Mortality In Moscow Research Articles

Mortality from circulatory diseases as a reflection of demographic aging

Introduction. Even a decade ago, an increase in mortality from circulatory diseases (CVD) in Russia until 2050 was predicted, in parallel with an increase in number of people older than working age. The forecast did not materialize.
 The purpose is to identify the relationship between the level and structure of mortality from CVD and the proportion of elderly people.
 Materials and methods. Official Rosstat data on mortality in Moscow and the Russian Federation for period 1975–2019 were used. There was made a comparison of age patterns of mortality from CVD at the beginning and end of the analysed period in the country and in the capital separately for men and women. For simplicity of calculations, the trend in the gain in mortality with increasing age was approximated by an exponential function in the Microsoft Excel Software.
 Results. Since 2003 to 2019 in the Russian Federation, mortality from CVD was found to decline among men and women by 2.0 and 2.2 times. In Moscow, with a 2.3- and 2.2-fold decrease in mortality from CVD. During this period losses fell as a result of premature death from CVD by 1.8 and 1.9 times in men and women, as well as in Moscow.
 Limitations. The quality of analysed data is limited by quality of coding of the causes of death in different regions and by accuracy of estimate of age structure of the population in period between population censuses.
 Conclusions. Demographic aging does not lead to an increase in the contribution of CVD to the mortality of the population. The decrease in mortality from CVD significantly contributes to the growth of life expectancy and is accompanied by an increase in the proportion of elderly people. Only during periods of increased mortality, the contribution of CVD to it is directly proportional to proportion of elderly people. Age structure of mortality from CVD indicates the need to strengthen measures to prevent mortality.

Contribution of migrants to mortality in Moscow during the COVID-19 pandemic

Introduction. The COVID-19 pandemic influenced the health status and mortality of population all over the world. The mortality rate in Moscow also increased significantly since the density of Moscow population is high and the city is very attractive for migrant workers. Objective. To determine the contribution of migrants died from the COVID-19 to the mortality in Moscow for 2019–2021. Materials and methods. In study, authors used the data on Moscow population and the real-time data on deceased persons by death causes according to the ICD-10 provided by the Moscow Healthcare Department.
 Results. The average contribution of migrants to the total mortality in Moscow is 10% among women and 16% among men. As for the age composition, the most significant contribution is from the migrant children and working-age youth aged 20 to 30 in women (an average of 50%) and 35 in men (an average of 60%). These results are especially true for migrant workers. Diseases of the circulatory system, external causes and neoplasms were the leading death causes among migrants before the pandemic. Then, the COVID-19 became the third common cause in 2020 and the first one in 2021. As for the death cause, the migrants contributed most to the perinatal and maternal mortality as well as to the mortality from infectious diseases, mental disorders and external causes.
 Conclusion. Cardiomyopathy and endocarditis, leading causes from the diseases of the circulatory system, often become the complications of infectious diseases, including imported infections. It is crucial to reimplement a rigorous record-keeping by citizenship and place of birth or residence, particularly within the databases on deceased population, in order to monitor the epidemiological situation and to make timely organizational decisions.

Suicidological analysis of Moscow and Saint Petersburg in the context of the pandemic

