Midlife mortality in Russia at the beginning of the 21st century: is there any reason for optimism?

Abstract

Since at least the 1960s, midlife mortality has determined the main trends in life expectancy at birth in Russia, which has rightly attracted the attention of demographers and other public health specialists. The "silent" anti-alcohol campaign of 2005 and the general rise in living standards led to a significant reduction in midlife mortality in 2005-2019, resulting in a rapid, albeit somewhat compensatory increase in life expectancy. How sustainable will this progress be in the face of new challenges? Are there still reserves for improving the health of Russians of working age? To try to answer these questions, we look at what we believe to be the most important changes in the level and structure of mortality by cause of death among Russians aged 15-60 years old. The study covers the period from 2000 to 2021 and is based on official statistics, including a depersonalised database of the deceased, which allowed us to construct time-comparable series for some causes of death, which is not always possible due to changes in Rosstat's short nomenclature of causes of death. We also use data from the Human Mortality Database when making comparisons with countries with the lowest midlife mortality. At the beginning of the 21st century, the most significant progress in Russia was achieved in the fight against external causes (homicides, suicides, accidents); in the structure of mortality they gradually began to be replaced by diseases of exogenous nature (mainly by liver diseases and cardiomyopathy). This was particularly noticeable in the female population. The correlation between the changes in midlife mortality from all causes and from alcohol-related causes, which was initially very strong, weakened markedly in the second half of the 2010s. Finally, the COVID-19 pandemic resulted in substantial losses in the working-age population, both from mortality due to coronavirus infection and from excess deaths due to drug poisoning and cardiomyopathy. Despite a significant reduction in 2005-19, midlife mortality in Russia remains at a very high level by international standards, maintaining significant reserves for its further reduction and thus for an increase in life expectancy. The COVID-19 pandemic and most likely its aftermath pose new challenges to maintaining the health of Russians at young-middle ages. Show more