Introduction

This chapter addresses issues of data quality that affect the interpretation of reported mortality levels and trends in the New Independent States (INS). It presents an overview of data quality issues for readers who are not necessarily specialists in demography or familiar with the quality and types of data that are available from this part of the world. We examine data from selected regions and dates, while drawing the reader's attention to broader issues and the existing literature on the quality of data from the former Soviet Union. Our focus is on the traditionally Moslem NIS countries, including the Central Asian states of Kyrgyz, Tajikistan, Turkmenistan, and Uzbekistan, plus Kazakstan and Azerbaijan, which are linked both historically and culturally to Central Asia; these are cases in which real levels and trends in mortality, both past and present, are obscured by data error. Russia and Latvia are cases in which the reported adult mortality patterns and evidence of increasing mortality can be believed, and they are therefore used as a frame of reference for the reliability of the Central Asian data; these cases are fairly typical of the European part of the NIS. To aid in the analysis, we also draw on some detailed data from Xinjiang (in China), where one finds major ethnic groups that are culturally similar to Turkic groups in the Central Asian states. The purpose of the analysis is to identify ways of improving data collection in the NIS, especially Central Asia, so that policies and interventions related to health and mortality can be more effectively developed and targeted.

It may be noted that although mortality rates are normally the highest among infants and the elderly, these are the ages for which error due to age misstatement and underreporting of deaths is most likely to occur. In this chapter, we first discuss problems with Soviet data on infant mortality and the elderly as a general caution to researchers who are not familiar with data from the region. In the data analysis, however, we focus on an age range for which we can have more confidence in the data. For much of the analysis, we examine data for ages 10-79; for some of the analysis, though, we focus on the age range 20-59.

Our approach to studying demographic trends in the former Soviet Union and the NIS is to start with official statistics, but to view them with a critical eye. Scholars have devoted less attention to the evaluation and adjustment of demographic statistics in this region than to the evaluation and adjustment of economic statistics.¹ We do not subscribe to the view that all of the data from the Soviet Union were fabricated or intentionally altered to make the state or political leaders look good or to mask negative trends in popular welfare. A frequent concomitant of such a point of view is a readiness to accept official data from the region only when they reveal negative trends or facts.

Nor do we subscribe to the view that the data are ''in the ballpark" and reliable enough for designing appropriate health and welfare interventions. While we agree that the available data provide a fairly clear picture of the main problems in public health and welfare for some regions and purposes, issues of data quality are too substantial to ignore. Acceptance of reported mortality data at face value would lead to errors in evaluating the impact of intervention strategies, because changes in data quality can obscure changes in real demographic behavior or outcomes. Moreover, some of the mortality rates, including cause-specific rates, have been extremely volatile in response to short-term factors and may now be at or near their peaks. Consequently, there is considerable risk of confusing the effects of policy interventions with "regression effects."²

We assess the plausibility of the reported figures by looking for internal consistency and by comparing them with levels and patterns in reported statistics from other countries. On occasion, formal tests for the consistency of age and mortality data have been applied to data from the Soviet Union and the NIS. Because of the lack of needed data, however, the formal application of consistency checks is not yet feasible for most regions of the former Soviet Union and for most types of mortality data. Furthermore, some methods for estimating error require untenable assumptions about the data. For example, methods of estimating the underregistration of deaths using vital registration and intercensal survival rates work reasonably well only if there is no appreciable age exaggeration in the census or death registration, a precondition that does not exist in data from Central Asia. Hence, a naive application of so-called formal checks for completeness of registration would give a false impression (most likely an underestimate) of the extent of underreporting of mortality in this region.

We have devoted a great deal of effort to examining the demographic information system in this part of the world and what biases it might impart. Often we have had to use indirect methods or to compare patterns from the region with those in other countries because the lack of detailed data or access prohibits direct checks on data accuracy. However, some data problems are easy to detect. For example, there were more persons reported alive at ages 11-15 in the 1970 census than were reported at ages 0-4 in the 1959 census. Although immigration of young children between 1959 and 1970 could have led to this result, in principle the only plausible explanation is that there was an undercount of young children in the 1959 census. A similar pattern occurs in later censuses.³ It is also not possible that the proportion of children who were physically or mentally handicapped was more than 10 times greater in the relatively developed Baltic republics than in the relatively undeveloped Central Asian republics (Anderson et al., 1987). Similarly, there is an obvious deficiency in the reported data showing that the month in which the lowest number of infant deaths occurred in the Soviet Union was December, while the month in which the highest number of infant deaths occurred was January (Anderson and Silver, 1988), and this pattern persists into the post-Soviet period for many regions.

