In the early 1990s, Russia experienced one of the most extreme
increases in mortality in modern history. Men's life expectancy
dropped by six years; women's life expectancy dropped by three.
Middle-aged men living in Moscow were particularly at risk of dying
early deaths. While the early 1990s represent the apex of
mortality, the crisis continues. Drawing on fieldwork in the
capital city during 2006 and 2007, this account brings ethnography
to bear on a topic that has until recently been the province of
epidemiology and demography.
Middle-aged Muscovites talk about being unneeded ("ne nuzhny"), or
having little to give others. Considering this concept of "being
unneeded" reveals how political economic transformation undermined
the logic of social relations whereby individuals used their
position within the Soviet state to give things to other people.
Being unneeded is also gendered--while women are still needed by
their families, men are often unneeded by state or family. Western
literature on the mortality crisis focuses on a lack of social
capital, often assuming that what individuals receive is most
important, but being needed is more about what individuals give.
Social connections--and their influence on health--are culturally
specific.
In Soviet times, needed people helped friends and acquaintances
push against the limits of the state, crafting a sense of space and
freedom. When the state collapsed, this sense of bounded freedom
was compromised, and another freedom became deadly.
"This book is a recipient of the annual Norman L. and Roselea J.
Goldberg Prize for the best project in the area of medicine."
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