Reserves for Reducing Mortality in Russia in the Context of Its Age and Nosological Characteristics

Abstract

The unattainability of increasing the life expectancy of the Russian population to 78 years within the announced time frame due to the epidemiological (COVID-19 pandemic) and subsequent geopolitical crisis has actualized the task of finding reserves for reducing mortality and concentrating efforts on priority areas. Based on official statistics, we analyzed the dynamics of mortality in the main (15-year, with age up to 1 year) age groups of the population from leading causes of death (causing 3/4 of mortality in the male population and 2/3 in the female population in each age group) for period 2000–2021. We calculated standardized mortality rates (European age structure standard). Mortality caused by alcohol and drugs was assessed collectively, taking into account external causes (poisoning with psychoactive substances, accidental and with uncertain intentions) and psychosomatic pathologies. When analyzing mortality from diseases of the circulatory system we distinguish acute and chronic forms of pathologies, since they are determined by various risk factors. There are reserves for increasing life expectancy at all ages due to a decrease in mortality from socially determined and preventable causes, but the main risk group is the most demographically and economically significant age stratum of 30–44-year-olds, the mortality rate in which (due to losses due to alcoholism and its consequences, HIV/AIDS, injuries of uncertain intent and ill-defined conditions) indicate persistent marginalization. In turn, this once again emphasizes that without the policy to reduce mortality going beyond healthcare, its effectiveness will be extremely low. A necessary condition for developing effective policies is the reliability and quality of information. Meanwhile, the general problem of accounting for the mortality of the Russian population, regardless of age, is the problem of diagnostic quality, as evidenced by the abnormally high level and contribution of losses from vague, uncertain and unidentified causes. The scope of application of the results obtained is their use to adjust the goals, priorities and system of measures in national projects aimed at increasing life expectancy. Directions for future research are related to the analysis of differentiation of mortality from the main causes from the social status of the deceased.