These and other patterns of error in reported demographic data require careful analysis before one can best assess what was actually true, as opposed to what was reported to be true. The existence of error in the data does not mean that the data were deliberately "faked" and ought to be dismissed out of hand. In many cases, the error probably occurred for other reasons. Moreover, the data did not suddenly get better just because the Soviet Union broke up in 1991 and was replaced by multiple new governments, each with varying capabilities and commitments to the reform and improvement of demographic statistics. Nor did a large treasure trove of previously unpublished but validated data suddenly become available (Anderson et al., 1994).

Users of the data need to be aware of how the data were and are generated and to what extent the data in the hands of the government (whether published or not) reflect the true situation among the population. For example, because of differential access to and utilization of services, a great deal of data based on program usage may be an inaccurate reflection of the actual level of program need, both overall and by category of the population (region, urban-rural residence, sex, and other characteristics). A clear instance of this is the published information about disability (Anderson et al., 1987). The same issue must be considered in the analysis of a wide variety of data on morbidity, as well as some data on mortality. For example, the relatively high incidence of and mortality from cervical cancer in Estonia as compared with Finland appears to be due mainly to more effective mass screening in the latter (Aareleid et al., 1993).

The next section identifies various problems with Soviet and post-Soviet mortality data and describes our approach to analyzing the data. The following section presents mortality data for Russia and Latvia, areas where those data quality problems are less severe; thus these data can be viewed as relatively reliable, providing a frame of reference for the reliability of the data for the

Central Asian states. Next is a section examining how the identified data quality problems apply to the Central Asian data, thereby limiting their utility in policy and intervention terms. The final section presents conclusions and recommendations for improving the collection of mortality data in the NIS.

Some Problems with Soviet and Post-Soviet Mortality Data

Detailed data on mortality among the Soviet population were published sparsely before 1975 and almost completely suppressed between 1975 and 1986. The four relatively bountiful years in the publication of population and health statistics during the glasnost period have been followed since the demise of the Soviet Union in 1991 by a decrease in the amount of published data. Recently, however, life tables for 1992 for some of the new states have appeared, and life tables by ethnic group⁴ for 1990 and for the rural and urban populations of republics in 1990 have been published. Data are now plentiful enough to allow detailed examination of reported mortality conditions by age, sex, country, and rural-urban residence so that earlier conclusions about the plausibility or implausibility of the reported data can be examined more concretely. The following subsections describe various specific problems with Soviet and post-Soviet mortality data; the final subsection explains our approach to data analysis.

Mortality Trends in Russia and Latvia

Mortality patterns in Russia have, of course, been the subject of great interest. Yet the study of Russian mortality has been hindered until recently by the lack of detailed published data. Although life tables were published for many other republics of the Soviet Union, life tables for Russia for the post-World War II period were not published until 1988 (for the years 1970-1971 and later). Hence, as the divergence between mortality trends in the Soviet Union as a whole and those in other developed countries became especially evident in the early 1970s (Vallin and Chesnais, 1974), it remained virtually impossible for scholars to identify the regional (republic) components of the Soviet trends, including Russia's contribution.

However, after examining age-specific death rates and expectation of life at birth for the Soviet Union as a whole and for individual republics, Dutton (1979) speculated correctly that poor survival of men in the Soviet-era Russian Federation was responsible for a large portion of the high mortality of men and for increases in their age-specific mortality in the Soviet Union as a whole. Some years later, using inferential methods, we estimated life tables for Russia for 1958-1959 and 1969-1970 (Anderson and Silver, 1986a). The latter turned out to be very similar to the table ultimately reported for Russia for 1970-1971.

