Abstract
SummaryBackgroundOver the past few decades, social and economic changes have had substantial effects on health and wellbeing in Russia. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to evaluate trends in mortality, causes of death, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and associated risk factors in Russia from 1980 to 2016.MethodsWe estimated all-cause mortality by use of a multistage modelling process that synthesised data from vital registration systems, surveys, and censuses. A composite measure of health loss due to both fatal and non-fatal disease burden (DALYs) was calculated as the sum of YLLs and YLDs for each age, sex, year, and location. Health progress was evaluated in comparison with patterns of change in similar countries by use of the Socio-demographic Index that was developed for GBD 2016.FindingsFollowing rapid decreases in life expectancy after the collapse of the Soviet Union, life expectancy at birth in Russia improved between 2006 and 2016. The all-cause mortality rate decreased by 16·6% (95% uncertainty interval 9·4–33·8) between 1980 and 2016. This overall decrease encompasses the cycles of sharp increases and plateaus in mortality that occurred before 2005. Child mortality decreased by 57·5% (53·5–61·1) between 2000 and 2016. However, compared with countries at similar Socio-demographic Index levels, rates of mortality and disability in Russia remain high and life expectancy is low. Russian men have a disproportionate burden of disease relative to women. In 2016, 59·2% (55·3–62·6) of mortality in men aged 15–49 years and 46·8% (44·5–49·5) of mortality in women were attributable to behavioural risk factors, including alcohol use, drug use, and smoking.InterpretationTrends in mortality in Russia from 1980 to 2016 might be related to complicated patterns of behavioural risk factors associated with economic and social change, to shifts in disease burden, and to changes in the capacity of and access to health care. Ongoing mortality and disability from causes and risks amenable to health-care interventions and behaviour modifications present opportunities to continue to improve the wellbeing of Russian citizens.FundingBill & Melinda Gates Foundation.
Highlights
After episodes of disruption and interim improvements in life expectancy at birth in Russia and other former Soviet republics in the 1990s, the decade of 2006 to 2016 was characterised by reductions in mortality from many causes of death and a steady improvement in life expectancy
We focused on the data and analyses from the GBD 2016 study that quantified mortality, years of life lost (YLLs), years lived with disability (YLDs), and life expectancy at birth in Russia and comparator countries
disability-adjusted life-years (DALYs) in Russia subsequently decreased from the peak rate of 53 140·5 (95% uncertainty intervals (UIs) 48 656·8–58 111·1) DALYs per 100 000 people in 1994 to 43 056 (34 476·2–53 258·6) DALYs per 100 000 people in 2016, representing an annualised decline of 3·1% (1·1–4·9; appendix)
Summary
After episodes of disruption and interim improvements in life expectancy at birth in Russia and other former Soviet republics in the 1990s, the decade of 2006 to 2016 was characterised by reductions in mortality from many causes of death and a steady improvement in life expectancy. Russia has expertise and data on demographic and epidemiological trends in the country and, some of these patterns have been presented elsewhere,[1,2,3] the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) contributes a comprehensive estimation of morbidity and mortality by cause, age, and sex, and allows benchmarking of these metrics in Russia compared with data from other countries These analyses support the development of policy priorities that are based on the most up to date and accurate information about health, disability, and mortality. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to evaluate trends in mortality, causes of death, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and associated risk factors in Russia from 1980 to 2016
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