Health promotion in the field of substance misuse in post-Soviet Russia

Abstract

This thesis is an investigation into health promotion in post-Soviet Russia in the field of substance misuse defined as the problematic and chaotic as well as recreational use of alcohol, solvents and both prescription and illicit drugs. The thesis outlines and analyses developments in the provision of health promotion in Russia since the collapse of the Soviet Union in 1991 in two areas: institutional shifts in the provision of health promotion (the relative and changing roles of state, non-state and international actors); and changes in content and form of health promotion messages. The hypothesis that health promotion in the field of substance misuse in post-Soviet Russia remains fixed within a medical model of health is tested through an analysis of the way in which health promotion is developing in two regions – Saratov and Sverdlovsk oblasts. The relative and changing roles of state, non-state and international actors in the development of health promotion interventions, and the way health education materials framed the issue of substance misuse, both illuminated significant barriers to the development of alternative community empowerment approaches and confirmed that the medical model of health is indeed still hegemonic among approaches to health promotion in post-Soviet Russia.