 20- to 30-somethings (“Generation X” would be the U.S. equivalent) were precisely those who attained the highest or the lowest levels of income in subsequent years. Their parents, roughly comparable to the U.S. “baby boomers,” by and large entered the new system in middle age or close to retirement age. Their lifestyles or occupations did not change much, and their incomes remained relatively unchanged (i.e., low). Likewise, the youngest workers in Russia today started working after the major economic shift occurred, so again their incomes are more comparable to each other, although usually much higher than those of the older workers. Middleaged Russians today, on the other hand, either sank to the very bottom or floated close to the top in the mid-1990s. Many of my high school classmates (class of 1987) have very comfortable lifestyles today, but others unfortunately do not. In fact, a few are no longer even around, because they fell victims to violent crime or drugs (at least 2 from a class of 30; also, at least 1 of my 10 or so high school teachers died in an armed robbery).

Who have the new wealth in Russia today? Besides the oligarchs and other rich business owners and executives, they also unquestionably include government officials at all levels (e.g., members of the parliament, governors, mayors, the highest-ranking police officers, and customs/ border patrol officials), mainly because of widespread corruption. Also among the wealthy are many professionals who work for foreign or the best Russian companies (e.g., BP-TNK, Gazprom, Alfa Bank). Although official statistics systematically underestimate the actual level of Russia's personal income, some recent research paints the following, more realistic picture.

In 2002, about 1% of Russia's households had incomes approaching or exceeding that of the average American middle-class family ($7,500 per month; all figures in this passage are given in U.S. dollars). The average income in this group was $90,000 per year. About half of these households lived in and around Moscow, and made up about 10% of all Moscow households. Some of these people had considerably higher incomes, in the millions of dollars. The presence of these people makes Moscow one of the most expensive cities in the world. Another 3%, the so-called Russian upper middle class, had household incomes between $20,000 and $45,000 per year.

Next in line are the “true middle class” (about 6%) with incomes between $10,000 and $20,000 per year, averaging $1,170 per month. Many of these people, unlike their Western counterparts, cannot afford a private home, but most own an apartment with all the modern essentials and one car per family. (A typical modest two-bedroom Soviet apartment today costs over $100,000 in most major cities, and more than triple that in Moscow.) A typical car is either a 5-year-old Russian Lada or an 8-year-old used German or Japanese sedan. A typical family from this class can afford a nice, but short, annual vacation abroad in Turkey or Egypt; it eats out a few times per month; and it can save a little extra cash for music lessons for the children and an occasional theater visit or rock concert for the adults. Another 10% are the “lower middle class,” with incomes of $6,000 to $10,000 per year (averaging $660 per month). These people and those in the “true middle class” buy most of the durable goods in Russia (e.g., refrigerators, TVs, and other appliances). They have some extra money to spend, but little to invest. The mass consumption boom in major cities is largely driven by them.

A large portion of Russia's society (about 40%) belongs to the “moderately-low-income” and “low-income” categories with about $3,600 to $4,800 available per household per year (or $300–400 per month). The average Russian household consists of 2.7 persons, so these incomes are not too bad, as long as people do not have to rent living space or own a car. The vast majority of residents in the provincial towns and cities, and the wealthier villagers, fit into these two categories. The remaining 40% are “truly poor” people. About one-quarter of these, or 10% of all households, live in abject poverty on $75 per month per household. This is the global poverty level currently defined as $2 per day by the United Nations. Many of the truly poor are recent migrants or refugees from the Asian and Caucasian FSU republics, Moldova, or Ukraine; they include some ethnic minorities, but also many people of Russian descent from the same regions. This category also includes native Russian citizens who are disabled, unemployed, alcoholic/addicted, war veterans, single women, and/or pensioners (the average Russian pension for seniors is about $100 per month).

The wealthiest regions in Russia are the same as the most economically productive or active: The top five by average per capita income in 2007 were the city of Moscow and the Nenets, Yamalo-Nenets, Chukotsky, and Khanty-Mansi Autonomous Okrugs. The lowest were some of the republics of the Northern Caucasus. The income in Moscow was eight and a half times greater than that in the poorest subject of federation, the Ingushetiya Republic.

