Injurious Inequalities.

T he close relationship between a nation’s physical health and its economic and political health has been a central tenet of statecraft since the rise of the mercantile economy in the 18th century. Especially in England, France, Germany, and Austria during this time, health statistics became an important measure of social cohesion. In the 19th century, politicians, doctors, social reformers, and revolutionary thinkers—from William Farr and Otto von Bismarck to Rudolf Virchow, Edwin Chadwick, Karl Marx, and Frederick Engels—continued to use the physical health of a nation’s citizens as a broad gauge of its social well-being (for classic examples, see Edwin Chadwick’s 1842 Report on the Sanitary Condition of the Labouring Population of Great Britain and Friedrich Engels’s 1845 The Condition of the Working Class in England). Indeed, the arguments they made combined with the data they collected were central to the establishment of a social security health insurance. In the 20th century, policymakers looked to poor health statistics as a harbinger of social and political disequilibrium. One notable example was a 1981 article entitled “Health Crisis in the USSR” by the demographer Nick Eberstadt, who made some startling assertions:1 He found that alcoholism, infant mortality, and suicide rates were taking a horrendous toll on Soviet society and concluded that a society plagued by so many markers of poor health was not sustainable. Coming in the midst of the Cold War, even the most hardened spokespeople from both the Right and the Left found it difficult to believe his conclusion that the Soviet Union was on the verge of collapse. In the weeks and months that followed there appeared a flurry of furious responses in the Review’s letters to the editor and other forums, accusing Eberstadt of grossly exaggerating and misinterpreting the data. On the Right, critics reacted vehemently to the suggestion that the Soviet Union was not the powerful adversary that required huge military budgets. On the Left, the idea that socialism, no matter how corrupted,