Detailed scholarly study of mortality in Russia as a whole and for its separate regions is still at an early stage, but recent work has been of high quality (see the chapters by Vassin and Costello and by Murray and Bobadilla, in this volume; Shkolnikov and Vassin, 1994; and Shkolnikov et al., 1994). Moreover, the quality of data for Russia has improved such that observed trends for the last two decades or so can be taken as fairly reliable, especially for the working ages.¹⁶ For this reason, the substantial increases in mortality among Russian men after the mid-1960s, as well as increases in mortality in Russia in 1992 and 1993, can be interpreted as real—not as an artifact of changes in data quality.

The Baltic states, especially Latvia and Estonia, have long had high-quality demographic data. We examine Latvia as an example of the situation in the Baltic states. The course of mortality in Latvia and the possible effects of the Soviet regime on the course of mortality have been the subject of recent scholarly examination (Krumin , 1993, 1994).

Among all populations, age-specific death rates are high in infancy and childhood, rise slowly from about age 10 through later adulthood, and then rise more rapidly after about age 50. Coale and Demeny (1983) summarize the typical pattern of change in mortality at different ages as the overall mortality conditions in a population change. Among all populations, the age-specific mortality rate at ages 20-24 is lower than at ages 70-74. However, the age-specific mortality rate in a given population can be relatively high or low for that age range in comparison with other populations.

To judge whether an age-specific mortality rate at one age is relatively high or low as compared with the age-specific mortality rate at another age, we need a standard for comparison. We use Coale-Demeny West model life tables for this purpose. With every age-specific mortality rate from a population of interest, we associate the expectation of life at birth from the Coale-Demeny West model life table that has the same age-specific mortality rate. If the pattern of mortality by age were the same in the population of interest as in the Coale-Demeny West tables, the expectation of life at birth associated with every age would be the same; a plot of the fitted or implied expectation of life at birth across ages would be a horizontal line. However, if mortality were low at one age in comparison with another, the age with relatively low mortality would be associated with a relatively high implied or fitted expectation of life at birth; in this case a plot of the implied expectation of life at birth would not be horizontal. ¹⁷

For the purposes of this discussion, the choice of which Coale-Demeny family to use as a standard or whether to use another standard, such as the U.N. General Pattern (United Nations, 1982a), makes little difference to our substantive conclusions. We do not use conformity with the standard as an absolute test of data quality. We use it instead to provide a more readily interpretable metric for comparing mortality at different age levels and for different populations.¹⁸

Figure 4-1a shows the expectation of life at birth, e(0), associated with age-specific mortality rates for females in Russia in 1978-1979, 1990, and 1992, while Figure 4-1b shows the values for females in Latvia in 1978-1979 and 1990. In Russia, mortality rates for females declined between the late 1970s and 1990; this mortality decline was lost between 1990 and 1992. For females in Latvia, mortality was quite low at all ages even in 1978-1979; between the late 1970s and 1990, mortality declined at some ages and increased at others.

Figure 4-1a

Implied e(0) for Russia in 1978-1979, 1990, and 1992, females.

Figure 4-1b

Implied e(0) for Latvia in 1978-1979, 1990, and 1992, females.

Figure 4-2a shows the expectation of life at birth for males in Russia associated with age-specific mortality rates, while Figure 4-2b shows the values for males in Latvia. The implied expectation of life is sharply lower for Russian men at the older working ages as compared with what would be expected if their mortality were consistent with the Coale-Demeny ''level" of that found among younger men. A similar, although less extreme, pattern by age is seen for men in Latvia.

Figure 4-2a

Implied e(0) for Russia in 1978-1979, 1990, and 1992, males.

Figure 4-2b

Implied e(0) for Latvia in 1978-1979, 1990, and 1992, males.

This pattern for males in Russia and Latvia is probably due partly to deaths related to smoking and alcohol consumption. After a period of rising mortality among men from the mid-1960s through 1980, mortality fell until 1990. Shkolnikov and Vassin's (1994) examination of mortality change in Russia by month makes it clear that the fall and rise in male mortality in the mid-1980s was substantially a result of the effects of the anti-alcohol campaign. However, not only were the gains among Russian males from the late 1970s through 1990 lost between 1990 and 1992, but real mortality among older working-age Russian men in 1992 was higher than in the late 1970s.

