What impact did communist education systems have on people’s health? Joan Costa-Font and Anna Nicinska find evidence Soviet-style education systems produced clear health benefits due to their emphasis on physical education, preventive health and gender-equal participation in sports.
Communist education systems – particularly those of the Soviet Union – are often remembered for their ideological rigidity and indoctrination. However, they also embedded features that produced surprisingly durable health benefits in the population, albeit without reducing health inequality more than European welfare states. These elements offer valuable lessons for today’s policymakers and educators.
Education as a tool for social formation
At its core, education builds human capital by developing cognitive skills, literacy and problem-solving abilities. Yet it also performs a broader social function: transmitting shared norms, values and behaviours that sustain social cohesion and political stability.
Scholars have long noted that schooling shapes not only academic achievement but also habits related to health, citizenship and social cooperation. Through repeated routines and institutional incentives, schools influence how individuals process information, how they value physical activity and how they perceive long-term well-being.
Education can enhance health by improving individuals’ ability to interpret medical information, encouraging them to maintain healthy lifestyles and embedding physical activity into everyday life. These mechanisms become especially powerful when reinforced systematically over many years.
Communist education systems and health
In a recent paper, we shed light on how these mechanisms operated under Soviet communist education systems. The educational narrative of communist regimes reflected exceptionally high ambitions, aiming to shape physically strong “Soviet men” who were loyal to communist authorities and free from the influences of family and religion.
By comparing European cohorts exposed to different lengths of compulsory schooling – using reforms that extended or shortened mandatory education – we isolate the long-term health effects of additional schooling. We distinguish between education received under communist regimes and education obtained in non-communist contexts, including post-communist and western European countries.
The findings suggest that an additional year of education led to significantly larger improvements in long-term health when it was received under Soviet communist systems. These benefits appear in self-reported health, reduced prevalence of chronic illness and healthier behaviours later in life.
The effects are particularly strong for men, though women also experience notable gains. This is remarkable given the widely documented shortcomings of communist healthcare systems, which struggled with inefficiency, limited innovation and poor access to advanced medical technologies.
Physical activity as the key mechanism
Soviet education systems placed exceptional emphasis on compulsory physical education, organised sports and lifelong fitness. Physical education was mandatory at all levels of schooling. It was aimed not only at finding talent for professional sport but also at facilitating mass and life-long participation.
One defining feature was the “Ready for Labour and Defence” programme, introduced in the 1930s, which required all children – typically beginning around age ten – to pass standardised physical fitness tests that included endurance, strength and basic military preparedness.
In contrast, many western European education systems during the same period emphasised voluntary participation, playfulness and individual choice in sports. While this approach fostered inclusivity, it often resulted in weaker long-term engagement in physical activity, particularly among students who were less athletically inclined.
Schools as health-promoting institutions
Communist schools also played a broader role in promoting hygiene and preventive health. Many provided access to basic medical checkups, vaccinations and health monitoring – especially in rural and peripheral regions where healthcare access was limited. Schools ensured that children had exposure to health information, structured routines and consistent expectations around physical well-being.
These policies created an environment where healthy habits were formed early and reinforced daily. We find that an additional year of communist education significantly improves self-reported general health and reduces the likelihood of chronic illness in later life, an effect that adds to the impact of an additional year of education.
As a result, physical activity became a normalised part of adult life rather than an optional leisure pursuit. We find that an additional year of communist education increased the frequency of moderate physical activity by approximately 1.3% for men and 1.9% for women, above and beyond the effects observed in non-communist systems.
Smoking and alcohol consumption
Education under communism also had stronger effects on behaviours closely linked to long-term health. For men, an additional year of schooling reduced the duration of regular smoking by around 25% and excessive alcohol consumption by approximately 15%.
For women, smoking declined by about 27%, though alcohol consumption showed little change. These behavioural effects suggest that education can act as a powerful preventive tool, shaping lifestyle choices decades before chronic diseases typically emerge. In this sense, schooling functions as an early-life health intervention with long-lasting returns.
Gender equality in physical education
One often-overlooked feature of Soviet education was gender equality in physical education. Girls were expected to participate in physical activities on the same basis as boys, challenging social norms that discouraged female athleticism in many countries during the mid-20th century.
This contrasts sharply with contexts where girls’ participation in sports was limited or socially stigmatised, leading to weaker lifelong engagement in physical activity. By institutionalising equal participation, communist education systems helped reduce gender gaps in physical fitness and normalised the idea that physical strength and health were important for everyone, not just men. However, we find evidence that in later life the benefits of Soviet communist education were more pronounced for men than for women.
Education as a substitute for weak healthcare systems
What is perhaps most striking is that these positive health effects emerged despite the failures of communist healthcare systems. While hospitals and clinics often lacked quality and innovation, education partially compensated by promoting preventive behaviours and active lifestyles.
In effect, schooling acted as a substitute for limited access to healthcare technologies later in life. This finding reveals a crucial insight: investments in education – especially in health-related behaviours – can yield substantial population health benefits even when healthcare systems are underfunded and lack investment, as was the case in Soviet education systems.
Lessons for today’s schools
The beneficial aspects of communist education on healthy lifestyles and habits may have mitigated the regime’s overall detrimental impact on health. The lesson is that what students learn and practice in school matters far beyond academic outcomes. Education policies that prioritise physical activity, structured routines and healthy habits can deliver enduring health benefits.
As many countries today grapple with rising sedentary lifestyles, obesity and mental health challenges, schools represent a uniquely powerful intervention point. Reintegrating compulsory, high-quality physical education, ensuring equal participation across genders and embedding health promotion into the daily life of schools could pay dividends for decades.
In reconsidering the role of education, policymakers would do well to remember that schools are not just places of learning – they are places where lifelong habits are formed. The experience of communist education systems, stripped of ideology, offers a compelling reminder that healthy citizens are not just born, but educated.
For more information, see the authors’ recent paper (in press with Economica).
Note: This article gives the views of the author, not the position of LSE European Politics or the London School of Economics.
Image credit: Beyger provided by Shutterstock.
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