Components and possible determinants of decrease in Russian mortality in 2004-2010

Abstract

BACKGROUNDAfter a long decline, life expectancy in Russia substantially increased in 2004-2010; this is the longest period of health improvement that has been observed in the country since 1965. This study is the first analysis of this positive trend. OBJECTIVESWe seek to determine the causes and age groups that account for the additional years of life gained in 2004-10 and the remaining gap between Russia and Western countries, to assess to what extent these recent trends represent a new development relative to previous mortality fluctuations, and to identify possible explanations for the improvement. METHODSWe present an analysis of trends in life expectancy, and in age-and cause-specific mortality in Russia and selected countries in Eastern and Western Europe. We use decomposition techniques to examine the life expectancy rise in 2004-2010 and the Russia-UK life expectancy gap in 2010.

The Recent Mortality Decline in Russia: Beginning of the Cardiovascular Revolution?

“…The recent improvements have also been longer lasting. Unlike many other causes of death, cerebrovascular mortality is now lower in Russia than it was in the 1970s and 1980s, and it has reached a historic low among women (Shkolnikov et al 2013). 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 100 200 300 400 Standardized death rate per 100,000 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 100 200 300 400…”

“…These achievements can be attributed to the large-scale national priority project "Health," initiated by Russian authorities in 2006. The aim of the project was to improve the infrastructure for primary and emergency care, to promote high-tech medical care, and to construct new federal medical centers (Shkolnikov et al 2013). Furthermore, during the period studied, the federal target program "Prevention and treatment of arterial hypertension in the Russian Federation" was launched.…”

“…A recent study (Shkolnikov et al 2013) analyzed changes in mortality and life expectancy in Russia over [2004][2005][2006][2007][2008][2009][2010], including decreases in cardiovascular mortality. The authors concluded by asking whether Russia has joined the cardiovascular revolution, a major health development that began in advanced economies during the 1970s.…”

Impact of Economic Conditions and Crises on Mortality and its Predictability

“…Hungary has registered large increases in life expectancy since the mid-1990s, largely due to increasing investments in the health care system, which in turn led to a reduction in the numbers of premature death due to alcohol consumption, tobacco use, and accidents; and in mortality from cardiovascular disease. In Russia, these developments appear to have occurred 10 years later (Shkolnikov et al 2013).…”

“…According to Shkolnikov et al (2004), the persistence of this large gap in life expectancy until the mid-2000s is attributable to many decades of relatively low levels of investment and a lack of technological innovation in the health care system; along with excessive alcohol consumption, tobacco use, and relatively high levels of psychosocial stress, which are linked to a high rate of premature death. Although improvements in the health care system have since been made and the numbers of premature (cardiovascular and external) deaths have declined since 2005, Shkolnikov et al (2013) pointed out that it is still unclear whether the recent progress in Russian life expectancy can be sustained in the future, and whether these positive developments mean that Russia is finally catching up to international trends.…”