Masha Gessen comes to the conclusion that Russians are “dying of a broken heart” only by eliminating what she sees as previously considered explanations for the high rate of premature death caused by cardiovascular disease, poisoning, and accidental injury. She first explains the shortcomings of Parsons’ and Eberstadt’s conclusions then moves on to comparing Russians’ activities and historical experiences to other regions. One by one she rules out infectious disease, caloric and alcoholic intake, mental illness, low birth rate, and poverty as the causes of cardiovascular disease and poisoning, primarily using Western Europe as the control.  She finds that none of these factors can explain the massive discrepancy in rates of cardiovascular disease and thus she concludes the rapidly decreasing life expectancy in Russia is due to hopelessness.

I am not convinced by this argument.  If Gessen wanted to come to a conclusion by eliminating all possible, obvious explanations, she should have considered multiple other factors. She does not, for example, consider lack of or incorrect education that might endanger young adults when it comes to accidental injury treatment or poisonous substance ingestion. She also does not consider genetic abnormalities that might be plaguing the relatively homogenous Russian population. She does not consider the quality of Russians’ diets, only the caloric and fat value.  Most surprisingly to me, she does not address the possibility of politically-motivated killings.  If there is no obvious biological reason that so many should be dying of cardiovascular disease, poisoning, or injury, perhaps it is the death certificates that are falsified.

I would argue that if one is attempting to do science by elimination, it would be nearly impossible to be sure that one has considered and discarded all potential explanations. I believe that Gessen’s methodology is seriously flawed and that without actual evidence to support the idea that hopelessness is killing Russians her argument fails.