BACKGROUND: Suicide mortality in Moscow and St. Petersburg the two most populated federal cities of Russia is not characterized enough. However, these cities have been mostly affected by the pandemic. AIM: To analyze the latest trends in suicidal behavior in the historic capitals of Russia in an observational study, taking into account pandemic waves. METHODS: The monthly numbers of suicides (date of death, sex, age, and method), and number of cases in Moscow (n=1558) and St. Petersburg (n=2077) from January 01, 2016, to September 30, 2021, were used to calculate frequencies per 100,000 and to analyze tendencies across sex and age groups. Statistics were based on Z-criterion, and confidence intervals were calculated as per Wilson. RESULTS: Moscow and St. Petersburg belong to regions with suicide rates lower than the world average rates. Suicide mortality in both capitals was declining, but was more pronounced in Moscow. In St. Petersburg, the average rate was 3.28 higher, with 3.53 times in men and 2.84 times higher in women. The male-to-female ratio in St. Petersburg was also higher than that in Moscow (3.39:1 versus 2.87:1). In both cities, the highest rates were found among citizens aged 80 years, and the rates in young and adults (aged 2049 years) are also high. Those aged 6069 years have comparatively low rates. After a brief decline in the suicide rates during the first quarantine period in 2021, the decline in Moscow stopped, whereas in St. Petersburg, a gradual increase began, reaching significant levels among men in September. The most traditional method of self-harm (hanging) decreased, whereas the proportion of falls from a height increased (38.8% growth), as well as self-poisoning and self-cutting. A more detailed analysis of the urban method of suicide such as falling from a height revealed that in 2021, in St. Petersburg, a category of persons emerged among whom this method has grown dramatically (five times) in men aged 60 years. CONCLUSIONS: Suicides among the urbanized population of the largest metropolitan areas in Russia during the pandemic demonstrate trends that raise concerns, and the structure of mortality and methods of self-harm are changing. Further monitoring and intensification of preventive measures are needed, especially in St. Petersburg.

Healthcare Performance Evaluation using preventable mortality criteria

Introduction. There is an urgent need to develop independent objective criteria for evaluating the Moscow healthcare system in accordance with the priorities of increasing life expectancy. Objectives. The study is aimed at assessing the methodology of preventable mortality by Moscow healthcare specialists, identifying the scale and dynamics of preventable mortality in Moscow on the basis of this methodology and assessing the impact of healthcare on life expectancy of Moscow population according to the set of criteria. Methods and materials. In 2019, an electronic survey was conducted among the experts from 14 medical specialties (937 respondents) working in inpatient and/or outpatient organizations. Upon the received results, trends and causes of preventable mortality in Moscow are presented. Results. There are three criteria that indicate the effectiveness of Moscow healthcare system over the past two decades (2000-2018): rapid-decreasing mortality from preventable causes against the background of the dynamics of total mortality in patients up to 75 years; higher rates of mortality reduction from causes dependent on behavioral risk factors; reduction in preventable mortality share in the life expectancy loss. At the same time, the rates of preventable mortality in Moscow remain quite significant, indicating that there is more potential for reducing premature mortality in Moscow. Of the 6.8 years for males and 3.7 years for females reduced by the maximum possible life expectancy before the age of 75 due to premature mortality, preventable deaths account for 5.0 and 2.3 years, respectively. By reducing mortality from preventable causes classified in group 1 and depending on the quality of medical care, life expectancy at the age of 75 years can be increased according to 2018 data by 2.3 years for men and 1.4 years for women. Due to causes classified in group 2 and dependent on effective primary prevention and public health efforts, the increase could be 2.8 and 0.8 years, respectively. The results of our study reveal potential for reducing mortality from nosological and age perspectives, and can be used to update health policy measures.

Life expectancy loss due to the COVID-19 pandemic exemplified by Moscow

Abstract There is high excess mortality against the background of the pandemic in Moscow (an increase of 36.2% against 18.1% on the national average). According to preliminary data, the loss of life expectancy is 3.1 years for Muscovites (from 78.9 years in 2019 to 76.2 years in 2020) and 1.9 years for the Russian population (from 73.4 to 71.5 years). As in other countries, elderly people suffering from chronic diseases were the most affected. The age-specific mortality rates in 2020 are significantly higher than those of 2019 in the age interval of 45 years and older as well as among children 10-14 years old and young people 25-29 years old. The maximum increase in mortality was recorded in age groups over 80 years old in males and 25-29 years in females. At the same time, infant mortality in Moscow has significantly decreased which is associated with a sharp decrease in the share of births among nonresidents (it exceeded a quarter of all births in the capital in 2019). The reduction in labor migration due to the closure of borders has led to a decrease in births among nonresidents. Using the decomposition method, it was shown that the greatest negative contribution to the loss of life expectancy in both sexes was made by mortality in the age group of 70-74 years which reduced life expectancy by 0.36 years for men and 0.27 years for women. Life expectancy decreased by 0.25 and 0.19 years due to death of men and women aged 75-79 years and by 0.09 and 0.02 years due to death of people aged 25-29 years. Reducing infant mortality yielded a life expectancy gain of 0.15 years for men and 0.11 years for women. These results changed the assessment of the significance of shifts in mortality in age groups. Analysis of changes in age-specific mortality and evaluation of its impact on changes in life expectancy shows different perspectives of the problem, which is important for making adequate decisions in health. Key messages The reduction in labor migration due to the closure of borders has led to a decrease in births among nonresidents. Analysis of changes in age-specific mortality and evaluation of its impact on changes in life expectancy shows different perspectives of the problem.

