Another dose of Ukraine stats for Monday morning

Another dose of Ukraine stats for Monday morning

KIIS asked some of the same questions in both the May 2015 and May 2016 Omnibuses (their translations from the Ukrainian and Russian versions of the questionnaire):

  • “Do you consider yourself a happy person?”
  • “If to speak about Ukraine in general, how do you think, in one year from now the situation in Ukraine will be better or worse than now?”
  • “How do you think, in one year from now your family will live better or worse than now?”

First, Ukrainians aren’t exactly getting happier – 54% said they were happy in May 2016 compared to 59% a year earlier. It’s not a huge change, but it’s significant.

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Second, Ukrainians are getting less optimistic about the future, as you can see below.

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What’s also interesting is that fewer people in 2016 felt the questions about optimism were difficult to answer (i.e., don’t know)…

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Some of the breakdowns for these questions are what you’d expect – i.e., older people, those with lower incomes/lower self-reported descriptions of their financial situation and those with lower levels of education= less happy and less optimistic about the future. I may dig in further. Ask and ye quite possibly may receive. Enjoy your Monday.

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Some fairly random Ukraine stats to start the week

Some fairly random Ukraine stats to start the week

I’ve had some of this data kicking around for a few days, in some cases a few weeks. Enjoy.

Ukraine’s optimists

In the May 2016 wave of the Kyiv International Institute of Sociology’s Omnibus (the most recent publicly-available wave), respondents were asked (KIIS’ translation from Ukrainian/Russian versions):

If to speak about Ukraine in general, how do you think, in one year from now the situation in Ukraine will be better or worse than now? 

  • Only 10.6% of Ukrainians think things will be better; 31.3% think it’ll be the same and 47.5% think it’ll be worse.
  • People who think Ukraine will be better were more likely to say they’d vote for Bloc Petro Poroshenko (14.5% compared to 7.1% who said the situation will be the same and 3.2% who said it’ll be worse) and Samopomich (8.8% compared to 4.4% who said the situation will be the same and 3.2% who said it’ll be worse).
  • Conversely, people who think the situation in Ukraine will be worse were more likely to say they’d vote for the Opposition Bloc (9.1% of those who said the situation’ll be worse, compared to 3.7% who said it’ll be the same and a whopping 0.9% [!!] who said it’ll be better).
  • People who think the situation in Ukraine will be worse are less likely to say they’ll vote (28.1% compared to 21.0% same and 13.4% better).
  • Young Ukrainians (18 to 29 years old) are more likely than older Ukrainians (13.9%, compared to 8.0% of 60 to 69 year olds and 8.6% of those aged 70+) to think the country will be better.

The sausage fest on the far right

  • In the same May 2016 Omnibus just 2.9% of women said they’d vote for a far right party (i.e., Svoboda, Pravyi Sektor or Yarosh’s national whatever), compared to 6.9% of men (4.7% overall). Even with such a relatively small sample size for far-right supporters, this is a statistically significant relationship.
  • Same goes for the February 2016 Omnibus, when 2.8% of women and 5.3% of men would vote for a far-right party (3.9% overall)
  • The May survey also asked a number of questions about which social issues troubled people the most, asking respondents to choose the top three from a list. “Revival of the Ukrainian nation” was chosen by 4.2% of people –5.2% of men and 3.4% of women.
    • No, that’s not a huge difference (a Cramér’s V of .05 for anyone who cares) but it’s still a big enough one to be statistically significant.
    • Relevant/unsurprising too: 13.9% of supporters of far-right parties chose “revival of the Ukrainian nation” in their top three compared to 4.2% of all Ukrainians….

Undecideds…

  • Women were more likely than men (27.9% compared to 21.5% in May 2016; 27.7% compared to 20.3% in February 2016) to say they were undecided, that they didn’t know who they were going to vote for.
    • There’s a separate post or article or two buried just in those numbers and others like it. Interpretations and perspectives more than welcomed, particularly from members of the human race who are a) Ukrainian and b) not men.

Depression in Ukraine

Lastly, some data from the 2012 European Social Survey (ESS), the last wave Ukraine took part in. Despite the name, fieldwork actually took place in July and August 2013 for anyone keen to place this data within a very specific pre-Maidan time frame.

This wave of the ESS used a shortened version of the Center for Epidemiologic Studies Depression Scale – a higher score on the index means you show more depressive symptoms.

Graphs.

