Demography of Russia and the Former Soviet Union

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Demography of Russia and the Former Soviet Union

• Lecture 10
• Sociology SOCI 20182

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Demographic Crisis in Russia
Which Statement is Wrong? (slide from alarmist
lecture of Western researcher)

• Fertility and Birth Rates Declined
• Population Ageing
• Marriage Rates Declined
• Divorce Rates Increased
• Abortion Rates Increased
• Mortality Rates Increased
• Natural Growth of Population Declined

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Life Expectancy in Russia
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Selected Causes of Death
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Social Context of Current Trends in Russian
Mortality
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Transition period was accompanied by
unprecedented growth of crime rate and homicide
mortality
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Tendencies of Intentional Murders in Russia and
the United States
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Trends in Homicide Victimization Rates for Young
and Middle-Aged AdultsData from Russian Vital
Statistics
Males
Females
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Age Profile of Homicide Mortality in Russia
1981-2002
Females
Males
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Traditionally high rate of alcohol-related
mortality increased further during the 1990s
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Age Profiles of Mortality from Accidental
Poisoning by AlcoholData from Russian Vital
Statistics
Males
Females
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Rapid increase in the number of abandon children
and children without parental support during the
last decade
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Degradation of Mortality Statistics in Russia

• In 1997 Russian parliament made a decision that
  information about social status, education,
  marital status and ethnicity should not be
  indicated in medical death certificates (because
  of privacy protection).
• This decision made studies of mortality
  inequalities by social status very difficult

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Social structure of young (16-39) males died in
2004 in Kirov region
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External deaths in marginal and socially adapted
groups of men (), Kirov region, 2004
Marginalized unemployed or low-skilled workers
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Period of reforms, started in the late 1980s,
resulted in qualitative changes in the pattern of
Russian mortality. These changes may be
summarized as marginalization of Russian
mortality
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The main characteristics of marginalization are

• Degradation of registration of causes of death
  among socially disadapted
• Misrepresentation of real mortality pattern
• Formation of specific social portrait of deceased
  in the age groups of maximal risk (young and
  middle working ages)

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It may be suggested that the growth of mortality
in the 1990s was determined by

• Widening of marginalized groups of population
  (more people became involved in these groups)
• Accelerated growth of mortality in marginalized
  groups

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Marginalization of Mortality is Accompanied by
Return of Old Infections
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Tuberculosis and Syphilis 1990-1999
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Age Profiles of Mortality from Tuberculosis
Males
Females
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Prevalence of syphilis in Kazakhstan per 100,000
(1991-1999)
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Current trends in life expectancy
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Changes in regional distribution by life
expectancy. Men
Number of regions
Life expectancy
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Main features of recent improvement

• Highest gains in working ages (15-64)
• Main improvements due to causes directly related
  to alcohol, accidents and respiratory diseases
• These improvements may be related to the recent
  measures of increased control after alcohol
  production adopted in 2005

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Additional factor fluctuations in
alcohol-related mortality
Age-standardized mortality of men (per 100,000)
from accidental poisoning by alcohol
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Improvement in life expectancy in 2005-2006, Men
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Improvement in life expectancy in 2005-2006, Women
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Causes of death and their classification

• Established by the World Health Organization as
  International Classification of Diseases (ICD)
• Has several revisions. The most recent revision
  is the 10th revision. Adopted by most countries
  in the mid 1990s

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Classification of causes of death in Russia

• Classification of causes of death used in the
  Soviet statistical forms was different from WHO
  classification.
• Form 5 (later called form C51) had 185 causes of
  death.
• Main differences between WHO and Soviet
  classification are found in the groups of CVD and
  injuries

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New classification of causes of death in Russia

• After dissolution of the Soviet Union most FSU
  countries continued to use the old classification
  of causes of death
• In 1999 Russia adopted a new classification of
  causes of death corresponding to the 10th ICD
  revision
• Still incompatible with the WHO classification

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Major causes of death within the group of
injuries. Men
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Major causes of death within the group of
injuries. Women
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Degradation of mortality statistics in Russia
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Pace of Growth of Age-Adjusted Mortality in
1989-2000 for Classes of Causes of Death
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Proportion of deaths from ill-defined conditions
is a measure of quality of mortality
statisticsProportion higher than 5 indicates
poor qualityIn developed countries most deaths
from ill-defined conditions are diagnosed at
older ages
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Is this increase in mortality from ill-defined
conditions related to more cases of deaths from
senility?
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Age Profile of Mortality from Ill-Defined
Conditions in Russia
Males
Females
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Top Five Causes of Death for Young Adult Males
(20-24)
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Top Five Causes of Death for Young Adult Females
(20-24)
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What Causes of Death Are Hidden Behind the
Ill-Defined Conditions?
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We Used Individual Death Certificates With More
Detailed Description of Circumstances of Death
Collected by Kirov Department of Health Kirov
is a Typical Russian Region with Lower than
Average Mortality from Ill-Defined Conditions
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Age-Adjusted Mortality from Injuries in 1996 for
Russian Males Aged 0-64 yearsData from the
WebAtlas Project (http//sci.aha.ru/ATL)
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Deaths from Ill-Defined Conditions in Kirov
Region of Russia in 2003

• Sudden infant death (R95)
  3.3
• Decomposition in water (river, well, pond) (R99)
  13.0
• Decomposition at home (R99)
  53.5
• Decomposition in garden, summer house (R99)
  1.7
• Decomposition in forest or field (R99)
  6.0
• Decomposition in nonresidential building, on the
  street (R99)
  
  12.3
• Decomposition in water pipe (R99)
  0.7
• Decomposition on the cemetery (R99)
  0.3
• Decomposition in bath, lavatory or barn (R99)
  1.0
• Decomposition in other place (R99)
  5.5
• unknown (R99)
  2.3
• senility (R54)
  0.3

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Mortality in Moscow city
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Ill-defined conditions and external deaths of
undetermined intent are two sides of the same
coinIt appears that both causes of death may be
used for concealing criminal cases of violent
death
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Top Five Causes of External Mortality in Russia
and Moscow in 2001
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Autopsies in Russia

• Autopsies are used to verify cause of death
• Autopsy is mandatory for violent death, death of
  woman during pregnancy, labor or postpartum
  period, death of infant below 1 year, death from
  cancer not supported morphologically, death from
  any infectious disease

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Situation with medical examiner services

• Only 34-48 of jobs are filled by physicians
• 38-54 of jobs are filled by histologists
• 35 of workers reached retirement age