Poverty and Welfare

We have just learned that about 20% of Russian residents live well or very well, but that the other 80% do not. Poverty in the new Russia takes diverse forms: Many people struggling with chronic illness, unemployment, single parenthood, recent migration, or drug addiction also struggle to make ends meet. A striking image of the early 1990s was that of hungry grandmas who appeared near subway stations or newly opened Western restaurants, gnawing on scraps of food from the trash. Typically pensioners on fixed incomes had lost their life savings in a series of ruble devaluations during the late 1980s. One old relative of mine had 10,000 rubles saved from all the tips she earned while checking coats for over 40 years at the famous Academy Theater in Moscow. In 1988, the amount was sufficient to buy a new car, or even an apartment. Then, without a warning, the value of the ruble fell sharply, while the savings accounts nationwide were frozen on orders from the government. Virtually all of her savings turned worthless in a few months because of inflation, never to be recovered.

A particularly infamous problem of the Yeltsin period also caused many people to see a decline in income: delays in payment of state pensions and salaries to the workers. Newly privatized banks, many of which were run by people close to the Kremlin, were deliberately put in charge of the state payroll accounts. They would deliberately hold on to the money for a few weeks to accrue some interest. With inflation raging in double digits over much of the 1990s, even a few days' delay would considerably lessen workers' purchasing power. The people in charge of the payrolls made millions of dollars from late payments in this manner; some of them are still prominent in Russia today.

The unraveling social net also contributed to the rise of the new poor. In the Soviet Union, there was no unemployment (at least not officially). People were used to guaranteed, lifelong jobs with benefits. There were no temporary job offices, no welfare, and no soup kitchens. People were not used to sleeping in the streets. In fact, if they tried, they'd be promptly picked up by the cops and sent either to a mental clinic for evaluation or to jail, and then to their original homes, if they had any. People lacked the professional skills required to find a new job in a dynamic, Westernstyle job market—skills such as resum? writing, networking, or business etiquette. Lack of a job or pension in the early reform period meant that many people swelled the ranks of the poor or very poor and spilled into the streets.

There were also some benefits of the new situation. The greatest benefit that the state bestowed upon its ordinary citizens was to allow free privatization of the formerly state-owned apartments. This was an underappreciated aspect of Yeltsin's period of reforms (??slund, 2007). The families that did have apartments on the eve of the reforms were lucky, because the market rate for these quickly skyrocketed. Effectively, a new class of apartment owners, a majority of the population, was created overnight. Those people who did not have apartments or were waiting for apartments from the state were out of luck; they had to pay the new market rate to rent. In addition, some elderly and/or chronically ill people lost their apartments in elaborate con schemes. A signature on the dotted line sometimes meant that instead of obtaining in-home care until death, an elderly pensioner was signing over his or her only piece of real estate to a shadowy company that would come and harass him or her later to give up the apartment altogether. In some cases, seniors simply disappeared without a trace after signing what was in effect their death sentence. Eldar Ryazanov's dark comedy Old Hags (2000) provides an insider's look at this type of situation.

A society can be judged the best by how it treats its most vulnerable members: the elderly, the sick, and the children. The earliest versions of this statement are ascribed to Confucius; more recently, it has been attributed to Dostoevsky or Mahatma Gandhi. Like the sick and the elderly, children fared poorly in the new Russia, with orphans hit the hardest. The Soviet orphanages were never very good, but at least they provided a level of stability and shelter. Russia today has some of the worst-run orphanages in the world, as well as one of the highest ratios of child abandonment. Many children also live with a single parent, a grandparent, or even alone. Whereas 63% of all Soviet children lived with both of their parents in 1970, only 54% in Russia do now. The rate of single-parent households has correspondingly risen from 16 to 21.6%. A common scenario is that of an alcoholic parent dumping the child(ren) on the doorstep of a state orphanage or having parental rights revoked after a particularly egregious case of repeated child abuse. Many real-life stories are too painful to be presented here, but a quick search online are cause for true concern.

