Over Vladimir Putin’s first two decades in power, much of his enduring popularity with the public can be traced to improvements in public health, a stabilization of population trends, and, through general economic improvement, the presence of a more welcoming environment for family planning as compared to the late Soviet and early Russian periods. Many demographic measures showed severe setbacks in the 1990s: alcoholism, drug use, and the spread of communicable diseases, such as tuberculosis and HIV, which worsened dramatically. The rapid deindustrialization and deep recession experienced between 1992 and 1998 led to a great decline in the basic capacity to provide public services, with cuts in education and healthcare spending, and the general social trauma of state failure led to natural population declines through a combination of emigration, declining births and increasing deaths. When Putin came into office, restoring the state appeared to be a matter of public welfare. In large part, Putin has been successful relative to the past but middling compared to Russia’s current peer competitors.

This chapter outlines the health, life prospects, and economic culture enjoyed by Russians today. The last cardinal success of the improvement of most demographic, health, and socioeconomic indicators has been the emergence of a strong consumer culture in Russia. High GDP growth rates and rising state spending on social programmes such as pensions in the 2000s led to large rises in household incomes. Western firms and brands established a large presence, luxury goods flooded into large cities, and Russian businesses serving domestic tastes and preferences grew. The decline of real incomes since 2013 has reversed some of these gains and been accompanied by a proliferation of efforts to encourage consumption of domestic equivalents, from cars to television series watched using domestic streaming services. Stagnation ultimately interacts with every other component of these various socioeconomic and demographic indicators since the state of the economy affects public budgets, family formation, the demand for labour, and more. The conservative, statist model that has emerged over the last two decades will continue to evolve and adapt to a low-growth environment affected by Putin’s policy choices and social trends that are beyond the Kremlin’s control, especially the consequences of war, sanctions and deglobalization.