Generalized indicators of economic and social/human development, such as GDP per capita or HDI, typically place Russia into a medium-high category. However, such ratings overlook regional differences in economic and social development, which are highly pronounced in Russia. To examine these regional patterns, GeoCurrents has created a mini-atlas of Russia, designed using GeoCurrents customizable maps, which are available for free download. These maps examine a wide range of topics, from food consumption to alcoholism, and from crime rate to healthcare; additional maps cover issues that help explain regional patterns in development, such as the age structure and ethnic composition of the population. Unless indicated otherwise, the data comes from the Federal State Statistics Service, and refers to the year 2013. Since the data offered by the FSSS is presented in 83 Word files, one for each federal subject, we have re-organized the data into one Excel file (available for download here: Rosstat_data); some of the measures, such as the percentage of working age adults or of pensioners and sex ratios, have been calculated based on the FSSS data. Additional data comes from the “Children in Russia” publication by the FSSS, available (in Russian) here; this document, published in 2009, contains data from the preceding year. Some other data come from Wikipedia and refer to 2010 or 2013. Unfortunately, we have not been able to obtain data from a more recent date, particularly from after the annexation of Crimea in March 2014; if any of our readers know of such publicly available data, in English or Russian, please let us know.
We’ll begin by looking at two rather unusual measures of the standard of living: the availability of living space and food consumption. Although Russia is a large and sparsely populated country, the availability of residential housing has long been a problem. As can be seen from the map on the left, residents of central Russian oblasts have more living space per capita than average, with inhabitants of Tver oblast enjoying an average of 29 sq. meters (312 sq. feet) per person. The only exception here is Moscow City, where an average resident has only 19.2 sq. meters (207 sq. feet) of living space, reminding one of Mikhail Bulgakov’s lament about Moscovites written some 75 years ago: “mercy sometimes knocks at their hearts…ordinary people… only the housing problem has corrupted them…” (Master and Margarita). While residents of Northern European Russia, the Volga region, and the Far East (Chukotka, Kamchatka, Sakhalin) have fairly ample living space, the North Caucasus and most of Siberia offer an average citizen more crowded housing. Dagestan, Kabardino-Balkaria, and Chechnya have less than 20 sq. meters (215 sq. feet) of living space per capita, while Ingushetia posted the second-lowest figure in all of Russia: 13.5 sq. meters (145 sq. feet). A notable exceptions here is North Ossetia-Alania, with the figure of 26.9 sq. meters (290 sq. feet) of living space.
Similarly, several Siberian regions, such as Khanty-Mansiysk and Yamalo-Nenets Autonomous Okrugs, and Altai Republic (not to be confused with Altai Krai), have less than 20 sq. meters (215 sq. feet) of living space per capita. Particularly striking is the situation in Tuva: 12.9 sq. meters (139 sq. feet) per capita. As we shall see in subsequent posts, Tuva is found at the bottom of many development rankings. As mentioned above, the Far East overall has more residential housing per capita, although differences between, on the one hand, Primorsky Krai and Jewish Autonomous oblast, with less than 22 sq. meters (237 sq. feet) per capita, and Magadan oblast, with its ample 29 sq. meters (312 sq. feet) per person, is striking. However, in the case of Magadan, the higher availability of residential housing may be a symptom not of a higher standard of living, as one might think, but actually of a lower standard of living: since the dissolution of the Soviet Union, Magadan oblast has a significant depopulation trend, and as we shall see in subsequent posts, many other indicators of human development there paint a grim picture, which helps explains this trend.