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Ukraine’s depression score was third highest out of all countries surveyed – and Ukrainian women had higher depression scores than Ukrainian men (8.14 compared to 7.12)
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As in all ESS countries, depression scores were markedly different between younger and older respondents, but the difference was much starker in Ukraine

Comments, interpretations and questions welcome.

Digging into the data: Ukraine’s pursuit of happiness

Digging into the data: Ukraine’s pursuit of happiness

Ukraine isn’t the happiest place in the world right now, and according to some stats that’ve come out recently it might actually be one of the unhappiest.

Take a look at data released last month in the World Happiness Report 2016, a project that ranks countries by their happiness levels using data from the Gallup World Poll, which 1,000 Ukrainians take part in every year.

The main measure of happiness they use is a zero to 10 scale called the Cantril Ladder, which to get all psychometricky is “a measurement of subjective well-being”:

“Please imagine a ladder, with steps numbered from 0 at the bottom to 10 at the top. The top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you. On which step of the ladder would you say you personally feel you stand at this time?”

The World Happiness Report then takes an average of these rankings for each country and ranks each country by that average score.

Back in 2007 and 2008, Ukraine didn’t rank too badly, as you can see below in the first chart I’ve done up – about half of countries scored lower than Ukraine, including several other European countries.

But in 2013, almost three-quarters of all countries surveyed had higher happiness scores than Ukraine, though Ukraine’s was still higher than Bulgaria, Georgia and Armenia.

By 2014, around 80 per cent of countries had higher scores than Ukraine and by 2015, Ukraine ranked in 120th place out of 136 countries – the lowest of any European country.

graph11

The World Happiness Report also looks at a few other measures, including the freedom to make life choices. To calculate this measure, they take a national average of responses to the question “Are you satisfied or dissatisfied with your freedom to choose what you do with your life?”

This figure’s never been too high in Ukraine to begin with; only in 2011 did Ukraine come close to breaking out of the bottom fifth of countries on this measure.

But it’s the decline from 2013 to 2015 that’s the most jarring, as you can see in the graph below (I’ve cut the y-axis to the 50th percentile to make it more obvious). In 2015, Ukrainians ranked second last out of all countries on this measure, behind only Haiti.

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I also took a look at the corruption measure, but I’m not sure the way they calculate the corruption measure is that well-suited for Ukraine. The measure the World Happiness Survey uses is the national average of survey responses to two questions: “Is corruption widespread throughout the government or not?” and “Is corruption widespread within businesses or not?” Splitting the question into a ‘government’ corruption question and a ‘business’ corruption question seems weird to me – aren’t they kind of one and the same thing? – but it’s the only data I’ve got, it’s still worth looking at and, plus, I’m no perceptions-of-corruption expert.

When it comes to corruption, these stats aren’t at all shocking. Ukrainians perceive far more corruption in their own country than people in most other countries, and this perception’s only got worse in the past few years – only Bosnians/Herzegovinians and Romanians felt corruption was worse in their own countries.

There’s other data from the Gallup World Poll 2015, released in January, that paints an even unhappier picture of Ukraine:

  • The percentage of Ukrainians who reported being satisfied with their standard of living dropped from 27% to 17% in 2015
  • 6% of Ukrainians are “suffering” – the highest among all post-Soviet states Gallup surveyed
  • 56% of Ukrainians feel they’re “struggling”
  • Only 9% of Ukrainians feel they’re “thriving”

On top of that, last year I ran some data from the 2012 version of the European Social Survey (for which, despite the name, was done in July 2013 in Ukraine), and found some more unhappy stats.

Aside from being some of the most likely people to feel depressed over the past week (only Hungarians and Albanians were more depressed), Ukrainians also were more likely than anyone from the other 28 countries surveyed to have:

  • Felt anxious in the past week (29% compared to 11% on average)
  • Felt sad in the past week (23% compared to 9% on average)
  • Felt lonely in the past week (21% compared to 8% on average).

None of these stats should be a revelation to anyone even minimally aware of goings-on in Ukraine over the past few years, and they raise more questions than answers.

For one, why are Ukrainians so unhappy? Well, yes, obvious answer is obvious (something like “uh, you know, everything? Like, do you know anything, Michael?”) but I mean more in the sense of whether there’s one or two things that Ukrainians really hit on when they talk about being unhappy. The war? Corruption? The economy? Or is it a not-easily-quantifiable combination of factors, the aforementioned ‘everything’?

What does this unhappiness mean for Ukraine’s already-stretched health and social systems? Does this unhappiness mean we’ll see an increase in mental health issues (e.g., PTSD, depression, even suicide) in Ukraine? Have we already?