Figures 4-3a and b show the implied expectation of life at birth from age-specific mortality rates for residents of Russia and Latvia on the one hand, and ethnic Russians and ethnic Latvians in the Soviet Union as a whole on the other hand. The values for Russians and for Russia are virtually identical. However, the mortality levels in Latvia are somewhat lower than those in Russia. This is because almost half the population of Latvia comprises people—primarily Russians—who are not ethnic Latvians. Ethnic Russians in Latvia have higher mortality rates than ethnic Latvians (Krumin, 1994). As a result, mortality rates for all residents of Latvia are higher than those for ethnic Latvians.

Figure 4-3a

Implied e(0) for Russians and Latvians in 1988-1989, and RSFSR and Latvian SSR in 1990, males.

Figure 4-3b

Implied e(0) for Russians and Latvians in 1988-1989, and RSFSR and Latvian SSR in 1990, females.

As discussed earlier, age-specific mortality rates are low at the adult ages among all populations. It is important to bear in mind that because mortality rates at some ages are typically very low, those rates even if doubled would cause only a few days' reduction in the average length of life for the population.

Table 4-1 shows the percentage of people in Russia and Latvia alive at age 20 who would be expected to die before reaching age 60 given the age-specific mortality rates in effect. For both males and females in Russia and in Latvia, there was a decline in that percentage between 1978-1979 and 1990. Between 1990 and 1992, the percentage of 20 year olds who would die before age 60 increased for both males and females in Russia. In 1992, the age-specific mortality rates imply that 36 percent of men reaching age 20 would die before reaching age 60. By world standards, the survival rate of men in Russia from ages 20 to 60 is extremely low (Anderson and Silver, 1994a). The level of mortality between ages 20 and 60 for Russian men in 1992 is consistent with an expectation of life at birth of 52 years. Moreover, a recent report by the Russian Federation Ministry of Health (Russia Minzdrav, 1994) indicates that mortality rates in Russia rose considerably between 1992 and 1993.

TABLE 4-1

Percentage of 20-Year-Olds Expected to Die by Age 60, for Russia in 1978-1979, 1990, and 1992, and Latvia in 1978-1979 and 1990.

This very high level of mortality among Russian men at working ages has substantial policy implications. In a period of social disruption, high levels of male mortality mean that high levels of widowhood exacerbate the effects of high divorce rates in breaking up families. The increase in female-headed households resulting from high adult mortality contributes to high levels of poverty. Households headed by women have long been a major segment of the poor in Russia.

Age-Specific Mortality Rates in the Traditionally Moslem NIS Countries

Many problems with mortality data from less-developed countries are found in the data for the traditionally Moslem NIS countries. As discussed earlier, all of these problems result in reported mortality rates lower than the actual rates. As the quality of the data improves, the mortality rates increase, even if the actual mortality situation has not changed.

Figure 4-4 shows the implied levels of expectation of life at birth for males in Sweden in 1989, for Uighur males in Xinjiang in 1990, and for males in Latvia in 1990. For Sweden, there is a comparatively horizontal line. The results for

Figure 4-4

Implied e(0) for Sweden (1989), Uighurs in Xinjiang (1990), and Latvia (1990), males. NOTE: Fitted levels are based on Coale-Demeny (1983) male West model.

Latvia show a decline with age in the implied level of expectation of life at birth, both because of high mortality at the older working ages and because more recent cohorts were born into a generally more favorable mortality situation than earlier cohorts. The data for Uighurs show a higher implied expectation of life at birth at older than at younger ages; indeed, among Uighur men aged 75-79. the implied expectation of life is as high as that for Swedish men.

A higher implied expectation of life at older ages does not by itself indicate that the data are poor, since a variety of mortality conditions and causes of death could produce such a shape. (See also Shkolnikov et al. and Kingkade and Arriaga, in this volume.) However, the very low mortality rates that are implied at older ages for Uighurs as compared with Swedes are clearly implausible given the known public health conditions in Xinjiang as compared with Sweden. Thus those low rates suggest poor data quality (see Coale and Li, 1991; Anderson and Silver, 1994c).

Further indications of data quality problems result from examining the implied expectation of life at birth based on age-specific mortality rates for urban and rural populations of Uzbekistan, Azerbaijan, Russia, and Latvia for 1978-1979 and 1990. Except for Latvia, the implied expectation of life at birth is higher at older ages among rural than among urban populations. This is more evident for 1978-1979 than for 1990. We interpret this rural-urban crossover as another indication of problems with data quality. Although this crossover occurs in Russia, the age at which it occurs is much later in Russia than in Azerbaijan and Uzbekistan, and the distance between rural and urban populations is much smaller for Russia than for the other two.