Consumption of different foodstuffs, particularly meat and dairy, which tend to be the pricier components of the Russian diet, is another interesting topic. According to Rosstat data cited in an article in Kommersant.ru, the type of food consumed in largest per capita quantity is dairy: an average Russian consumes over 200 kg (440 lbs) of it a year. (The most popular type of dairy is 3.2% milk and yoghurts.) Meat, however, takes the third place in the Russian diet: an average Russian citizen consumes 75-80 kg (165-176 lbs) of meat annually, which is less than the average annual consumption of bread and other grain-based foods. However, there are significant differences in the amount of meat and dairy consumed in different regions. For example, residents of Kalmykia consumed more than twice as much meat per capita as residents of Dagestan (114 kg vs. 40 kg). As for dairy, per capita consumption in Tatarstan is more than 3.5 times greater than Chukotka.
The geographical patterns of meat and dairy consumption can be explained only in part by economic factors, as they seem to correlate more closely with culinary traditions. For example, higher meat consumption correlates well with the presence of traditionally semi-nomadic, Turkic- and Mongolic-speaking peoples: Kalmyks (Mongolic), Sakha (Turkic), and smaller Turkic-speaking groups in Altai Republic. As can be seen from the map of ethnic composition, these regions have substantial populations of their titular ethnicities and lower percentages of ethnic Russians. But this pattern does not work elsewhere; thus, Chuvashia, Tatarstan, and Tuva also feature a significant Turkic population yet have much lower figures for meat consumption. Economic factors may play a more prominent role here. But economics does not tell the whole story either, as such high GDP areas as the three Autonomous Okrugs (Nenets, Yamalo-Nenets, and Khanty-Mansiysk AOs) and Tyumen oblast have some of the lowest meat consumption figures. I find especially perplexing the low figure in Chukotka—merely 51 kg (112 lbs) per person per year, less than half of the amount of meat consumed by an average Kalmykian—because Chukotka is both economically productive and has a substantial indigenous population, which traditionally lives on reindeer and seal.* It is much easier to explain similarly low meat consumption in Northeastern Caucasus—Dagestan (40 kg), Ingushetia (54 kg), and Chechnya (58 kg)—a region of both low GDP and a culinary tradition of supplementing meat (mostly lamb and goat, as well as poultry) with a lot of fruits and vegetables (for more on the cuisine of different parts of the Caucasus, see here and here).
As for dairy, one finds higher levels of milk consumption in (some of the) steppe regions, including Tatarstan (364 kg per capita per year), Bashkortostan (312 kg), Orenburg oblast (308 kg), parts of southwestern Siberia (esp. Altai Krai, 335 kg, and Omsk oblast, 301 kg), as well as in Sakha Republic (281 kg)—all areas where reliance on milk has been an important feature of traditional cuisine of cattle- and horse-raising semi-nomadic indigenous groups. However, milk has not been a staple for reindeer pastoralist groups: Evens, Evenkis, Nenets, Chukchi—so even today dairy consumption in their traditional areas remains fairly low. Another area which registers higher-than-average dairy consumption is St. Petersburg (315 kg) and the surrounding Leningrad oblast (293 kg), which probably goes back to the high number of dairy-producing sovkhoz (state-owned farms) during the Soviet era.
More perplexing are the relatively low figures of dairy consumption in four neighboring oblasts in north-central Russia: Yaroslavl (246 kg), Tver (243 kg), Vologda (236 kg), and Kostroma (194 kg). These regions are traditionally renowned for their specialty butter (Vologda) and cheeses (Yaroslavl, Tver, and Kostroma), so one might expect higher dairy-consumption figures. Historically, Russians produced and consumed “white” or “farmer’s cheese” but not “yellow” or “hard cheeses”, which first came to Russia from Holland with Peter the Great. According to moloko.cc website, the first cheese-making facility in Russia was opened in 1795 in Tver gubernia (now, oblast) in the estate of Prince Meschersky. The first large-scale cheese-making factory was also opened in Tver gubernia in 1866 by Nikolai Vereschagin (brother of famous artist). Cheese-making then spread to Yaroslavl gubernia, where local specialty cheeses were developed: Yaroslavsky, Uglichsky, Poshekhonsky cheeses (the latter two are named after the towns where they were first made: Uglich and Poshekhonye). In 1878, a first cheese-making facility opened in Kostroma by Vladimir Blandov; according to the Wikipedia, by 1912 Kostroma gubernia boasted 120 cheese-making factories in which a variety of cheeses, including the specialty Kostromskoy cheese, were being produced. Kostroma became an unofficial “cheese-making capital of Russia”, notes Vkusnoblog.net. What, then, explains the decline in local cheese-making and dairy consumption in this area? The answer seems to be Soviet food policy. During the communist era, regional specialty cheeses were turned into standardized recipes, mass-produced in factories all around the country, undermining the local specialization. Since the 1990s, some local artisanal cheese making has been revived, but most small local producers have not been able to complete with larger domestic factories and foreign imports. Kostromskoy and Poshekhonsky cheeses, for example, gave way to imported brie and camembert. Russia has imposed sanctions on the importation of many foreign foodstuffs, but it remains to be seen what effect these measures would have on local cheese production. (I thank Sonia Melnikova-Raich for a helpful discussion of this topic.)