What are the implications of all this ballooning unhappiness for Ukraine’s political leaders as they continue to pretend to fight corruption and reduce the power of the oligarchs? Does all this unhappiness mean that Ukrainians will sit back, or will it make them angry enough to make yet another stand?

Syrian refugees’ mental health is top priority

In this Oct. 20 image, a distraught Syrian refugee disembarks from a flooded raft at a Greek beach.(CMAJ/REUTERS/Yannis Behrakis)

My new piece in CMAJ.

Doctors in a handful of clinics across Canada are preparing for the arrival of many thousands of refugees fleeing the war in Syria. So far only a few have arrived, but more are expected as part of the new government’s commitment to settle 25 000 Syrian refugees through 2016.

“The most significant part of our practice is dealing with mental health issues,” says Dr. Meb Rashid, who works at the Crossroads Clinic, a refugee clinic in Toronto, and is currently working with Lifeline Syria to establish clinics for the expected influx of Syrian refugees in Toronto.

The impact of the war on Syrians’ mental health is impossible to ignore. The Syrians he has met in Canada all have family back home, says Rashid, who co-founded Canadian Doctors for Refugee Care, They get anxious and anguished when they are not able to get in touch with their family members. When they are finally able to reach them, they often hear gunfire and shelling in the background. Continue reading “Syrian refugees’ mental health is top priority”

Ukraine struggles with rise in PTSD

A piece I wrote for the Canadian Medical Association Journal (CMAJ) on the rise in PTSD in Ukraine, and what’s being done to try and stop it.

Marc Lapointe, a Canadian Forces veteran working with Hero’s Companion in Ukraine, assesses a candidate therapy dog near Kyiv. Photo courtesy of Hero's Companion
Marc Lapointe, a Canadian Forces veteran working with Hero’s Companion in Ukraine,
assesses a candidate therapy dog near Kyiv.
(Photo courtesy of Hero’s Companion)

On the Maidan in Kyiv, the site of protests that ended in bloodshed in February 2014, almost every ledge and concrete step is covered with hasty memorials to the fallen. Fresh flowers and red glass candles surround framed pictures of dead soldiers. Next to them, rows of placards depicting photos from the war zone, from tanks on the move to soldiers playing soccer in shelled gymnasiums. In between the placards and pedestrians, volunteers from various organizations walk back and forth with little pails hanging from their necks, asking for donations to help wounded soldiers and their families.

These volunteers know, as does everyone in Ukraine, that there are legions of traumatized soldiers returning from the east. Since the war with Russia started in April 2014, some 70 000 Ukrainian soldiers have fought and approximately 2500 have died. Soldiers have seen friends killed in front of them with high-powered Russian artillery. Some have lost limbs; others have seen entire towns turned to rubble.

…read more in the CMAJ: http://www.cmaj.ca/content/early/2015/10/19/cmaj.109-5160.full.pdf+html?sid=b072a15e-5130-4b5a-83bf-56d8cccc23a8

 

Mental health in Ukraine – a bit of background

A few facts about mental health in Ukraine, by way of a quick point-form backgrounder:

– Suicide is a big problem in Ukraine. Figures from 2007 show that Ukraine has one the highest suicide rates in the world, and that the suicide rate has been increasing since independence. The risk of dying from suicide in Ukraine is about twice as high as dying in a car accident. I haven’t come across any more recent statistics on suicide (and the situation in the country now makes it even tougher to do any sort of large-scale public health research, period) but nothing suggests these statistics have changed.

– People who have mental health issues in Ukraine, like depression or anxiety, rarely seek help. There are a lot of complex reasons for this, some of which I touch on here, but the fact that 75% of people with major depression who admitted to suicidal thoughts never talked to a professional about their problems is pretty worrying.

– In the 2012 European Social Survey, respondents in 28 countries, including Ukraine, were asked a series of questions about their self-rated mental health. Ukrainians scored at or near the bottom of almost every measure.* They were the most likely to have felt anxious in the past week (29% compared to 11% on average), most likely to have felt sad in the past week (23% compared to 9% on average) and most likely to have felt lonely in the past week (21% compared to 8% on average). When it came to feeling depressed over the past week, only Hungarians and Albanians were more depressed than Ukrainians.

The papers I’ve linked to above are well worth a read, by the way.

*As a former stats man, I ran this analysis in SPSS using the 2012 data, which you can download for free. For anyone so inclined, I saved my SPSS syntax so if you happen to have SPSS or its open-source alternative, you can run it yourself. 

