This paper examines the association of political ideology with health lifestyle practices and self-rated health in Belarus, Russia, and Ukraine. The political trajectory of post-Soviet societies has taken two divergent paths, either toward democracy or autocracy. The health trajectory has followed the same pattern with the more autocratic states continuing to experience a mortality crisis, while those former socialist countries that have embraced democracy and moved closer to the West have escaped this crisis. This paper investigates whether political ideology in three post-Soviet countries that are firmly (Belarus), increasingly (Russia), or recently (Ukraine) autocratic is related to health lifestyles and health self-ratings. Data were collected by face-to-face interviews (N=8406) with a representative national sample of the adult population. The results show that respondents who are against restoring communism have healthier lifestyles and rate their health better than respondents who wish to see communism return. © 2005 Elsevier Ltd. All rights reserved.