Russia

Mortality

The social and economic crises that gripped Russia in the early 1990s are reflected in increased mortality and declining life expectancy, especially among able-bodied males. Contributing to Russia's long-term population decline is a projected mortality rate increase from 11.3 per 1,000 population in 1985 to 15.9 per 1,000 in 2005. Russia's mortality rate reached its lowest level, 10.4 per 1,000 population, in 1986 (for which a state anti-alcohol campaign received substantial credit); then the figure rose steadily in the ensuing decade. The largest jump was from 12.2 to 14.6 per 1,000 between 1992 and 1993; after having reached 15.7 per 1,000 in 1995, the rate was projected to remain virtually flat over the next decade.

According to 1994 statistics, the life expectancy for Russian males had reached 57.3 years and for females 71.1 years. These are the lowest figures and the largest disparity by sex for any country reporting to the World Health Organization, and they are a sharp decline from the 1987 levels of 64.9 years for males and 74.6 years for females. In 1990 the Russian Republic ranked only seventh in this statistic among the fifteen republics of the Soviet Union. The lag in the average life expectancy of males was attributed to alcohol and tobacco abuse; to unsafe conditions at work, on the road, and in the home; and to declining heath care.

Mortality rates are especially high for able-bodied males in rural areas. Served poorly by the health care system and lacking basic sanitary facilities and conveniences, many farming communities have been transformed into enclaves for the elderly, the indigent, and the sick. Moreover, indigenous nationalities such as the Evenks and the Nenets have suffered catastrophic declines in life expectancy and high rates of sickness and death that have prompted speculation that some of those groups may become extinct. Geographically, the lowest average life expectancy in Russia is in the Siberian Republic of Tyva, and the highest figures are in the Caucasus Republic of Dagestan and in the Volga region. In the first half of the 1990s, the imbalance between the birth and death rates was especially acute in major cities. In Moscow and St. Petersburg, the number of deaths in 1992 was almost double the number of births.

Since 1987 mortality from accidents, injuries, and poisonings has risen significantly, from 101 to 228 per 100,000 population. Contributing to that figure are an estimated 8,000 fatal workplace accidents per year, largely the result of aging equipment, the proliferation of risky jobs in the unofficial "shadow economy," and the deterioration of work discipline. For the period between 1990 and 1994, the suicide rate rose by 57 percent to a total of nearly 62,000, putting Russia in third place among eighty-four developed countries. The stress of the transition period is one explanation for this rising statistic. The homicide rate rose by more than 50 percent in the same period (see Crime, ch. 10). In 1994 Russia's 35,000 motor vehicle deaths nearly equaled the 40,000 in the United States, although Russia has less than 1 percent as many automobiles. Deteriorating roads and declining police discipline are the main causes of that fatality statistic.

The chief natural cause of death is diseases of the circulatory system, which accounted for 769 deaths per 100,000 population in 1993. The next causes in order of frequency are cancer and respiratory diseases. Among people of working age, 41 percent of deaths are attributable to unnatural causes; the proportion of such deaths was highest in Leningrad Oblast, the Permyak Autonomous Region, the Republic of Tyva, and the Evenk Autonomous Region. The number of alcohol-related deaths also climbed in the mid-1990s; the 1994 figure was 25 percent higher than the 1993 total. In some regions, alcoholism has assumed epidemic proportions; in the Bikin Rayon of Khabarovsk Territory on the Pacific coast, nearly half the deaths between 1991 and 1995 were alcohol related (see Health Conditions, ch. 5).

The overall aging of the population also is an important factor in the higher mortality rate. Between 1959 and 1989, the percentage of retirees in the population and the percentage of Russians eighty or older nearly doubled, although declining life expectancy already was reducing the impact of that trend in the mid-1990s.