Mental health and war in Ukraine

A piece I wrote about (as the title a bit obviously suggests) mental health and war in Ukraine. Published in the Winnipeg Free Press print edition April 27, 2015 A11 (http://www.winnipegfreepress.com/opinion/analysis/mental-health-and-war-in-ukraine-301392321.html)

Maidan Nezalezhnosti, Kiev

The hallway of the mental health department at the Railway Clinic Hospital No 1 in Kyiv is empty except for me and two middle-aged women. They sit over by the window at the end of the bench, their heads together in the sunlight, whispering.

After a few minutes of waiting, Dr. Svitlana Polshkova calls me in to meet with her and the chairman of the mental health department at the hospital, Prof. Oleh Chaban.

Polshkova, in jeans and a Minnesota Twins jacket, is a psychiatrist who studied in Donetsk and has worked at the University of Michigan. Chaban, a towering figure with a grey moustache, looks as much like a retired defenceman as a Soviet-educated psychiatrist. Both Polshkova and Chaban are keen to talk about how the war in eastern Ukraine has hurt people far from the front lines. It all started in the Maidan — Kyiv’s central square where the current bloody turmoil started.

“The Maidan situation was very strong, and had a lot of emotional power,” Polshkova says. “When people tried to help, they got into a specific state, a state of elevated mood. It went up, and it came down.”

Later in 2014, Polshkova and Chaban started seeing more patients with post-traumatic stress disorder, and this doesn’t surprise them. But a sense of disillusionment with the current situation in the country hasn’t helped matters. “People have not been able to believe in things,” Polshkova says bluntly.

The trauma extends far beyond the Maidan. “There has been no time since the Maidan without war,” Chaban reminds me. More than a million refugees, he estimates, have fled the war in the east, and an unknown number of these have come to Kyiv. Most of these refugees live with relatives in the city, mostly in small Soviet-era apartments, but some live on the streets, a sight immediately obvious in the city centre.

“They are emotionally exhausted,” Polshkova says of the relatives of refugees in Kyiv. “At first, people were happy and helpful.” Time though has taken its toll on those supporting their refugee relatives and on people in the city in general. “They have become exhausted,” she says again.

Mental health professionals in Ukraine have felt this personally. Olena Zhabenko, a psychiatrist originally from Lugansk in separatist-occupied eastern Ukraine, is candid about her own story.

“Unfortunately, my parents became refugees because of the situation,” she tells me from Singapore, where she is now a research fellow at Nanyang Technological University. “They lost everything.” Her grandmother is still in Lugansk and has refused to leave the war-torn city.

And it isn’t just her, she stresses. Even in such a big country, the connections to the east run deep. “I know even in Kyiv,” she says, “almost everyone has either a neighbour or relatives who are living in the east or are somehow connected.”

Richard Styles echoes Zhabenko’s story. He is the chief medical director at the American Medical Centre in Kyiv. Originally from Britain, he has spent more than 15 years working in Ukraine.

“A lot of people have had their social networks and their support networks, both their family and friends, shattered,” Styles says. “A lot of those relationships have been broken.”

Styles says the war has had a noticeable impact on people’s mental health in Kyiv. “What people here live with, although they’re not involved in the actual conflict in a physical sense or in a visual sense,” he says, “They are very much involved in a mental sense, in that there is a sort of daily anxiety about what is happening.” People constantly follow the latest news from the war zone on their phones or on TV, where images of fatigues and fighters dominate newscasts.

He sees examples of this daily anxiety more often now in Kyiv than ever before. “In Kyiv, there are regular bomb scares, and that adds to people’s anxiety.” Fears of petty crime in the city centre have increased, thanks in part — justifiable or not — to the new transient population made up largely of refugees. This anxiety is changing the city, he says. “Kyiv used to be a golden, light-hearted city. Now it’s taken on a slightly dour sort of mood.”

But back at the Railway Clinical Hospital No 1, both Polshkova and Chaban reflect a ray of hope. The stigma around mental health may be strong in Canada, but it is much stronger in Ukraine, where rates of seeking help for mental health problems are much lower than in Canada and suicide rates are some of the highest in the world.

“The stigma around mental health in Ukraine is decreasing,” Polshkova says. “Because of this catastrophic situation, people are talking more about mental health. People who need help don’t have as much fear of talking about it.”

Republished from the Winnipeg Free Press print edition April 27, 2015 A11

Continue reading “Mental health and war in Ukraine”