The fate of children cannot be separated from that of their parents, especially their mothers. Much has been written about gender relations and issues in post-Soviet societies (e.g., Engel, 2004; Hughes, 2005). The women in these societies have experienced a disproportionate rise in inequality based on ageism, sexism, and related prejudices. For example, it is very common now to see female workers recruited for boutique jobs on the basis of their height or age; typically, only taller women under age 30 are encouraged to apply. In the Soviet system, the vast majority of women worked full-time. With perestroika, some were forced to scale back their hours by their employers, whereas others were simply terminated. Yet others were attracted to wealthier, older men who promised them carefree lives as housewives, only to be abandoned later. Today women in Russia receive fewer maternity benefits than under Soviet rule and are accustomed to lower-level office positions, typically with sexist male bosses. A small number of women have nevertheless succeeded as business leaders, but these remain a small minority in the generally male-dominated world of commerce. Fewer than 10% of Russia's legislature members are female. Among top state or business managers, men outnumber women by a 3:2 ratio. At the same time, 79% of women are employed in the FSU overall—a higher percentage than in Europe (72%) or Latin America (65%).

Women remain the primary providers of services at home, essentially working two jobs. Russian men play with children less than American or Western European fathers do (fewer than 30 minutes per day on average). They also cook or wash dishes less commonly than their Western counterparts do. At the same time, they expect their spouses to remain physically attractive, fit, slim, and so on without necessarily living up to that ideal themselves, as is amply demonstrated by observations of Russian women and men in public places. Of course, many men in the region do not fit this uncaring stereotype, but unfortunately many others do. The number of single mothers in Russia today, therefore, does not tell the whole story. The existing, but uninvolved, partners are partly to blame for the heavy burdens imposed on women.

Which regions are the hardest hit with social ills in Russia? One way to find this out is to look at the available unemployment statistics, bearing in mind that underreporting is commonplace. In 1998 the post-Soviet economy hit bottom. The highest estimated unemployment rates for that year were found in some of the national republics of the south (e.g., Kalmykia, 31%; Dagestan, 30%; Karachaevo–Cherkessiya, 25%). There were no numbers available for Chechnya, but neighboring Ingushetia had 50% unemployment. Some Siberian republics had slightly lower rates (Buryatia, 21%; Tyva, 20%; Altay, 18.5%). Most Russian regions had rates close to 13%; the lowest unemployment was in Moscow (4.8%) and the Central district (8–10%). The general situation has since improved somewhat. In 2007 the official national unemployment rate was 5.6%, although independent social research suggests that the actual unemployment was two or three times higher than that.

One important statistic with respect to post-Soviet unemployment is that men are about onethird more likely to be unemployed than women, although women are typically laid off first. Why may this be the case? One factor is massive layoffs among male-dominated professions, such as factory workers or military officers. A lot of men in these professions were abruptly laid off in 1993–1994, as the economic reforms got fully under way, and have not been rehired since. Another factor is that women have remained in the jobs that men have left in their search for other opportunities. Also, many women were and are underemployed, but they do not enter official unemployment counts because they remain in the part-time workforce or do not officially declare unemployment. Men typically work full-time and, if they are laid off, search only for full-time jobs. An important coping mechanism for households is simultaneous participation in multiple economies, both formal and informal (Pavlovskaya, 2004). The proportion of families with diverse sources of income has been rising, at least in the cities, in the post-Soviet period. Many families are able to survive by working multiple parttime jobs, or by receiving the direct benefits of informal services from relatives and friends.

Education is no guarantee of employment in the new Russia: About one-third of Russia's unemployed are people with 2-year technical college degrees, and about 10% have university diplomas. Generally, however, educated people have fared better in banking, finance, information technology, and management, while less educated ones have failed to make the required adjustments. Their two most obvious deficiencies are in foreign-language skills and computer skills. Very few of those who were over 40 in 1991 had managed to master either skill set, but those who did fared considerably better than their peers. For example, a sociological study from 2003 (Gorshkov & Tikhonova, 2004) found that 31% of the Russian upper class had professional computer skills, versus only 4% among those with lower incomes. Likewise, 7.5% of the rich had a foreign-language skill (even this is a low figure by European standards), versus only 3% among the poor. On the other hand, some of the most gainfully employed people or new businessmen came into the field with only minimal education—some after being released from Soviet prisons, using their underworld backgrounds as an advantage. Nevertheless, the richest in modern Russia are also very well educated, typically with PhDs (or the equivalent) or advanced engineering degrees. For the young generation, having a university diploma is a must, although the few top programs are the most competitive and the hardest to get into.