In Latvia, the rural population comprises predominantly ethnic Latvians (72 percent in 1989), while the urban population contains a high proportion of ethnic Russians (41 percent). In the traditionally Moslem NIS countries, Russians and members of other European groups are concentrated in urban areas. The rapid increase in the implied expectation of life at birth with increasing age for rural males in Azerbaijan and Uzbekistan is not plausible. If detailed mortality data were available by urban-rural residence and ethnic group within the former republics of the Soviet Union, the actual sources of these strange patterns would be clear. We think the figures for Uzbekistan and Azerbaijan would be similar, even if data only for the indigenous ethnic group were shown.

We have much less faith in rural than in urban data both because rural deaths (especially infant deaths) appear to be much less well enumerated than urban and because we find indirect evidence of many rural deaths being attributed to urban populations (Anderson and Silver, 1994b). Usually, mortality conditions are better in urban than in rural locales (United Nations, 1980:34; 1982b:88,106, 136, 164). Worse urban than rural mortality and crossovers in mortality rates between urban and rural areas provide evidence to support the conclusion that the actual mortality rates in rural areas have been much higher than the reported rates.¹⁹

We think rural mortality rates at older ages are underestimated for a combination of reasons: exaggeration of age in the census (or base population estimate), exaggeration of reported ages at death, and underregistration of deaths. Our research in Xinjiang in Chinese Central Asia, however, suggests that underregistration of deaths may not be the main culprit. Uighurs outnumber Han Chinese in Xinjiang. In addition, in the data from China we used, deaths were reported in the census rather than in the vital registration system. However, even when life tables for Uighurs in Xinjiang are constructed on the basis of census data alone (using the count of persons by age in the population and the reported deaths of persons by age in the 6 months preceding the census), patterns of implausible mortality rates at older ages similar to those in the former Soviet Central Asian republics appear in the Uighur population of Xinjiang (Anderson and Silver, 1994c).

Figures 4-5a through d show data for Latvia, Russia, and Uzbekistan for 1990. If these data are to be believed, males in rural Uzbekistan had much better mortality conditions than males in rural Russia and Latvia; the comparison is similar, but less extreme, for urban males. The mortality levels for females in all three former republics are similar. We do not think it possible that the actual mortality rates of males were lower in rural Uzbekistan than in rural Latvia in 1990.

Figure 4-5a

Implied e(0) for urban population of Latvia, Russia, and Uzbekistan in 1990, males.

Figures 4-6a and b show the implied expectation of life at birth for males and females in the six traditionally Moslem republics. Among those republics, Kazakstan and Azerbaijan have a relatively high level of socioeconomic development, and Tajikistan and Uzbekistan a relatively low level. One would suppose that the implied expectation of life at birth would be higher in the more-developed republics. The results for females have a certain amount of plausibility: the more-developed republics generally have higher implied expectation of life at birth. For males, however, the implied expectation of life at birth tends to be higher the less developed the republic.

Figure 4-6a

Implied e(0) for total population of six Moslem republics in 1990, males.

Figure 4-6b

Implied e(0) for total population of six Moslem republics in 1990, females.

Figure 4-5b

Implied e(0) for rural population of Latvia, Russia, and Uzbekistan in 1990, males.

Figure 4-5c

Implied e(0) for urban population of Latvia, Russia, and Uzbekistan in 1990. females.

Figure 4-5d

Implied e(0) for rural population of Latvia, Russia, and Uzbekistan in 1990, females.

Some of the differences in mortality among the urban populations of these republics reflect differences in the ethnic composition of the urban population, but except for Kazakstan, the rural population of each republic comprises predominantly indigenous populations. Men of European background may consume more alcohol than men from indigenous ethnic groups in Central Asia; thus the indigenous men may have lower mortality from causes directly related to alcohol consumption. However, the magnitude of implied life expectancy for older men from some of the Central Asian republics is so high and so inconsistent with age-specific mortality rates at younger ages as to be out of the range of relationships of mortality at different ages in any well-recorded populations. The data indicate that rural males in Tajikistan have an extremely high implied expectation of life at birth: over 70 years for all age groups from 45-49 through 75-79.

