Abstract
BACKGROUND: Ambient air pollution is a serious problem in many Eastern European countries. Elevated levels of fine airborne particulate matter (PM(2.5)) pollution in the former Soviet republics relative to the rest of Europe contribute to elevated rates of disease, especially cardiovascular disease (CVD). OBJECTIVE: Information on the underlying social and political causes of air pollution in Eastern Europe is important for pollution control and disease prevention. METHODS: To quantify relationships between pollution, and air-pollution-related CVD, and political corruption throughout Europe and particularly in the former Soviet republics, we relied on the State of Global Air report for information on air pollution levels; on the 2019 Global Burden of Disease study (GBD) for estimates of the burden of air-pollution-related CVD; and on Transparency International (TI) for rankings of governmental corruption. FINDINGS: Air-pollution-related CVD was responsible for an estimated 178,000 (UI: 112,000-251,000) premature deaths and for the loss of 4,010,000 (UI: 2,518,000--5,611,000) productive years of life (DALYs) in 2019 in the former Soviet republics. A significant positive correlation (R = 0.72, p 1.7e-8) was found across Europe between air-pollution-related CVD mortality rates and national corruption rankings. CONCLUSIONS: We conclude that lack of governmental transparency, inadequate air pollution monitoring, and opposition by vested interests have hindered air pollution control and perpetuated high rates of pollution-related morbidity and mortality in the former Soviet republics. Ending corruption and modernizing industrial production will be key to air pollution and related diseases.