Did Mass Privatisation Really Increase Post-Communist Mortality?

David Stuckler and colleagues1 claim that mass privatisation of enterprises was “a crucial determinant of differences in adult mortality trends in post-communist countries”. We attempted to replicate their results and found that the relationship is not robust. Here we summarise our findings, which are expanded in a webappendix. Because Stuckler and colleagues do not find a positive correlation between privatisation and mortality in central and eastern Europe, but only in the former Soviet Union, we focus on the latter set of countries. In our replication we carried out three simple checks. First, by examining the data used by Stuckler and colleagues, we found inconsistencies between the published description of their dummy variable measuring “implementation of mass privatisation”—one of two privatisation measures used in the paper—and the coding of this variable. We therefore created a new variable coded precisely as described in the article (“a jump from 1 to 3 on the EBRD large-scale privatisation index”), and we re-estimated Stuckler and colleagues' model using this corrected measure. Second, because an instantaneous effect of privatisation on mortality is implausible, we re-estimated the model assuming short lags (1 or 2 years) between policy changes and mortality. Third, we controlled for differences across countries in long-term mortality trends, a common statistical method (indeed, one used by Stuckler and colleagues in other work2). The results, shown in the table, demonstrate that any one of these changes substantially weakens the positive correlation between privatisation and mortality reported by Stuckler and colleagues, and a combination of any two changes eliminates it entirely. Indeed, the estimated effect of privatisation on mortality is negative when assuming 2-year lags and controlling for trends. Although the correct functional form is unknown, one could as easily conclude that privatisation lowered as raised mortality in the former Soviet Union.