Alcohol and drug abuse as a manifestation of social stress due to the COVID-19 pandemic

During the pandemic, deaths associated with mental health deterioration due to social stress have contributed to excess mortality. The purpose of the study is to evaluate changes in mortality from causes associated with social stress during the pandemic in Moscow. The analysis is based on the Rosstat statistics and RFS-EMIAS database (Medical death certificates issued by the Moscow health institutions) in 2019-2020. Deaths from mental disorders and suicides during the maximum and minimum excess mortality in Moscow in 2020 were compared to 2019 (May and December, when mortality exceeded the 2019 indicators by 57.2% and 56.7%, and July with the 7.1%) excess. First, the excess mortality from mental disorders in these months was almost entirely due to disorders related to alcohol and drug abuse. Second, alcohol and drug abuse also results in deaths from poisoning. This necessitates a joint evaluation of deaths associated with alcohol and drugs (from mental disorders and poisoning). The evaluation shows that excess deaths from alcohol abuse in men in May 2020 compared to May 2019 equaled to 65%, falling down to 52.3% in July, followed by its maximum (2.5-fold) in December. Females show a steady increase: 52.9%, 76.5% and 2.1-fold, respectively. Distribution by sex of the total deaths associated with drug addiction (mental disorders and poisoning) was reversed: a steady increase in males (55.4% in May, 67% in July and 2.1-fold in December) and a significant decrease in females: 63.6%, 31.6% and 2.7-fold, respectively. Third, the pandemic has paradoxically affected deaths from suicide (including hangings, falls and undetermined intent poisoning). In men, excess deaths equaled to zero in May, 1.2% in July and decreased by 20.6% in December. The female excess suicidal mortality increased: 13.5%, 30.6% and 36.7%, respectively. Thus, the male reaction to social stress caused by the pandemic was passive (alcohol and drug abuse), while the female reaction was aggravated by suicides.Key messages During the pandemic, deaths associated with mental health deterioration due to social stress contributed to excess mortality.Alcohol and drug abuse results in deaths not only due to mental disorders.

Cardiovascular diseases as a reservoir for latent deaths from drug addiction (exemplified by Moscow)

Abstract The life expectancy gap between Russia and post-industrial countries is mainly due to mortality from diseases of the circulatory system (DCS), primarily in working ages, substantiating the need for a program to reduce cardiovascular mortality, currently implemented in Russia. In general, this program has resulted in a multiple reduction in cardiovascular mortality in Russia, however, in 2015-2017, Moscow turned out to be the absolute outsider among the Russian regions in DCS mortality among males of young and middle working ages and a contrastive outsider among females: in ages 15-29 mortality increased 4.4-fold among males and 3-fold among females; in ages 30-44 - 2.1-fold and 2.0-fold, respectively. The purpose of the study is to identify causes of the abnormal increase in mortality in Moscow in 2015-2017. The study shows that, first, the abnormal dynamics were due to cardiomyopathy, unspecified (CU) (I42. 9): the CU mortality in ages 15-44 increased 20-fold in males and 10-fold in females; in ages 45-59 - 7-fold and 8-fold, respectively, resulting in the highest ever CU mortality in Russia. Second, the CU deaths were usually sudden, not predated by a long-term treatment: admissions one month prior to death were registered in about 1% of cases in both sexes. Third, similar processes with the same reference point (2015) have been reported for drug poisoning, the rates of increase are comparable: about 10-fold in ages 15-29, 13 and 29-fold in ages 30-44 and 7.5 and 4-fold in ages 45-59, respectively. Fourth, numerous studies have shown that drug addiction (DA) leads to cardiovascular disorders, especially cardiomyopathies. Official data show that total DA mortality in Russia in the 2010s ranged from 3,752 to 5,581, which hardly corresponds to the actual scale of the problem because of underestimation of DA deaths due to their transferring to a latent form. In Moscow, DCS and cardiomyopathy, unspecified, in particular are one of the reservoirs for DA latent deaths. Key messages Drug addiction (DA) leads to cardiovascular disorders, especially cardiomyopathies. As to the capital, DCS, CU in particular, are one of the latent reservoirs of DA mortality.