The rest of this post examines figures and maps concerning healthcare infrastructure. Overall, Russia ranks very high in physician density and the number of hospital beds per capita, but quite low in nurse density. Regional differences in these indicators are quite pronounced, however, and some of the geographical patterns are rather baffling. For example, unsurprisingly, Saint Petersburg boasts the highest physician density (81.2 physicians per 10,000 population), whereas Vladimir, Tambov, Tula, and Vologda oblasts in central Russia are served by fewer than 35 physicians per 10,000. One might expect Saint Petersburg to lag behind Moscow in this measure, but the figure in Moscow City is actually much lower (68.6). This contrast is probably related to the rapid population expansion in Moscow in the last two decades, something that did not occur in Saint Petersburg (for illustrative population graphs, see here); Moscow’s health infrastructure simply could not keep up with that demands of the growing population. (Saint Petersburg also has more nurses per capita and substantially more hospital beds per capita than Moscow.) Overall, Siberia’s population is served by more physicians per capita than that of European Russia and the southern Urals, although there are exceptions: Khakassia and Jewish Autonomous oblast have fewer than 40 physicians per 10,000, and Kurgan oblast is served by merely 30.2 physicians per 10,000. Another geographical pattern that stands out is the disparity in the concentration of physicians between major cities and their surrounding oblasts (Saint Petersburg: 81.2; Leningrad oblast: 34.5; Moscow City: 68.6; Moscow oblast: 39). Sharp contrasts between neighboring federal subjects are found elsewhere as well: Vladimir oblast (33.9) and Yaroslavl oblast (58), Vologda oblast (34.7) and Arkhangelsk oblast (54.5), Volgograd oblast (48.2) and Astrakhan oblast (65.8), Jewish Autonomous oblast (37.7) and Amur oblast (60.6), North Ossetia-Alania (71.7) and Ingushetia (37.7). The high physician density in Astrakhan oblast and North Ossetia-Alania is perplexing in and of itself.
As for nursing personnel, higher nurse density (over than 130 nurses per 10,000 population) is found across the Russian Far North and in parts of the Altai region, which are generally areas of lower population density. The highest figures are found in Magadan oblast (151.3), Chukotka (151.1), and Komi Republic (146.6). In contrast, lower figures (fewer than 100 nurses per 10,000 population) characterize most of European Russia, the North Caucasus region, southwestern Siberia, and the southern part of the Far East. The shortage of nurses is experienced in federal cities (Moscow City: 97.9; Saint Petersburg: 98.4) and even more acutely in the surrounding oblasts (Moscow oblast: 76.7; Leningrad oblast: 73); Leningrad oblast has the lowest figure in all of Russia. Another area where nurses are in short supply is the North Caucasus economic region (Krasnodar Krai: 88.1; Dagestan: 82.1; Ingushetia: 77.1; Chechnya: 73.2). As with physician density, sharp contrasts are observed in some cases between neighboring federal subjects: Leningrad oblast (73) and Karelia (123.6), Samara oblast (91.7) and Ulyanovsk oblast (127.7), Zabaikalsky Krai (114.4) and Magadan oblast (151.3).
