Similar but different: Health and economic crisis in 1990s Cuba and Russia

The collapse of the Soviet Bloc caused devastating economic crises in Cuba and in the Russian Federation but triggered remarkably different public health responses: while mortality rates in Russia increased substantially the crisis was barely visible in Cuban public health statistics. Fundamental social, political and cultural differences in the two countries and the respective specificities of the crisis in either country seem responsible, including different long-term health trajectories and different traditions of health-related agenda setting. Cuban policies combined traditional top down activism with grass root activities, strengthening social capital, while the “shock therapy“ adopted in Russia had a corrosive effect on society, increasing psycho-social pressure and weakening support.

► The severe 1990s economic crisis had fundamentally different effects on public health in Russia and in Cuba. ▶ The reasons derive from long-term health developments as well as from the acute specificities of the crisis and its management. ▶ Relevant factors include: political prioritization of health, diet, gender expectations, lifestyles and social capital. ▶ Cuba was geographically, culturally, socially and politically better equipped than Russia to face the crisis. ▶ Crisis management may reflect and reinforce pre-existing developments, but can also profoundly change-affected societies.