The L.A. Times has an article about the declining population in Russia, and one of the reasons cited is the poor health of many Russians. Indeed, that was one of the impressions that I had walking around Moscow and St. Petersburg when I was there. Health conditions that would be routinely treated here are left untreated there, the majority of the population smokes, and pollution was rampant.
The scary thing is, here, we tend to think of most of those health problems as being long-term, and here they largely don't affect people of child-bearing age. If conditions have become so bad across Russia that even the younger generation is having its fertility significantly reduced, then they are in serious trouble.
While we in the U.S. celebrated the fall of Communism, all has not gone well in Russia. The "New Russians" (those who made fortunes in the unstable period following the collapse) are fabulously wealthy, the streets of Moscow and St. Petersburg are full of luxury import cars. But the "average" Russian makes $38 a month. Think about that, I spent twice that much on my last pair of shoes.
I think the real danger in this is that Russia will turn away from Democracy, toward a more authoritarian state. Putin has already assumed quite a bit of power, and moved to squelch dissenters, and the sense I got is that the Russians admire, and need, what they perceive to be a "strong" leader, more than one with strong democratic values.