Crime and Punishment

Sharp differences in the levels of income in a society can be dangerous. If the most basic needs of the poor are not met, a revolt may happen; this is, of course, the basic tenet of Leninist ideology. Up to a point, some inequality is inevitable, and it can even be stimulating when there are opportunities available to improve one's life. However, excessive inequality and a high degree of perceived injustice will bring about social unrest. Gorshkov and Tikhonova (2004) report that the new poor have a high degree of awareness about the new rich. The most often cited items that the latter have but the former don't include better living conditions (such as a large modern apartment or a new suburban home), opportunities to travel abroad, the ability to buy new furniture and major home appliances, better health care, and better education for children. In a society where inequality is prominent, it is small wonder that the poorer people respond with jealousy and sometimes with criminal behavior. At the same time, the rich are more sheltered from everyday violence than the poor, and so with the increasing crime rates, the most typical victims are the poor themselves. Generally, crime rates in Russia increased sharply soon after the start of the economic reforms, but have abated a bit since Putin came into power. Some of the factors that led to the increase were as follows:

The rapid release of many thousands of criminals under Gorbachev to save money.
A sharp drop in government spending on law enforcement.
Criminalization and corruption of the police.
Gang wars erupting over privatization of the most lucrative state assets, such as metal smelters and oil refineries.
The appearance of private security contractors who would replace state law enforcement and sometimes clash violently with the latter.
The initial appearance of rich people without spatial segregation from the poor.
The appearance of expensive shops and restaurants in prominent locations.
The emergence of casinos, brothels, escort services, drug-dealing networks, and other trappings of Western decadence that were previously either nonexistent or only secretly run.
The appearance of large numbers of clueless Western tourists and business travelers, eager to spend money and easily conned.
Yeltsin's revisions to the Soviet penal code and suspension of the death penalty, so that Russia could join the Council of Europe.
The federal government's general inability to control the situation in the regions, and its noninterference in the doings of the regional elites.

Just how bad the crime situation in Russia is today is a matter of much debate. In the late 1990s, Russia had the 5th highest rate of murders per capita among 62 countries tracked by the U.N. Survey of Crime Trends—behind countries such as Colombia, South Africa, Jamaica, or Venezuela, but ahead of Mexico, Zimbabwe, and all other FSU republics. (Among the latter, interestingly, the prosperous and democratic Baltic states led the pack—not Ukraine or Kyrgyzstan, for example. The latter nations may have underreported serious crimes, however.) The U.S. rate of 0.04/1,000 was only 20% of Russia's rate of 0.2/1,000 per year. This data set, however, did not include any countries in central Africa or in much of Asia and South America. In robberies, on the other hand, Russia's rate was only 66% of the U.K., U.S., or Mexican levels, and was more similar to that of Germany or Canada. The United States also topped the charts with a total of 23 million recorded crimes per year; Russia was only in 6th place worldwide, with a total just short of 6 million. This, by the way, does not automatically mean that the situation in the United States is that much worse: The difference can be explained in part by better U.S. law enforcement statistics (and of course by the much bigger U.S. population).

Russia had over 1 million prisoners in 1995, and about 872,000 10 years later. Seven percent of the inmates in 2005 were women, and about 17% were repeat offenders. Based on crime rates alone, your chance of being killed or mugged in Moscow is about as high as in New York, but higher than in most European capitals. There are lots of perfectly safe neighborhoods; however, there are also late-night train rides and walks through dark areas of the city periphery where safety is questionable. One positive development recently has been a drop in the most violent crimes (this is also true in the West). For example, there were 31,800 murders and attempted murders in Russia in 2000, versus only 22,200 in 2007. The majority of contract killings were perpetrated by the mob against prominent businessmen and journalists in the mid-1990s (Volkov, 1999); such attacks are now rare. Most domestic homicides happen between spouses and involve alcohol. Random drive-by shootings, bomb explosions, and so on are mercifully very rare, although widely publicized. Another common target is anyone who is perceived as different, especially migrants from the Caucasus and some categories of people of color. However, the vast majority of Russians are friendly people, and outside a few big cities you are unlikely to experience much trouble. This is not to say that you should not remain alert at all times, of course.

