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Population health in Russia in an international context

Priority areas of development: sociology
2019
The project has been carried out as part of the HSE Program of Fundamental Studies.

Goal of research

A comprehensive study of the health of the population of Russia: monitoring (healthy) life expectancy and key risk factors; mortality estimates by causes of death, generating the largest burden of preventable mortality in Russia; assessment of spatial inequality in mortality in Russia based on the development of new and improvement of existing demographic and epidemiological methods.

Methodology

Modern methods of demographic analysis and modeling are used: methods of direct and indirect standardization, analytical (step-by-step replacement) and contour decomposition, construction of life tables; statistical methods: logistic regressions and hierarchical cluster analysis; epidemiological methods: triangulation, meta-analysis, building population models based on data on morbidity and mortality; geographical: cartographic visualization, geographic information analysis and modeling.

Special attention in our work was devoted to assessing the quality of demographic data (primarily in connection with the change in the registration of the natural movement of the population as part of the creation of the Unified State Register of Civil Status) using the data obtained from administrative sources and based on mathematical modeling.

Empirical base of research: includes two main types of sources

The first type includes demographic data by age, gender and causes of death contained in the following databases: Russian fertility and mortality database (RBD), Human Mortality Database (HMD), which is the most authoritative source of mortality data for different countries; Human Cause-of-Death Database. These databases have been developed and are maintained by laboratory staff in cooperation with the foreign partners and statistical offices in many countries of the world. Also, we use unpublished tables and reports by the Federal State Statistics Service - Rosstat (in particular for cities of Russia with a population of more than 100 thousand people), microdata of the All-Russian population censuses and individual depersonalized data on all registered deaths in Russia from 01.01. 2000 to December 31.12. 2017.

The second type of data is the individual data of 11 independent epidemiological cross-sectional studies conducted from 1975 to 2016. In order to conduct further analysis of risk factors,  we are to create a single data set (integrated dataset), which includes the results of more than 20 surveys of public health and risk factors.

Results of research

In 2019 the laboratory staff published 6 (six) papers, as well as 2 (two) commentaries in journals indexed in 1 quartile (Q1) of Web of Science; about 25 papers were presented at the international conferences and seminars; 6 persons from the laboratory staff took part in international academic mobility programs. The international laboratory, together with the colleagues from the HSE Institute of Demography, held the international seminar “Data Quality on Population and Demographic Processes in Russia” (September 20, 2019) and the international conference “Demographic Trends in Russia: the Legacy of the Soviet Time or a New Turn?” (21 - 22.09.2019) with more than 30 participants from scientific centers of Russia and foreign countries. A scientific seminar “Modern Demography” is regularly held by the laboratory, in 2019 4 speeches by leading Russian and foreign researchers were presented there. Laboratory staff takes part in the study of the phenomenon of high mortality from diseases of the circulatory system in Russia as part of an international project in collaboration with the London School of Hygiene and Tropical Medicine (UK).

Content-wise, we conducted a detailed analysis of the dynamics of mortality and life expectancy during the last period of stable life expectancy growth in Russia in 2003-2018. The decomposition of changes in LE by sex, age and causes of death showed that changes at the present stage are more likely to be of a fundamentally new rather than the restorative nature.

Most of the studies in 2019 focused on spatial (geographical) inequality in mortality, using the data for more detailed geographic entities, mostly at the level of cities with different populations and rural areas. Among other things, it was shown that differences in life expectancy between Russian cities with a population of more than 100 thousand people, with the exception of Moscow and St. Petersburg, decreased and were mainly explained by differences in the educational structure of the population. To explain the significant advantages of Moscow over the rest of Russia, we used the data on the self-assessment of the health by residents in Russia and Moscow separately.

A significant part of our research was devoted to the analysis of mortality by causes of death, namely from HIV infection and diseases of the circulatory system. It was shown that in 2018 the standardized mortality rate from HIV infection in Russia increased once again, but the rate of its growth decreased significantly. Using the methods of geographic information analysis and cartographic visualization, we showed patterns of mortality from HIV infection in Russian regions, including the most affected regions, where we clearly indicated the spread of the infection from the center of the regions to its periphery.

Using the materials of 9 Russian and 2 foreign health studies for the period from 1985 to 2015, we assessed the prevalence of high blood pressure in Russia in comparison with Great Britain and Norway, and using meta-regression, we analyzed trends in changes in mean SBP, DBP, and the prevalence of high pressure and hypertension among men and women in the age groups of 35-54 years and 55 years and older. The study showed a decrease in the prevalence of high blood pressure among women, but no change in consistently high prevalence of high blood pressure among men.

Analysis of statistics of mortality by causes of death showed that the structure of cardiovascular diagnoses in Russia is fundamentally different from the similar structure in most European countries. We attempted to create a formal classification of the structures of mortality from cardiovascular diseases. It was shown that the distribution of countries according to the structure of diagnoses looks like a continuous distribution in which Russia is not an isolated point.

Publications:


Shchur A. Cities of over a million people on the mortality map of Russia / Пер. с рус. // Демографическое обозрение. 2019. Vol. 5. No. 5. P. 64-84. doi
Oksuzyan A., Dańkoa M. J., Caputo J., Jasilionis D., Shkolnikov V. Is the story about sensitive women and stoical men true? Gender differences in health after adjustment for reporting behavior // Social Science & Medicine. 2019. Vol. 228. P. 41-50. doi
Shkolnikov V., Leon D. A., Danilova I. A Changeable Relation Between Alcohol and Life Expectancy in Russia // Journal of Studies on Alcohol and Drugs. 2019. Vol. 80. No. 5. P. 501-502. doi
Wenau G., Grigoriev P., Shkolnikov V. Socioeconomic disparities in life expectancy gains among retired German men, 1997–2016 // Journal of Epidemiology and Community Health. 2019. P. 1-7. doi
Timonin S., Jasilionis D., Shkolnikov V., Andreev E. M. New perspective on geographical mortality divide in Russia: a district- level cross- sectional analysis, 2008–2012 // Journal of Epidemiology and Community Health. 2020. Vol. 74. No. 2. P. 144-150. doi
Andreev E. M. Reflections on demographic theories // Население и экономика. 2019. Vol. 3. No. 2. P. 1-9. doi
Jasilionis D., Jdanov D. Commentary: Important lessons from the unfolding health crisis in Venezuela // International Journal of Epidemiology. 2019. P. 1-2. doi
Концевая А. В., Леон Д., Макки М. Преодоление географических барьеров в лечении острого инфаркта миокарда в России / Пер. с англ. // Демографическое обозрение. 2019. Т. 6. № 1. С. 104-123. doi
Щур А. Е. Уровень образования как фактор демографического прогноза // Демографическое обозрение. 2019. Т. 6. № 2. С. 204-208. doi
Чурилова Е. В., Захаров С. В. Репродуктивные установки населения России: есть ли повод для оптимизма? // Вестник общественного мнения. Данные. Анализ. Дискуссии. 2019. № 3-4. С. 69-89.