Table 4-2 shows the percentage of people alive at age 20 who would be expected to die before they reached age 60 given the age-specific mortality rates in the given year. The data are shown for the six traditionally Moslem republics; for total, urban, and rural populations; and for 1978-1979 and 1990.

TABLE 4-2

Percentage of 20-Year-Olds Expected to Die by Age 60, for Six Traditionally Moslem NIS countries, 1978-1979 and 1990.

We have argued that the reported mortality rates for men in the Moslem republics are not plausible. At both dates shown in Table 4-2, the working-age mortality of men is reported as greater in urban than in rural areas in every Central Asian republic, Kazakstan, and Azerbaijan. However, the gap lessens over time. In every traditionally Moslem republic, the percentage of men in urban areas dying at working ages declines, while in all of these republics except Kyrgyz and Uzbekistan, the percentage dying in rural areas at working ages increases. This is exactly what should happen if urban data were much more accurate than rural and if the quality of rural data improved over time.

The data for women appear to be much more reasonable than those for men. In every case, except for Azerbaijan and Kazakstan in 1978-1979, the percentage expected to die between ages 20 and 60 is higher in rural than in urban areas, and the values for rural and urban Kazakstan are almost identical. In addition, the more-developed republics tend to have a lower estimated proportion dying between ages 20 and 60.

The health and mortality of the working-age population are a matter of great policy concern in the NIS. Policy planning that accepted as accurate the values shown in Table 4-2 would be in serious error. It is not plausible that men in Tajikistan, the least-developed republic, have the lowest working-age mortality anywhere in the NIS.

Conclusions and Recommendations

The serious health and mortality situation in the NIS deserves policy and scientific attention. In none of the states has mortality reduction kept up with the reductions seen in most of the developed world during the last 20 years.

It is beyond the scope of this discussion to provide a comprehensive overview of the data needs in each of the NIS countries. Instead, we have focused on interpreting reported levels and trends in mortality in the region. Consistent with this focus, we make some recommendations here for data collection and improvements in data quality that would strengthen the ability of policymakers to monitor and interpret mortality trends in the region.

As we have indicated, the overall high mortality rates in the NIS, both in the aggregate and by cause, are grounds for concern and action. But because of poor data quality, interventions to improve health conditions that would also improve data quality would be likely to produce equivocal results. For example, efforts to reduce infant mortality rates in Central Asia could also produce more complete reporting of infant deaths. Interventions that were actually lowering infant mortality could lead to apparent increases in infant mortality (or to a slower decrease in infant mortality than was actually occurring)—and perhaps to premature abandonment of policies and programs that were actually working. The same thing could happen in Russia, in which generally lower data quality in some of the predominantly non-Russian regions (e.g., Chechnya, Ingushetia, Daghestan, Balkaria) could disguise actual improvements in infant mortality if these improvements were accompanied by more complete registration of births and infant deaths.

Improvements in the accuracy of reporting of ages of the base population and of the deceased, or more complete registration of deaths, would also be likely to occur if there were a concerted effort to reduce adult mortality. The reported adult mortality rates would probably show a smaller reduction (and possibly even an increase), even while actual adult mortality rates were declining.

Thus, addressing the issue of data quality and building in standards for evaluating program success are essential if one hopes to obtain a realistic picture of program efficacy.

Acknowledgments

We thank Victoria A. Velkoff, Vladimir M. Shkolnikov, and the State Statistical Bureau of the People's Republic of China for providing some of the data used in this analysis. Research on this paper was supported in part by NICHD Grant No. P30 HD-10003.

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Footnotes

1. On the characteristics and problems of economic statistics in the Soviet Union, see Feshbach (1960, 1962, 1972), Shenfield (1992), and Treml and Hardt (1972).

2. For a discussion of the issues involved, see the classic study by Campbell and Ross (1968).

3. A greater than 100 percent apparent intercensal survival of young children persisted in the 1970 census (Anderson and Silver, 1985a; Kingkade, 1985). An analysis of the 1979 and 1989 censuses reveals a similar, though perhaps less serious, pattern of undercounting of young children.

4. The Russian word "natsional'nost" is translated into English as "ethnic group," since the English word "nationality" has connotations of ''citizenship."

