Center-peripheral differences in life expectancy in Russia: a regional analysis

  • Alexey Shchur National Research University Higher School of Economics
  • Sergey Timonin National Research University Higher School of Economics
Keywords: life expectancy, mortality, Russian regions, regional capitals, center and periphery

Abstract

Elevated mortality (compared with the West) and significant spatial differences in life expectancy are serious challenges facing Russia. The goals of improving Russians' health and increasing their life expectancy by reducing inequality in mortality between regions and settlements are closely intertwined with the goals of spatial development of Russia, aimed at reducing interregional differences in the quality of life.

This paper presents an assessment of the scope and dynamics of changes in mortality differences between the ‘center’ and the ‘periphery’ in 67 regions of Russia, which are home to three-quarters of the country's population. The selected research period - 2003-2018 - is characterized by a steady increase in life expectancy at birth (LE) in Russia. Using unpublished data from Rosstat for cities, we estimated life expectancy at birth in 67 regional centers and in the rest of the regions (‘periphery’). Depending on the magnitude of the differences in LE and the dynamics, we identified 6 types of regions. For those regions with a LE gap between center and periphery larger than the average, the decomposition method was applied, which made it possible to determine the key age groups and causes of death responsible for such high differences.

In 36 regions of Russia classified as types I-III, the center-peripheral gap exceeded the average Russian level, while only in six regions in 2003-18 was there a tendency towards a reduction in the size of this gap. The decomposition results showed that elevated mortality of males in the periphery is due to a higher mortality rate at working age from external causes of death, especially from traffic accidents, homicides and suicides, as well as from ‘alcoholic’ causes of death; females in the periphery suffer from higher mortality rate at older ages from chronic non-communicable diseases.

Despite the seemingly ‘objective’ nature of the mortality differences between the center and the periphery (the advantage of the former being due to the socio-demographic characteristics of its residents and the educational structure of the population, as well as to selective migration), the positive experience of other countries shows that effective public health policies can substantially reduce the degree of spatial inequality in mortality even if significant heterogeneity in the level of socio-economic development remains.

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References

Andreev E.M. (1979). Length of life in the USSR: A differential analysis. In E. Andreev, A. Vishnevski (Eds.), Length of life: Analysis and modelling. Moscow: Statistika. (In Russ).

Andreev E.M. (1982). The method of components in the analysis of length of life. Vestnik Statistiki, 9, 42–47. URL: http://www.demoscope.ru/weekly/knigi/andreev/andreev.pdf (In Russ).

Andreev E.M. (2012). On accuracy of Russia population censuses results and level of confidence in different sources of information. Statistical Issues, 11, 21–35. URL: http://www.demoscope.ru/weekly/2013/0549/analit01.php (In Russ).

Andreev E.M., Kvasha E.A., Kharʹkova T.L. (2006). Special points on the mortality map. In A.G. Vishnevsky (Ed.), Naselenie Rossii 2003–2004. Odinnadtsatyy-dvenadtsatyy ezhegodnyy demograficheskiy doklad (pp. 298–305) [Russia’s Population in 2003-2004. 11-12 Annual Demographic Report]. Мoscow: Nauka. (In Russ).

Center for Demographic Research. (2018). Russian Fertility and Mortality Database. Retrieved from http://www.demogr.nes.ru/index.php/ru/demogr_indicat/data (data downloaded on 15.03.2020).

Cummins S., Curtis S., Diez-Roux A.V., Macintyre S. (2007). Understanding and representing ‘place’ in health research: A relational approach. Social Science & Medicine, 65(9), 1825-1838. DOI: 10.1016/j.socscimed.2007.05.036.

Danilova I. (2015). Problems of the quality of cause-specific mortality statistics at advanced ages. Advances in Gerontology, 3, 409–414. URL: https://www.hse.ru/data/2018/10/11/1155689100/%D0%94%D0%B0%D0%BD%D0%B8%D0%BB%D0%BE%D0%B2%D0%B0.pdf (In Russ).

Diez Roux A.V. (2002). A glossary for multilevel analysis. Journal of Epidemiology and Community Health, 56(8), 588–594. DOI: 10.1136/jech.56.8.588.

Federal State Statistics Service (Rosstat) (FSSS). (2012). All-Russian population census 2010. URL: https://www.gks.ru/free_doc/new_site/perepis2010/croc/perepis_itogi1612.htm (In Russ).

Ivanova A., Semenova V., Dubrovina E. (2004). Chto skryvayetsya za "drugimi boleznyami serdtsa"? [What is hidden behind 'other heart diseases'?]. Demoskop Weekly, 181–182. URL: http://www.demoscope.ru/weekly/2004/0181/tema02.php (In Russ).

Ivanova A.E. Mikhaylov A.YU., Semenova V.G. (2009). Poteri prodolzhitel’nosti i kachestva zhizni naseleniya Rossii [Loss of length and quality of life of Russian population]. Narodonaseleniye, 3, 40-49. URL: https://cyberleninka.ru/article/n/poteri-prodolzhitelnosti-i-kachestva-zhizni-naseleniya-rossii (In Russ).

Ivanova A.E., Sabgayda T.P., Semenova V.G., Zaporozhenko V.G., Zemlyanova E.V., Nikitina S.YU. (2013). Factors distorting structure of death causes in working population in Russia. Social aspects of population health, 4(32). URL: http://vestnik.mednet.ru/content/view/491/30/ (In Russ).

Karachurina L.B., Mkrtchyan N.V. (2016). Regional’nyye tsentry Rossii v fokuse migratsii [Regional centers of Russia in migration's focus]. In V. Kotlyakov, V.N. Streletskiy, O.B. Glezer, S.G. Safronov (Eds.), Problemy regional’nogo razvitiya Rossii (pp. 209-233). Moscow: Izdatel’skiy dom «Kodeks». (In Russ).

