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The Impact of Privatization on the Mortality Crisis in Eastern Europe (PrivMort)
Start date: Sep 1, 2011, End date: Aug 31, 2017 PROJECT  FINISHED 

After the collapse of Communism 3 to 7 million ¿excess deaths¿ occurred, comparable to the toll exacted by Stalin. While public health research has uncovered a great deal about the proximal causes of these deaths, identifying alcohol and psychosocial stress as key causes, incredibly few studies have attempted to address the variation in these proximal causes. Why did people in some countries start to abuse alcohol much more and experience greater stress than in others? A recent article in The Lancet by the PI linked radical privatization policies to increased mortality via increased unemployment using longitudinal cross-national statistics. This article generated great controversy, and soon a critics claimed that with different specifications the model was not sufficiently robust, or that the cross-national data could conceal an ecological fallacy or miss another cause. Our study will provide decisive evidence on this debate by proposing a new methodology for studying the impact of economic policies on public health, and in so doing advancing an emerging new research tradition we call the Political Economy of Public Health. We will do this by way of developing an innovative methodology of establishing a convenience cohort study, based on the Brass indirect method traditionally used by demographers in countries without reliable vital registration data. The Brass method uses interviews with random population samples to collect data on deaths of their relatives to estimate key population mortality parameters. Our innovation is to select one-company towns that were privatized in a radical way, and matching them with towns which had a different privatization experience. In this way we can generate micro-data to test the privatization thesis. We will also be able to measure the importance of occupation on mortality. This new research method promises new tools to study the impact of large-scale politicaal, economic and organizational change on population health.

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