Fafo-report 407

Guri Tyldum, Larissa Riabova, Vigdis Nygård

Trying to be strong

A study of the impact of economy and culture on lifestyle choices and use of health care institutions in the Murmansk region of Russia

ISBN 82-7422-396-7
2003 72 s kr 172,- Ordrenr: 407 Bestilling

Web edition (pdf 333kb) * More publications on this subject

Trying to be strong portraits the health challenges and problems that individuals face in the Russian North. The analysis focuses on lifestyles, with particular emphasize on how people think and act in relation to risk factors such as diets, alcohol, smoking, stress, and workplace security. The analysis is based on interviews with more than 50 ordinary Russian citizens, health care workers and representatives from public administration in the city of Apatity and a nearby village in Murmansk oblast’.

The background for this study was the low life expectancy and high mortality from non-communicable diseases that we find in Russia today, where the mortality figures for middle-aged men are particularly worrying. Trying to be strong shows how an ideal of being strong often is translated into potentially harmful health behaviour, in particular among adult men. At the same time, the health challenges of adult men are often overlooked, also among health care workers and administrators. We argue that in order to reverse the high mortality trend for this group, it is necessary to focus on the challenges that these groups are facing. We also have to acknowledge that these traditionally strong groups of society may be vulnerable as well.

This report is a result of a co-operation between the Institute of Economic Problems/Kola Science Centre, the Norwegian Institute for Urban and Regional Research and Fafo Institute for Applied International Studies. It is financed through the Health Co-operation Programme in the Barents Euro-Arctic Region.

Introduction
The backdrop: Low life expectancy and a high occurrence of lifestyle-related illnesses
Sample and methods
The research site

Lifestyle choices between economy and culture
Dreaming about meat and white bread
‘Vodka is part of our culture’
Smoking is a man’s thing
Coping when the world turns upside down
The best jobs are high-risk jobs

Institutions – access to and use of health care facilities
Organisation and financing of health care in Russia
Those who can pay get quicker access and better service
Knowing what you are entitled to, and getting it
Cost of medicines
One in 20 visits the polyclinic every day

When being strong becomes a problem