Abstract
After several decades of negative trends and short-term fluctuations, life expectancy has been increasing in Russia since 2004. Between 2003 and 2014, the length of life rose by 6.6 years among males and by 4.6 years among females. While positive trends in life expectancy are observed in all regions of Russia, these trends are unfolding differently in different regions. First, regions entered the phase of life expectancy growth at different points in time. Second, the age- and cause-specific components of the gains in life expectancy and the number of years added vary noticeably. In this paper, we apply decomposition techniques—specifically, the stepwise replacement algorithm—to examine the age- and cause-specific components of the changes in inter-regional disparities during the current period of health improvement. The absolute inter-regional disparities in length of life, measured by the population-weighted standard deviation, decreased slightly between 2003 and 2014, from 3.3 to 3.2 years for males, and from 2.0 to 1.8 years for females. The decomposition of these small changes by ages and causes of death shows that these shifts were the result of diverse effects of mortality convergence at young and middle ages, and of mortality divergence at older ages. With respect to causes of death, the convergence is mainly attributable to external causes, while the inter-regional divergence of trends is largely determined by cardiovascular diseases. The two major cities, Moscow and Saint Petersburg, are currently pioneering mortality improvements in Russia and are making the largest contributions to the inter-regional divergence.
Highlights
The Russian mortality crisis, which started in the mid-1960s and continued over the later decades of the twentieth century, is well documented in the literature (Field 1995; Shkolnikov et al 1996, 2004; Shkolnikov and Cornia 2000)
We start our analysis by examining the links between the value of life expectancy in Russia, and how it varies at the sub-national level
The inverse correlation between life expectancy and weighted standard deviation (wSD) in Russia is especially pronounced, and corresponds to the short-term fluctuations in life expectancy observed in the 1990s and the 2000s (Fig. 2)
Summary
The Russian mortality crisis, which started in the mid-1960s and continued over the later decades of the twentieth century, is well documented in the literature (Field 1995; Shkolnikov et al 1996, 2004; Shkolnikov and Cornia 2000). The abrupt termination of the anti-alcohol measures, which was followed by a sudden increase in the availability and the accessibility of alcohol, was accompanied by a series of painful political and economic changes The chain of these events resulted in a sharp decline in life expectancy at the beginning of the 1990s (Shkolnikov and Cornia 2000; Shkolnikov et al 2001). In 1994, life expectancy in Russia fell to the lowest levels ever recorded in the country: to 57.4 years for males and to 71.7 years for females After hitting these low points, life expectancy increased rapidly between 1994 and 1998; over this 4-year period, females gained 2.1 years and males gained 3.8 years. The year 2012 marked the first time in history that Russian life expectancy at birth (for both sexes combined) exceeded 70 years (Human Mortality Database 2016)
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