Finally, Russia ranks 3rd in the world (after Japan and Korea) with respect to the availability of hospital beds per capita; unsurprisingly, these three countries top the charts in terms of average length of hospital stays (an average Russian patient stays in hospital for 13.6 days; compare to 4.9 days in the United States). But yet again, regional variation in Russia is quite pronounced, with 149 beds per 10,000 population in Chukotka, but only 46 beds per 10,000 population in Ingushetia. The availability of hospital beds correlates somewhat with nurse density, though far from perfectly. There are more hospital beds per capita (over 120 per 10,000 population) in Siberia (especially, in Eastern Siberia and the Far East) and in parts of the European North (especially, in Nenets Autonomous Okrug and Murmansk oblast). Besides Chukotka, the highest figures are found in Magadan oblast and Tuva (both 136), and Kamchatka and Sakhalin (both 129). Lower figures (fewer than 90 hospital beds per 10,000 population) characterize much of European Russia, the Mid-Volga region and southern Urals, parts of Western and Southern Siberia, and the North Caucasus region. As with physician density, federal cities have higher figures than the surrounding oblasts (Moscow City: 85; Moscow oblast: 79; Saint Petersburg: 92; Leningrad oblast: 69); however, even the two cities do not boast particularly high figures. As with the other healthcare indicators, sharp contrasts are found between neighboring regions, such as Lipetsk oblast (79) and Oryol oblast (101), or Altai Republic (80) and Tuva (136).
Overall, it should be noted that the per-capita healthcare infrastructure does not correlate with the region’s GDP.** For example, physician density is expectedly high in richer federal cities and in Chukotka, but it is fairly low in other high GDP areas, especially in Nenets Autonomous Okrug. Similarly, nurse density is predictably high in Chukotka, Sakhalin, Yamalo-Nenets and Khanty-Mansiysk Autonomous Okrugs, but surprisingly low in other high GDP areas, particularly in the federal cities and in Tyumen oblast. Likewise, the availability of hospital beds per capita is unsurprisingly high in such rich regions as Chukotka, Sakhalin, and Nenets Autonomous Okrug, but low in others, especially in Tyumen oblast and Khanty-Mansiysk Autonomous Okrug. Nor is there a close correlation between these three indicators. For instance, federal cities are characterized by a high level of physicians per capita but few nurses; conversely, there are few physicians but many nurses in Kurgan oblast. Similarly, there is no correlation between the numbers of nurses and hospital beds per capita: for example, Khanty-Mansiysk Autonomous Okrug and Altai Republic have more nurses than hospital beds (1.83 and 1.69 nurses per hospital bed, respectively), whereas in Primorsky Krai and Tomsk oblast there are fewer nurses than hospital beds (0.83 and 0.93 nurses per hospital bed, respectively).
*Figures for meat consumption refer to “meat and meat products, including offal of category II and raw animal fat”. According to the Wikipedia, “offal of category II” includes heads (without tongues), feet, lungs, ears, pigs’ tails, lips, larynxes, thyroid glands, esophagus meat, and stomachs. Tongues, livers, kidneys, brains, hearts, beef udders, diaphragms, and beef and mutton tails are considered “offal of category I”.
**Of course, quantitative measures of health infrastructure say nothing about its quality. Much has been written (especially, in Russian-language blogosphere) about the pitiful state of many Russian hospitals. Recently, two lethal incidents that happened in the 2nd city hospital in Belgorod have brought this point home. In the first incident, a doctor pounded a patient to death; a video of the incident caught on security camera is rather difficult to watch. Two weeks later, an 84-year old patient fell from a 4th floor window of the same hospital; whether he committed suicide, or was pushed, or whether it was an unfortunate accident remains to be seen.