In the early 1990s, the health care system that Latvia inherited from the Soviet regime had yet to meet Western standards. It continued to be hampered by shortages of basic medical supplies, including disposable needles, anesthetics, and antibiotics. In 1992 there were some 176 hospitals, with 130 beds per 10,000 inhabitants--more than in Estonia and Lithuania--but they were old, lacked modern facilities, and were concentrated in urban areas. The number of physicians, forty-one per 10,000 inhabitants, was high by international standards, but there were too few nurses and other paramedical personnel.

At a time when most of the modern world was experiencing rapid strides in the extension of average life span, the Soviet Union and Latvia were going backward. Between 1965 and 1990, the male life span in Latvia decreased 2.4 years, from 66.6 to 64.2 years. For females, there was a decrease between 1965 and 1979 from 74.4 to 73.9 years, but the average life span rose to 74.6 by 1990. In comparison, in 1989 the average life expectancy in the Soviet Union was 64.6 for males and 74.0 years for females. Overall, Latvia then ranked eighth among the Soviet republics. For males, however, Latvia was eleventh, ahead of three Soviet Central Asian republics and Russia. Among females, Latvia did better, sharing fourth ranking with Ukraine.

According to the calculations of a Latvian demographer in 1938-39, Latvia was about thirteen years ahead of the Soviet Union in life expectancy. No doubt, an important role in lessening the average life span statistics was played by the massive in-migration of people after 1945 from mostly rural and poverty-stricken parts of the Soviet Union. Even in 1988-89, within Latvia there was a difference of 0.8 year between Latvian and Russian life expectancy. Standardized rates that account for urban and rural differences show that Latvians live 1.7 years longer than Russians.

Perhaps no other index of the role of Sovietization is as indicative as the gap in life expectancy between Latvia and Finland, the Baltic states' northern neighbor. In 1988 Finland registered life span rates of 70.7 years for males and 78.7 for females, which were 6.5 and 4.1 years higher than the respective rates in Latvia. By 1994 life expectancy in Latvia had increased only marginally: 64.4 years for males and 74.8 years for females, compared with Finland's rates of 72.1 years for males and 79.9 years for females. During the 1930s, Latvia's rates had been higher than those in Finland and on a par with those of Austria, Belgium, France, and Scotland.

The infant mortality rate rose to 17.4 deaths per 1,000 live births in 1992, after a steady decline beginning in 1970 and an estimated eleven deaths per 1,000 live births in 1988. Its rate was higher than that of Estonia and Lithuania and almost three times the rate of infant mortality in Finland. In 1994 there were 16.3 deaths per 1,000 population in Latvia. The primary causes of infant deaths in Latvia are perinatal diseases; congenital anomalies; infectious, parasitic, or intestinal diseases; respiratory diseases; and accidents and poisonings. Environmental factors and alcoholism and drug abuse also contribute to infant mortality.

Latvia outpaced most of the other republics in the Soviet Union in deaths from accidents, poisonings, and traumas. In 1989 some 16 percent of males and 5.6 percent of females died from these causes. The suicide rate of 25.9 per 100,000 in 1990, or a total of 695, was more than twice that of the United States. In 1992 the number of suicides increased to 883. Other major causes of death include cancer, respiratory conditions, and such stress-related afflictions as heart disease and stroke. Although drug addiction and acquired immune deficiency syndrome (AIDS) are on the increase, their incidences are not yet close to those in many Western countries.

Traffic deaths in 1990 reached a rate of 43.5 per 100,000 population, or a total of 1,167. There were 245 homicides in 1990, a rate of 9.1 per 100,000. This increase represented a dramatic jump from 1988, when the rate was 5.8, and from 1985, when it was 5.2. The greater availability of weapons has been one cause. More important, Riga and other cities have been targeted by mafia-style criminal gangs intent on carving up and stabilizing their areas of operation against other gangs. Still another cause is the decrease in the efficiency of law enforcement organs because of low pay, rapid turnover of cadres, lack of gasoline for automobiles, and language problems. The rise in criminal activity has increased Latvians' stress, interfered with their enjoyment of life, and impaired their well-being, health, and physical survival.

Another important ingredient affecting the survival of people in Latvia includes dangerous life-styles and substance abuse. Alcohol consumption rose from an average per capita rate of 1.9 liters per year in the 1920-34 period to 11.7 liters per year in 1985. This sixfold increase in alcohol consumption has had deleterious effects in many other areas of life and health and is one of the main causes of traffic deaths, drownings, fires, and crime.

Most Latvian males are inveterate smokers. A study of six cities in the mid-1980s discovered that 63 percent of men were active smokers, 13 percent had quit, and only 24 percent had never smoked. Smoking takes a particularly heavy toll in Latvia because the allowable tar content in cigarettes is high (three times as great as in Finland), most of the cheaper brands do not have a filter, and most men prefer to inhale deeply. There is a high incidence of illnesses related to smoking and environmental pollution, such as emphysema, lung cancer, bronchial asthma, and bronchitis.

Another habit dangerous to health is the preference for fatty diets and minimal attention to exercise. The economic hardships of recent years appear to have decreased the number of grossly overweight people. This may be one of the few unintended benefits of the reconstruction period.

The total number of pension recipients in Latvia grew from 603,600 in 1990 to 657,700 in 1993. Old-age pensions accounted for the largest number of awards (500,300), followed by disability pensions (104,200) and survivor's pensions (26,300). Old-age pensions remained very low, ranging from LVL15 to LVL23.5 (for value of the lats--see Glossary) per month, depending on the number of years of work.

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Source: U.S. Library of Congress