СТРУКТУРА ИЗБЫТОЧНОЙ СМЕРТНОСТИ, ОБУСЛОВЛЕННОЙ ПАНДЕМИЕЙ НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ, У ГОРОДСКИХ И СЕЛЬСКИХ ЖИТЕЛЕЙ

Abstract

Significance. The pandemic of the novel coronavirus infection has further exacerbated the demographic problem in the Russian Federation, which was especially acute in rural areas. However, according to official data, only one third of the excess mortality in 2020 is accounted for by COVID-19. Purpose: to compare the structure of mortality growth in urban and rural residents and determine differences in loss associated with the COVID-19 pandemic. Material and methods. Based on the Rosstat preliminary data, the author has analyzed increase in the number of deaths per 100,000 population in 2020 compared to 2019 among males and females residing in urban and rural areas of the Russian Federation. The indicators were compared by major classes of death causes and individual diseases across the following three age groups: 15-49 years, 50-64 years, and 65 years and older. Comparison was carried out by the Chi-square test. Results. Among the urban and rural population the death rate increased by 20.6% and 15.4%, respectively; the COVID-19 mortality equaled to 109.4 and 67.5 per 100,000 population; the share of COVID-19 in the increased total mortality added up to 44.6% and 33.0%, respectively. Among urban residents, the frequency of deaths from COVID-19 in males exceeds the female one 1.8 times in population aged 15-49, 2.0 times in population aged 50-64 and 65 +; among rural residents, these values equal to 1.2, 1.4 and 1.8, respectively. Conclusion. In the structure of excess mortality associated with the spread of the novel coronavirus infection that accounted for almost one fifth of deaths in 2019, the share of direct loss due to COVID-19 is underestimated. The direct loss associated with co-infection with SARS-CoV-2 virus can be traced at the population level, starting from the age of 65 in males and 50 years in females, in case of deaths from diseases of the nervous system, coronary heart disease, chronic diseases of the lower respiratory tract and diseases of the pancreas. With a lower level of excess mortality among rural population, its quarter is accounted for by indirect loss due to the pandemic associated with the decreased access to medical care. In the structure of excess mortality among urban population, indirect loss accounts for about one tenth, and is mainly due to consequences of stress associated with the pandemic and forced isolation. Signs of incomplete examination of the deceased in older age groups to determine the death causes, especially among rural residents, have been identified.