Cardiac causes of death in Moscow and Moscow Region

Rationale: Cardiovascular disorders play a leading role in populational mortality, but they are not synonymous to cardiac pathology. The city of Moscow and the Moscow Region are one of the biggest urban agglomeration worldwide.Aim: Analysis of cardiac-related mortality in Moscow and the Moscow Region.Materials and methods: We calculated standardized mortality coefficients (SMC) for 23 death causes given as separate lines in the Short List of Death Causes by the Russian Agency of Statistics (Rosstat) in 2019.Results: In 2019, SMC for cardiac causes was 171.2 per 100 000 of the population in Moscow (27.6% of all causes) and 248.7 per 100 000 of the population in the Moscow Region (26.9% of all causes). More than 60% of deaths both in Moscow and in the Moscow Region were caused by chronic variants of ischemic heart diseases, whose criteria are not well-defined or are absent. In Moscow, SMC for myocardial infarction is significantly lower, whereas that for unspecified cardiomyopathy (the code by International Classification of Diseases and Health-related Conditions, version 10 (ICD10) I42.9) is higher. SMC from the groups of death causes related to chronic illness possibly unrelated to atherosclerosis, are comparable: 29.64 in Moscow and 24.59 in the Moscow Region. SMC from arterial hypertension (ICD10 I10-13) are 8.7 and 5.6 per 100000 of the population, respectively.Conclusion: Despite higher total cardiac mortality in the Moscow Region, SMCs for individual death causes in Moscow are significantly higher. SMC variability is mostly related to different algorithms for determination of primary death cause. ICD10 and the Rosstat the Short List of Death Causes seem to be suboptimal sources to understand the contribution of cardiac causes into the mortality structure. Any correct comparison would become possible after a consensus of expert positions by specialists in Moscow and Moscow Region on the criteria of diagnosis, choice of primary death cause and corresponding disease code.

Cardiovascular mortality rate in Moscow and St. Petersburg in 2015 and 2018

The differences in mortality rates between Moscow and St. Petersburg require study. Aim . Ranking and comparison of cardiovascular mortality in Moscow and St. Petersburg in 2015 and 2018. Material and methods . Data on the population and mortality rates was assessed according to the Brief nomenclature of causes of death of Federal State Statistic Service. Eleven out of 35 nomenclature lines related to cardiovascular disease (CVD) are represented by 4-digit ICD codes, the rest are represented by groups with 3- and/or 4-digit codes. Standardized mortality rates (SMRs) were calculated based on the European standard. Comparison of SMR differences between Moscow and St. Petersburg in 2015 and 2018 was carried out using the nonparametric Wilcoxon test. Results . The proportion of CVD in all-cause SMR in both cities is about 50%. There were no significant differences in SMR (2018-2015) between Moscow and St. Petersburg for 35 CVDs. The first 3 ranking places in the CVD pattern both in Moscow and St. Petersburg were occupied by CAD, different types of chronic CAD, and stroke. In 2015, their proportion was 58,3% and 48,9% and in 2018, 52,7% and 58,7%. Other causes varied significantly in relation to SMR and ranks in different years, which is probably due to different approaches to determining the code of death cause. The SMR and myocardial infarction contribution to cardiovascular mortality decreased. Conclusion. Differences in cardiovascular mortality between Moscow and St. Petersburg remain. To understand the mortality causes and to develop effective programs to reduce it, it is necessary to eliminate the identified defects.