5. Using detailed new statistics medical registration of births from Estonia, Katus (1994a) has calculated the differential in the infant mortality rate due to the shift to be 16.6 percent.

6. The shift to the WHO definitions of live birth and infant death was a good idea, but it creates problems of data comparability. Many other Soviet definitions were not standard. The Soviet definition of a family, for example, was different from that used anywhere else in the world (Anderson, 1986).

7. For a discussion of problems and opportunities in population statistics in the NIS, see Anderson and Silver (1994b). In that paper, we speculated that in the Central Asian states, reported infant mortality rates would fall, because of an increase in the proportion of infant deaths not being recorded. We also speculated that this would be interpreted as an indication of the positive consequences of throwing off Soviet control. In Uzbekistan and Tajikistan, both the reported decline in infant mortality and this rosy interpretation have in fact occurred (personal communication from Vladimir Shkolnikov).

8. Other patterns can also occur. Among Han Chinese, there is some evidence of heaping on a 12-year cycle corresponding to the animal years of the lunar calendar. See Anderson and Silver (1994c).

9. That this is not, strictly speaking, a characteristic of Moslem populations, but depends on other cultural characteristics, is illustrated by the case of the Hui (so-called Moslem Chinese), who also reside in large numbers in Xinjiang, but do not show any sign of the age heaping observed for the Uighurs and Kazaks. It appears likely that the Hui use the Chinese lunar calendar to reckon their ages.

10 It has been speculated that the higher mortality rates in urban than in rural areas could be real because of worse public health conditions, environmental hazards, and epidemics of communicable diseases in cities—akin, perhaps, to the experience in the United Kingdom in the eighteenth and nineteenth centuries. The mortality risks in the Soviet Union and its successor states in the latter half of the twentieth century have on the whole been significantly higher in rural than in urban areas.

11. We have estimated that the Soviet definition of a live birth and an infant death led to a reported infant mortality rate 22 to 25 percent lower than that which would have resulted from using the WHO-recommended definitions (Anderson and Silver, 1986b). But in Central Asia, the definitional difference is only a small fraction of the error. Baranov et al. (1990) estimate that in 1970, while the reported infant mortality rate for Central Asia was 36 infant deaths per 1,000 live births, the actual rate was 128 using Soviet definitions and 161 using the WHO definitions of live birth and infant death. Although Ksenofontova (1994) questions the methods used by Baranov et al. (1990), her own estimates are not much lower than those resulting from the latter methods for this period. For further discussion, see Anderson and Silver (1990b, 1994b). For an examination of cause of death for infant mortality in Central Asia as a way of detecting data error, see Velkoff (1990, 1992) and Velkoff and Miller (1995).

12. This is due in part to inconsistent application of rules for attributing deaths to the permanent place of residence of the deceased rather than the place of occurrence of the event. See Anderson and Silver (1985b, 1994a).

13. For further discussion of trends in mortality by age and region, see Anderson and Silver (1989b, 1990b), Blum and Monnier(1989), Dutton (1979), and Sinelnikov (1988).

14. For Estonia, infant mortality rates and life tables by county for the Soviet period and the early 1990s have just been published (Katus, 1994a, 1994b).

15. We have studied seasonal patterns of registered births in the republics of the former Soviet Union as an indicator of the overall quality of the vital registration system (Anderson and Silver, 1988). The rank ordering of the republics in the plausibility of the seasonal pattern of births corresponds closely to our evaluation of the quality of mortality data by republic.

16. This conclusion is based in part on an analysis of mortality data for Russian provinces we undertook in collaboration with Vladimir Shkolnikov and Sergei Vassin.

17. The U.N. program COMPAR, part of MORTPAK, was used to calculate the implied levels of expectation of life at birth. When the implied expectation of life at birth was greater than 80 years, it is plotted here as 82. There has been work on model life tables at very low levels of mortality (Coale and Guo, 1989, 1990). It is not plausible that in the traditionally Moslem republics of the former Soviet Union, actual mortality would be consistent with an expectation of life at birth of more than 80 years.

18. For discussion of the selection of a standard as a common metric and for an assessment of the plausibility of the reported "shape" of mortality curves in different regions of the former Soviet Union, see Anderson and Silver (1989a).

19. This was also argued by Dmitrieva and Andreev (1987).