Why is drinking one of the reasons? Is every male in EE a raging alcoholic?
No, but it’s pretty common.
Your assumption is more or less correct:
"While the Russian birth rate is comparable to that of other developed countries, its death rate is much higher, especially among working-age males due to a comparatively high rate of fatalities caused by heart disease and other external causes such as accidents. The Russian death rate in 2010 was 14.3 per 1000 citizens. For comparison, the US[14] death rate in 2009 was 8.4 per 1000 .
The causes for this sharp increase in mortality are widely debated, with some academics citing alcohol abuse as the main culprit,[15] and others citing the drastic and widely negative changes in lifestyle caused by economic reforms that followed the dissolution of the Soviet Union. According to a 2009 report by The Lancet,[16] a British medical journal, mass privatization, an element of the economic-reform package nicknamed shock therapy, clearly correlates with higher mortality rates. The report argues that the advocates of the economic reforms ignored the human cost of the policies they were promoting, such as unemployment and human suffering, leading to an early death. These conclusions were criticized by The Economist.[17]
According to the Russian demographic publication Demoscope,[18] the rising male death rate was a long-term trend from 1960 to 2005. The only significant reversion of the trend was caused by Mikhail Gorbachev’s anti-alcohol campaign, but its effect was only temporary. According to the publication, the sharp rise of death rates in the early 1990s was caused by the exhaustion of the effect of the anti-alcohol campaign, while the market reforms were of only secondary importance. The authors also claimed the Lancet’s study is flawed because it used 1985 death rate as the base, while that was in fact the very maximum of the effect of the anti-alcohol campaign.[18]"
Seriously, IME the culture there is such that men, especially, are pushed to drink heavily. My orientation booklet for 2 different study programs there listed a whole section of excuses to give if you didn’t want to drink any more. (One popular one was “I have an ulcer.”) The guys in my group used them so often that the Russians were seriously beginning to ask why so many Americans had ulcers.
Eva Luna, exchange student, St. Petersburg fall 1989/Nobvosibirsk summer 1995
Eva Luna I had a similar experience.
For Peace Corps we actually were offered free doctors notes if we didn’t want to drink. We had a two-day seminar on how to drink safely without offending our hosts, and how not to drink.
The Peace Corps does not send recovering alcoholics to a number of EE countries, and did not send them to Russia.
It’s that bad.
If you come into a Russian house and refuse to drink with your host without a medical reason, that implies disrespect. Used to be the same with business meetings, but I think by now Russian businessmen have had enough experience with Western counterparts to learn otherwise.
One good way to beg off is to say that you “zavyazal” (“tied it off” - slang for quit drinking because of extreme health problems due to alcoholism). People respect that.