Infant Mortality in Moscow: the Perils of Progress in Russia’s World City

This paper examines changes in infant mortality (IM) in Moscow, Russia's largest and most affluent city. Along with some remarkable improvements in Moscow's health system over the period between 2000 and 2014, the overall IM rate for Moscow's residents decreased substantially between 2000 and 2014. There remains, however, substantial intra-city variation across Moscow's 125 neighborhoods. Our regression models suggest that in higher-income neighborhoods measured by percent of population with rental income as a primary source, the IM rate is significantly lower than in lower-income neighborhoods measured by percent of population with transfer income as primary source (housing and utility subsidies and payments to working and low-income mothers, single mothers and foster parents). We also find that the density of physicians in a neighborhood is negatively correlated with the IM rate, but the effect is small. The density of nurses and hospital beds has no effect. We conclude that overall progress on health outcomes and measures of access does not, in itself, solve the challenge of intra-urban inequalities.

Особенности динамики и компоненты снижения смертности в Москве в 1989-2017 гг.

Москва – регион с самой высокой ожидаемой продолжительностью жизни в России. Это крупнейший город страны с высокими доходами, особой структурой населения, высокой концентрацией всех ресурсов, в том числе в сфере здравоохранения, которому уделяется особое внимание на уровне городских властей. Отдельные этапы изменения продолжительности жизни в Москве уникальны по сравнению с большинством других регионов России. Разница в продолжительности жизни между Москвой и Россией в период с середины 1990-х до середины 2000-х годов была обусловлена главным образом более низкой смертностью населения в средних возрастах. Впоследствии главный акцент смещается на смертность пожилого населения. При положительной динамике показателей смертности в целом уровень и динамика смертности в отдельных возрастных группах в Москве выглядят неправдоподобно. Качество данных может оказывать заметное влияние на достоверность демографических показателей и требует отдельного внимания при анализе продолжительности жизни. В частности, численность пожилого населения Москвы может быть завышена, что влияет на показатели смертности в старших возрастах. Особенности смертности по причинам смерти в Москве в целом соответствуют среднероссийским тенденциям, однако наблюдается более быстрое снижение смертности от новообразований, а также более реалистичные возрастные коэффициенты смертности в старших возрастных группах.

Main indicators characterizing medical care quality for children with cancer in 2013–2017 in Moscow and Moscow Region

Moscow is a city of federal significance with a high population of children and, accordingly, a large number of primary patients detected annually. The objective of the study is to analyze the main indicators characterizing the medical care for children with cancer in Moscow and the Moscow Region. Materials and methods. There were analyzed the operational reports of the Moscow Department of Health and the Ministry of Health of the Moscow Region for 2013–2017. The results. In 2013–2017 there were identified 18,090 primary patients in the Russian Federation, among them 1807 (10%) in the analyzed locations: 1315 (7.3%) in Moscow, 492 (2.7%) in Moscow Region. For 5 years the number of primary patients in Moscow increased by 18.1%, and in the Moscow region it decreased by 2.3%. The morbidity of the children aged 0–17 years in Moscow increased by 5.3%, while in the Moscow Region the morbidity decreased by 20%. The mortality rate in 2016–2017 in Moscow decreased by 37.5%, while in the Moscow region – by 50%. There were no actively identified patients in Moscow in 2016–2017, and in the Moscow region their percentage decreased from 34.2 to 7.3. The conclusion. The incidence of malignant neoplasms of the child population in Moscow and the region is slightly lower than the average for the Russian Federation. At the same time, the levels of morbidity and mortality in Moscow and the Moscow region differ significantly. This indicates obvious defects in diagnostics and accounting, which is confirmed by the discrepancy between these operational reports and the Federal State Statistics Service. District pediatricians demonstrated low oncological alertness.

Excerpts on the History of Mother and Infant Protection in Moscow at the beginning of the 20th century

The article is devoted to the important course of the medicine development at the beginning of the 20th century — mother and infant protection. The contribution of pediatricians and obstetricians to prevention of high infant mortality in Moscow is represented. The activities of G.N. Speransky and other doctors in public benevolent institutions are reported.

