The Blackwell Companion to Medical Sociology

The Russian Health Care Experiment 323
(Rimachevskaya 1998). ``As a result the upcominggeneration with poor health
couldn't reproduce a healthy new generation . . . This might be explained by the
drastic worseningof children's health, and particularly newborn's health''
(Rimachevskaya 1997).
Sociological
ociological Accounts ccounts of Health ealth Evaluation valuation
Health as a Value and Real Behavior
At the beginning of the 1990s a number of research projects were begun by
sociologists. Among them were studies of social adaptation by the handicapped
(Ellansky and Peshkov 1995); families of children with chronic diseases (Silaste
1997; Smirnova 1997); doctors' research and their values (Lavrikova 1999), the
transition of the health care system (Kucherenko 1995; Malachova 1995; Boikov
1999) and others. Some projects had a unique character, like one study of the
health and livingconditions of the population persecuted by Nazis duringWorld
War II in the former Soviet Union (Knazev 1996).
It is hard to find comprehensive research on health and health behavior in the
former Soviet Union, because sociologists were limited by Marxist±Leninist
theory that dominated Soviet society. In a representative research of Soviet
citizens' lifestyle, a majority of the respondents (87%) put a priority on ``health,''
choosingit from among16 main values (such as talent, education, and money)
important for the achievement of the success in life (Shilova 1989). There were,
however, a number of inconsistencies between a person's declared value of health
and actual behavior.
Evidence supportingthis fact is seen in the data. For example, in Nizniy
Novgorod, only 16 percent of the students took meals regularly (3 times per
day). Most of them (40%) didn't seek physicians in case of illness. In Moscow,
only 28 percent of respondents said they followed their physician's prescriptions.
Others (24%) undergo their own medical treatment and continue to work in
case of disease (28%) (Aktualnie medico-sozialnie aspecti propagandi zdorovogo
obraza zhizni 1986). Research from 1987 in Kamchatskaya oblast has
demonstrated that three-fourths of Russians recognized the importance of physical
exercise for people of their age, but in fact less than 40 percent exercise.
Half of the respondents realized the harm in smokingand drinking, but less than
one-third stopped these behaviors (Adametz 1990). Visitinga general practitioner
if required is one of the indicators of self-protective behavior. However, 60
percent of respondents see a general practitioner only if they need a document
confirmingtheir illness for their employer (Shilova 1999).
Since the introduction of the free market economy in Russia, attitudes
toward work have changed. As a result of restricted work opportunities,
people place a higher priority on work and less on health. Fewer people in
all age groups have been to a hospital or stay home because of illness than
in past years (Nazarova 1998). This situation may possibly be due to high
competition in the labor market and fear of unemployment, even in the case of
illness.