Russian Mortality Crisis and the Quality of Vital Statistics

Abstract

Mortality from ill-defined conditions in Russia has the fastest rate of increase compared to all other major causes of death. High proportion of deaths in this category is indicative for low quality of mortality statistics. This article examines the trends and possible causes of mortality from ill-defined conditions in Russia. During 1991During -2005, mortality from ill-defined conditions in Russia increased in all age groups. The pace of increase was particularly high at working ages and the mean expected age at death from ill-defined conditions has shifted to younger ages, particularly for men. The analysis of individual medical death certificates issued in Kirov and Smolensk regions of Russia demonstrate that 89-100% of working-age deaths from ill-defined conditions correspond to human bodies found in a state of decomposition. Data from Smolensk region shows that over 60% of these decedents were unemployed. Temporal trends of mortality from ill-defined conditions and injuries of undetermined intent in Moscow city suggest that deaths from the latter cause were probably misclassified as ill-defined conditions. This practice can lead to underestimation of mortality from external causes. Growing number of socially isolated marginalized people in Russia and insufficient investigation of the circumstances of their death contribute to the observed trends in mortality from ill-defined conditions.

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

“…These issues have been most acute for the category of circulatory diseases, as some non-specific codes were frequently used when the precise cause of death was not known . More recently, a number of additional problems have arisen, such as an increase in the number of deaths at unknown ages and from unspecified causes Andreev et al 2008;Gavrilova 2008), and in the number of violent deaths of undetermined intent (Pridemore 2003). For example, rates of homicide and suicide may have been affected by the misclassification of deaths from these two causes as unspecified violent deaths.…”

The Effects of Alcohol on Suicide Rate in Russia

“…At the same time, analysis by subcategory of deaths from external causes in Russia showed that there was a massive increase in the rates of injury death of undetermined intent, almost to a level on a pair with suicide rate in recent years [22]. In this context, some researchers argue that a rising rate of injury death of undetermined intent indicates declining quality of mortality statistics in Russia [23].…”

Divergence without decoupling

“…For France, the series has been supplemented at the beginning of the 19th century by 10 data points from Vallin and Meslé (2001). (Shkolnikov, Meslé, and Vallin 1995;Cockerham 1999;Gavrilova et al 2008;Billingsley 2011). Table 2 provides descriptive statistics for life expectancy sex differentials.…”