The micro consequences of macro -level social transition: A survival analysis of Russians who died during the 1990s

Using panel data from the Russian Longitudinal Monitoring Survey, this study investigated the role social changes played in affecting Russians' health status and chances of survival in the 1990s from a stress process perspective. The results of lagged Y-regressor analysis and the extended Cox regression analysis indicate that the dramatic deterioration of Russian health status and the rise of Russian mortality in the 1990s are attributable not only to epidemiological factors, but also, and even more importantly so, to social factors related to the recent Russian social transition. Changes in the Russian economy, value system, and social institution drastically damaged Russians' life chances, psychological resources, and mental well-being. Meanwhile, individuals' perceptions of the social changes affected their health behaviors, as is reflected by an unhealthy drinking behavior. These changes in life chances, psychological resources and well-being, and drinking behaviors further affected their health status and survival. The results show that respondents' negative perception of social changes, indicated by powerlessness, decline in self-esteem, and life dissatisfaction, significantly account for Russian unhealthy drinking behaviors which prevailed during the 1990s' transition. Furthermore, income drop and job loss during social changes, and respondents' negative perception of social changes, when combined with a high-risk lifestyle, negatively affected the Russian people's health and significantly reduced their chances of survival.;Because the death cases in this study were derived from panel survey data, the study design allowed me to link death events to respondents' perceptions of social changes measured before their death. This strategy enabled me to apply the stress process model for an analysis of the relationships between change-induced social stress and death. The study design further allowed me to link macro-level social changes to micro-level consequences and to clarify a much debated connection between Russian social transition and its mortality crisis.