Mortality in Moscow and other megacities of the world: similarities and differences

This paper is devoted to the comparison of mortality by cause of death in Moscow and other megacities of the world since 1990. The selection of megacities was determined by the availability of detailed mortality data in the selected period. The objects of our comparison are data for Berlin, Hong Kong, London, Los Angeles, New York, Singapore, St. Petersburg, and Tokyo. Mortality from major groups of causes of death are considered, including cardiovascular diseases, neoplasms, external causes, diseases of the respiratory and digestive systems, infections and some others. The analysis uses standardised mortality rates by cause of death.
 The mortality level in Moscow is significantly lower than in the majority of regions of Russia, but is still substantially higher than in foreign megacities. Due to a big lag at the beginning of the period, the mortality level in Moscow nowadays is higher than in all selected foreign megalopolises in the year 2000. Where Moscow’s mortality level lags most behind others is in mortality from circulatory diseases and external causes. Moscow's successes in reducing mortality in 2000-2014 are very impressive. However, it is difficult to predict how events will unfold in the deteriorating economic situation.

Handgrip strength and its prognostic value for mortality in Moscow, Denmark, and England.

BackgroundThis study compares handgrip strength and its association with mortality across studies conducted in Moscow, Denmark, and England.MaterialsThe data collected by the Study of Stress, Aging, and Health in Russia, the Study of Middle-Aged Danish Twins and the Longitudinal Study of Aging Danish Twins, and the English Longitudinal Study of Ageing was utilized.ResultsAmong the male participants, the age-standardized grip strength was 2 kg and 1 kg lower in Russia than in Denmark and in England, respectively. The age-standardized grip strength among the female participants was 1.9 kg and 1.6 kg lower in Russia than in Denmark and in England, respectively. In Moscow, a one-kilogram increase in grip strength was associated with a 4% (hazard ratio [HR] = 0.96, 95% confidence interval [CI]: 0.94, 0.99) reduction in mortality among men and a 10% (HR = 0.90, 95%CI: 0.86, 0.94) among women. Meanwhile, a one-kilogram increase in grip strength was associated with a 6% (HR = 0.94, 95%CI: 0.93, 0.95) and an 8% (HR = 0.92, 95%CI: 0.90, 0.94) decrease in mortality among Danish men and women, respectively, and with a 2% (HR = 0.98, 95%CI: 0.97, 0.99) and a 3% (HR = 0.97, 95%CI: 0.95, 0.98) reduction in mortality among the English men and women, respectively.ConclusionThe study suggests that, although absolute grip strength values appear to vary across the Muscovite, Danish, and English samples, the degree to which grip strength is predictive of mortality is comparable across national populations with diverse socioeconomic and health profiles and life expectancy levels.

Comparative Analysis of All-cause and Cardiovascular Mortality in Moscow and Irkutsk

Aim. To study standardized all-cause mortality and cardiovascular mortality (or deaths due to diseases of the circulatory system) in Irkutsk and Moscow including assessment in gender and age subgroups. Material and methods. To compare mortality in the two cities data of Federal State Statistics Service were used with calculation of coefficients of mortality adjusted for European age pattern. Results : Age-standardized indices of mortality per 100,000 of population were significantly lowerin Moscow as compared to Irkutsk in the entire sample (697.6 vs 1157.8; p<0.00001), in men (904.0 vs 1364.3; p<0.00001) and in women (535.1 vs 822.7; p<0.00001), and also in all age subgroups above 25 years. Cardiovascular diseases were dominated in the mortality patterns of the compared cities: 47% in Irkutsk, 64% in Moscow. Chronic forms of ischemic heart disease (47.9% in Irkutsk and 45.9% in Moscow) and cerebrovascular diseases (15.9% in Irkutsk and 16.7% in Moscow) were prevalent. There were significant distinctions in death rates encoded in such headings as: “Otherforms of acute ischemic heart disease”, “Atherosclerotic heart disease”, “Cerebral atherosclerosis”, “Hypertensive encephalopathy”, and “Unspecified cardiomyopathy”. Conclusion. Irkutsk had higher standardized coefficients of all-cause and cardiovascular mortality as compared to Moscow in the total population, in men and in women and in majority of age subgroups. This can be explained by economic, social and climatic factors.

