The east-west health gap is due in significant part to different societal forms of political organization, which affect the characteristics of a civic community: social cohesion and social capital. The health crisis in Russia cannot be reduced to individual life choices such as drinking or smoking behaviors but is part of a cultural context. This research demonstrated that individual health status is an integral part of a community matrix, which may foster health through a civic community, or else impede health-related quality of life in an environment of inequity and chronic sociopolitical uncertainty.