Besides personal crime, there is economic crime: tax fraud, embezzlements, bribery, and government corruption of all kinds. The Transparency International organization's global Corruption Perception Index for 2007 ranked Russia very much near the bottom, in 143rd place out of 179 countries—right above Togo, but below Indonesia. For comparison, the worst three were Somalia, Myanmar, and Iraq, while the best three were Denmark, Finland, and New Zealand; the United States ranked only 20th, and the United Kingdom was in 12th place. There are many reasons for widespread corruption in Russia, including but not limited to these:

A historical tradition of pervasive government corruption; as a result, people find such corruption acceptable or even inevitable (see Gogol's or Saltykov-Shchedrin's satirical descriptions of 19th-century Russian bureaucrats).
The low pay scale for some categories of government workers relative to businessmen, which encourages these workers to demand bribes.
The regulations requiring numerous government permits to do almost anything.
Civil servants' enjoyment of their power to make or break deals and to make money.
Deliberately confusing and frequently changing laws.
A lack of independent, objective courts or arbitration and a lack of transparency in general.
The sheer scale of the country: Distant places are less open to the scrutiny of the central government, while a scarcity of local resources encourages profiting on the side.
The abundance of resources, natural or economic, which actually encourages corruption.
Inability and/or unwillingness to enforce existing anticorruption laws.

Some forms of economic crimes can be arbitrarily prosecuted, as a means of reprisal against politically inconvenient businesses. For example, the Yukos affair of 2003–2005 (clearly perpetrated by the Russian courts on behalf of Putin's government) bankrupted the richest and one of the most transparent companies to benefit a small circle of Kremlin insiders, and imprisoned the top executives who had become too independent-minded (Baker & Glasser, 2005; ?slund, 2007).

What part of Russia has the highest crime rates? There is no apparent pattern. Some regions with the highest rates are in the distant coastal Pacific (Magadan, Jewish Autonomous Okrug, Sakhalin), as well as in the Urals (Kurgan, Perm) and Siberia (Buryatia, Tomsk). Many penal colonies and long-term reformatories are located in remote corners of Russia—for example, the Krasnokamensk facility on the border with Mongolia, where Yukos chairman Mikhail Khodorkovsky was sent. Northern European Russia and the Urals have many old prisons, which are still functioning with few changes since Soviet times.

Health, Income Distribution, and Crime in Other FSU Republics

Health, wealth, and crime trends in the other FSU republics have been comparable to Russia's in many ways, with some regional differentiation. The richest economies of the Baltics tend to have lower poverty, higher wealth, and more equitable income distribution; at the same time, the Baltics have relatively high crime rates—higher total rates than Russia's, in fact. The Central Asian states, of course, have high poverty, low wealth, and less equitable income distribution. Only 2 of the 15 FSU republics besides Russia (Ukraine and Kazakhstan) have resident billionaires; however, many very wealthy Armenians, Georgians, and Azerbaijanis undoubtedly exist, with many living comfortably abroad in Russia, Europe, or the United States. In fact, among the crop of billionaires on the 2007 Forbes list were one Belarusian, two Georgians, three Armenians, four Azerbaijanis, and six Ukrainians—all residing in Russia. The poorest countries of the FSU, Moldova and Tajikistan, have surprisingly low crime rates; perhaps this is due to underreporting, but it also may reflect the possibility that since people's means are truly modest, there is less incentive for crime. Some of the most corrupt countries in the world are Uzbekistan (175th) on the Transparency International list, and Turkmenistan (162nd). The least corrupt nation in the FSU is Estonia (28th), but it is still below most Western European countries or the United States.