Children's Infectious Disease in Moscow: Problems and Solutions

Based on statistical data, a comparative analysis of infectious morbidity and mortality in Moscow in 2015 and 2014 revealed a whole, the decline in these indicators. Made significant progress in reducing infectious morbidity in Moscow due to the vaccination of children, including — increased regional calendar of preventive vaccinations. However, analysis of the work of medical institutions indicates the feasibility of the development and introduction of technologies of management of patients with post-infectious syndromes, as well as improving the health care system for children with infectious diseases based on a multidisciplinary approach in close cooperation infectious disease and pediatricians of different specialties. To solve these problems is proposed a plan to improve the effectiveness of children's infectious diseases services relating to the reorganization of hospital beds and outpatient care, ensure the continuity of the different health facilities, implementation of modern methods of etiological diagnosis of infections, the organization of continuous vocational training of paediatricians in Moscow on a specialty «Infectious diseases».

Sex differences in health and mortality in Moscow and Denmark

In high income countries females outlive men, although they generally report worse health, the so-called male-female health-survival paradox. Russia has one of the world's largest sex difference in life expectancy with a male disadvantage of more than 10 years. We compare components of the paradox between Denmark and Moscow by examining sex differences in mortality and several health measures. The Human Mortality Database and the Russian Fertility and Mortality Database were used to examine sex differences in all-cause death rates in Denmark, Russia, and Moscow in 2007-2008. Self-reported health data were obtained from the Study of Middle-Aged Danish Twins (n = 4,314), the Longitudinal Study of Aging Danish Twins (n = 4,731), and the study of Stress, Aging, and Health in Russia (n = 1,800). In both Moscow and Denmark there was a consistent female advantage at ages 55-89 years in survival and a male advantage in self-rated health, physical functioning, and depression symptomatology. Only on cognitive tests males performed similarly to or worse than women. Nevertheless, Muscovite males had more than twice higher mortality at ages 55-69 years compared to Muscovite women, almost double the ratio in Denmark. The present study showed that despite similar directions of sex differences in health and mortality in Moscow and Denmark, the male-female health-survival paradox is very pronounced in Moscow suggesting a stronger sex-specific disconnect between health indicators and mortality among middle-aged and young-old Muscovites.

The effects of particulate and ozone pollution on mortality in Moscow, Russia

The objectives of this study were (1) to evaluate how acute mortality responds to changes in particulate and ozone (O3) pollution levels, (2) to identify vulnerable population groups by age and cause of death, and (3) to address the problem of interaction between the effects of O3 and particulate pollution. Time-series of daily mortality counts, air pollution, and air temperature were obtained for the city of Moscow during a 3-year period (2003–2005). To estimate the pollution-mortality relationships, we used a log-linear model that controlled for potential confounding by daily air temperature and longer term trends. The effects of 10 μg/m3 increases in daily average measures of particulate matter ≤10 μm in aerodynamic diameter (PM10) and O3 were, respectively, (1) a 0.33% [95% confidence interval (CI) 0.09–0.57] and 1.09% (95% CI 0.71–1.47) increase in all-cause non-accidental mortality in Moscow; (2) a 0.66% (0.30–1.02) and 1.61% (1.01–2.21) increase in mortality from ischemic heart disease; (3) a 0.48% (0.02–0.94) and 1.28% (0.54–2.02) increase in mortality from cerebrovascular diseases. In the age group >75 years, mortality increments were consistently higher, typically by factor of 1.2 – 1.5, depending upon the cause of death. PM10-mortality relationships were significantly modified by O3 levels. On the days with O3 concentrations above the 90th percentile, PM10 risk for all-cause mortality was threefold greater and PM10 risk for cerebrovascular disease mortality was fourfold greater than the unadjusted risk estimate.

Excess mortality during heat waves and cold spells in Moscow, Russia

Objectives: To estimate excess mortality during heat waves and cold spells, and to identify vulnerable population groups by age and cause of death. Methods: Daily mortality in Moscow, Russia from...