2.2.2 Life Expectancy and Health in Russia: State, Challenges and Perspectives

Research Area 2. Demography and Active Ageing  → Research Program 2.2 Contemporary Global Health and Life Expectancy Challenges

Project period

2020-2025

Context of Research Project within a Subject of Human Capital

Life expectancy is the main integral indicator of the state of population health and the best of all socio-economic measures reflecting the level of development of society as a whole. It also serves as a key condition for the development of human potential. In Russia, there is a lag in life expectancy at birth, which makes the country lag behind the most developed countries and other countries with a comparable level of GDP per capita. This is mainly due to the high mortality rates at the young and middle working ages mainly from cardiovascular diseases and external causes of death resulted from many factors such as dangerous alcohol consumption, a low level of self-preservation behavior, a large-scale epidemic of tobacco smoking, uncontrolled hypertension, etc. This has also led to a record gender gap in life expectancy and very pronounced inequality in the face of death. All this underlines the urgent need for detailed analysis and monitoring of mortality at different territorial levels and in different population groups, which is the focus of the scientific project Life Expectancy and Health in Russia: State, Challenges and Perspectives

Project Aim

Investigation of the patterns and tendencies in the health and life expectancy of the Russian population in the second half of the XIX – first quarter of the XXI century through the prism of regional, gender and social inequality in mortality and risk factors.

Project Objectives:

1. Assessing the magnitude and dynamics of intraregional differences in mortality and life expectancy in Russia at the beginning of the XXI century, classifying regions depending on the dynamics of changes in the center-peripheral scope
2. Studying geographical patterns of mortality in Russia against the background of Eastern European countries, analyzing the influence of administrative-territorial structure on the scope and nature of spatial disparities in mortality
3. Analyzing long-term trends and factors of gender differences in life expectancy and mortality in Russia, decomposing the gender gap by age groups and causes of death and identification of the main causes and risk factors determining the scope and dynamics of the gender gap
4. Studying the main trends in mortality by causes of death, assessing dynamics of excess mortality of the working-age population in Russia in the 1960s-2020s and identifying the contribution of "old" and "new" causes of death to the structure of excess mortality

Key Findings

2020

Three major segments of the life expectancy (LE) distribution have been distinguished: Moscow and Saint Petersburg at the top, large- and medium-sized cities in the middle, and smaller urban and rural areas lagging behind. The LE differences among these three groups increased, but the within-group differences decreased. Education, together with population size, explained 62 %  (for females) and 67% (for males) of LE variation across 292 geographic units in 2015–2017. Our results suggest that slower health progress in small urbanand rural areas is an important obstacle to further mortality reduction at the national level and is a matter of public health concern

2021

Estimating excess deaths rates based on the trend-adjusted average, Russia had the highest excess mortality of any of developed countries in 2020. Using the simple average, Russia had the third highest. Most of the excess deaths were recorded in the 4th quarter of 2020 and the level and trajectory of excess mortality in Russia and most of Eastern European countries differed from that in Western countries. While both the cumulative number of COVID-19 cases and deaths showed

positive correlations with excess mortality across countries (r=0.65 and r=0.75, p<0.001), the association across the Russian regions was, surprisingly, negative for cases (r=-0.34, p<0.01) and deaths (r=-0.09, p=0.42). When we replaced reported deaths with final data from death certificates the correlation was positive (r=0.38, p<0.001). 

2022

A comparative analysis of mortality and survival rate (probability of surviving/dying) in working age in Russia and a group of countries with the most favorable indicators for determining the potential for further reduction of mortality in middle age and reserves of growth in life expectancy at birth has been carried out.

Calculations of mortality rates by causes of death on the basis of a personalized database of microdata in Russia in 2000-2021 have been made.

The ratio of the mortality index of men to the mortality index of women of working age in 2017-2019

2023

It has been revealed that since the second half of the 2000s, healthy life expectancy (HL) has been increasing in both sexes because of both a decrease in mortality and an improvement in their health assessment. The improvement in self-esteem of health is pronounced among the female population: differences in self-esteem by gender, being significant in the 1990s and early 2000s, almost disappear by the end of the second decade of the 21st century. As a result, by 2020, the gap between women and men in terms of HDI has decreased and has become solely due to gender differences in mortality.

Decomposition in the age gap between men and women, as well as the contribution of differences in mortality and health in 1994, 1998, 2005, 2010, 2019 and 2021

Publications

1. Shchur A., Shkolnikov V., Timonin S., Andreev E., Leon D. Where Do People Live Longer in Russia in the 21st century? Life Expectancy across Urban and Rural areas // Population and Development Review. 2021; 47(4): 1049-1074.
2. Timonin S., Klimkin I., Shkolnikov V., Andreev E. M., McKee M., Leon D. A. (2022) Excess mortality in Russia and its regions compared to high income countries: An analysis of monthly series of 2020 //SSM-population health. – 2022. – Т. 17. – С. 101006. doi
3. Zakharov S., Churilova E. Religion, religiosity and fertility in Russia. Is there a relationship? //State, religion, church in Russia and abroad. – 2022. – vol. 40. – No. 4. – pp. 77-104. doi
4. Churilova E, Rodina O (2024) Sociodemographic and behavioral factors of pre-obesity and obesity among adult Russians. Population and Economics 8(1): 97-114. doi

Conferences

International Conference New Challenges of Demographic, Epidemiological and Medico-technological Development: Search for New Models of Healthcare Development (Moscow, Russia, December 15, 2021):
Shkolnikov V. The Main Patterns of Excess Mortality and Life Expectancy Reduction in Developed Countries in 2020
Andreev E. Demographic Consequences of the COVID-19 Epidemic in Russia

International Seminar “Impact of Covid-19 pandemic on life expectancy losses” (Moscow, Russia, December 15, 2022):
Andreev EM. Inequality in mortality from Covid-19 in Russia
Shkolnikov VM et al. Life expectancy losses in Eastern and Western Europe during the Covid-19 pandemic: from description to reflection
Timonin SA et al. The Covid-19 pandemic and maternal mortality in Russia and Eastern Europe

Autumn School "Population and Health 2023" (Moscow, Russia, October 16-20, 2023)