Russia's population sink.

• Author: Nelson, Toni

In the former heart of the Soviet empire, deaths are far outpacing-births.

In Nadvoitsy, a small Russian town near the Finnish border, an estimated 4,000 children have been poisoned by fluoride, which replaces calcium in the body, leaving its victims with blackened, rotting teeth and weakened bones. Although the town's aluminum plant no longer dumps fluoride into unlined landfills, the contamination persists because neither the authorities nor the company can afford a full-fledged clean-up. Today, 5 to 10 percent of the town's kindergartners continue to exhibit signs of fluorosis.

Nadvoitsy's experience provides a glimpse into the myriad problems facing the countries of the Former Soviet Union (FSU). Years of environmental contamination have combined with economic instability to push the region into a public health crisis, and several FSU countries are now experiencing the most dramatic peacetime population decline in modern history. In Russia, which has more than half the FSU's population, the situation may be at its worst. As the country's birth rate falls and its death rate climbs, the population is expected to shrink by some 9 million between 1992 and 2005. More important, perhaps, is the rising incidence of birth defects and other health problems whose effects may linger for generations.

Russia's demographic decline began in the mid-1980s, well before the collapse of the Soviet Union in 1991 (see graph). Total live births in Russia dropped from a peak of 2.5 million in 1987 to 1.4 million in 1994, while total deaths climbed from 1.5 million to 2.3 million over the same period. The year 1994 brought the most precipitous decline on record, with deaths exceeding births by more than 880,000 and the population falling by 0.6 percent (excluding immigration, which compensated for two-thirds of the decline). Life expectancy, which provides the best general measure of a country's health conditions, also dropped sharply between 1987 and 1994, from 65 to 57 years for men, and from 75 to 71 years for women. This decline has no precedent in industrialized societies; Russian male life expectancy is now the lowest of all developed countries.

Russia's deteriorating social and ecological conditions have had serious consequences for the country's children as well. Infant mortality has climbed to at least 20 deaths per 1,000 live births, although some experts suggest the figure could be as high as 30 per 1,000 - more than three times the U.S. rate and...