Kharʹkova T.L., Nikitina S.YU., Andreev E.M. (2017). Dependence of life expectancy on the education levels in Russia. Statistical Issues, 8, 61–68. URL: https://voprstat.elpub.ru/jour/article/view/546 (In Russ).

Leksin V.N. (2009). Goroda vlasti: administrativnyye tsentry Rossii [Cities of Power: Administrative Centres of Russia]. Mir Rossii: Sotsiologiya, etnologiya, 18(1), 3-33. URL: https://mirros.hse.ru/article/view/5127 (In Russ).

Mackenbach J.P., Bos V., Andersen O., Cardano M., Costa G., Harding S., Reid A., Hemström Ö., Valkonen T., Kunst A.E. (2003). Widening socioeconomic inequalities in mortality in six Western European countries. International Journal of Epidemiology, 32(5), 830–837. DOI: 10.1093/ije/dyg209.

Marmot M. (2006). Social determinants of health inequalities. Lancet, 365(9464), 1099‐1104. DOI: 10.1016/s0140-6736(05)74234-3.

Marmot M.G., Shipley M.J., Rose G. (1984). Inequalities in death—specific explanations of a general pattern? Lancet, 1(8384), 1003–1006. DOI: 10.1016/s0140-6736(84)92337-7.

Mkrtchyan N.V. (2012). Issues of acquiring population in certain age groups during the Census of 2010: The reasons for the deviations from the expected counts. In M. B. Denisenko (Ed.), Demographic aspects of socio-economic development (pp. 197–214). Moscow: MAKS Press (In Russ).

Nefyodova T., Treyvish A. (2020). Polarization and shrinkage of active space in the core of Russia: trends, problems and possible solutions. Demographic Review, 7(2), 31-53. https://doi.org/10.17323/demreview.v7i2.11138 (In Russ).

Novosel'skij S.A. (1911). O razlichiyah v smertnosti sel'skogo i gorodskogo naseleniya Evropejskoj Rossii [Differences in mortality between the rural and urban population of European Russia]. Obshchestvennyj vrach, 4. (In Russ).

Novosel'skij S.A. (1916). Smertnost' i prodolzhitel'nost' zhizni v Rossii [Mortality and life expectancy in Russia]. Saint Petersburg: Tipografiya MVD. URL: http://www.demoscope.ru/weekly/knigi/novoselskij/novoselskij_1916.pdf (In Russ).

Papanova E., Shkolnikov V., Timonin S. (2019). Distinctive features and components of mortality decrease in Moscow in 1989-2017. Demographic Review, 6(1), 50-103. https://doi.org/10.17323/demreview.v6i1.9113 (In Russ).

Pyankova A.I., Fattakhov T.A. (2017). Smertnost’ po urovnyu obrazovaniya v Rossii [Mortality by level of education in Russia] // HSE economic journal. 21(4), 623–647. URL: https://ej.hse.ru/data/2017/12/28/1160683586/%D0%9F%D1%8C%D1%8F%D0%BD%D0%BA%D0%BE%D0%B2%D0%B0.pdf (In Russ).

Razum O., Zeeb H., Rohrmann S. (2000). The ‘healthy migrant effect’– not merely a fallacy of inaccurate denominator figures. International Journal of Epidemiology, 29(1), 191–192. DOI: 10.1093/ije/29.1.191.

Sen A. (1998). Mortality as an Indicator of Economic Success and Failure. The Economic Journal, 108(446), 1–25. DOI: 10.1111/1468-0297.00270.

Shaw M., Dorling D., Mitchell R. (2002). Health, Place and Society. Singapore: Pearson.

Shchur A. (2019). Education level as a factor in demographic forecasting. Demographic Review, 6(2), 204-208. https://doi.org/10.17323/demreview.v6i2.9878 (In Russ).

Shkolnikov V.M. (1987). Geographical factors of length of life. Izvestiya AN SSSR. Geographical Series, 3(12), 35–44. (In Russ).

Shkolnikov V.M., Andreev E., Jasilionis D., Leinsalu M., Antonova O., McKee M. (2006). The changing relation between education and life expectancy in central and eastern Europe in the 1990s. Journal of Epidemiology and Community Health, 60(10), 875-881. DOI: 10.1136/jech.2005.044719.

Timonin S., Danilova I., Andreev E., Shkolnikov V.M. (2017). Recent mortality trend reversal in Russia: are regions following the same tempo? European Journal of Population, 33(1), 733- 763. DOI: 10.1007/s10680-017-9451-3.

Timonin S., Jasilionis D., Shkolnikov V., Andreev E.M. (2020). New perspective on geographical mortality divide in Russia: a district- level cross- sectional analysis, 2008–2012. Journal of Epidemiology and Community Health, 74(2), 144-150. DOI: 10.1136/jech-2019-213239.

Valkonen T. (1992). Trends in regional and socio-economic mortality differentials in Finland. International Journal of Health Sciences, 3(3-4), 157-166. URL: https://pubmed.ncbi.nlm.nih.gov/12345858/

van Raalte A.A., Klüsener S., Oksuzyan A., Grigoriev P. (2020). Declining regional disparities in mortality in the context of persisting large inequalities in economic conditions: the case of Germany. International Journal of Epidemiology, 49(2), 486–496. DOI: 10.1093/ije/dyz265

Vasin, S., Costello C.A. (1997). Spatial, age, and cause-of-death patterns of mortality in Russia, 1988–1989. In J.L. Bobadilla, C.A. Costello, F. Mitcell (Eds.), Premature Death in the New Independent States (pp. 66-119). Washington, DC: National Academies Press.

Vishnevsky A.G., Shchur A.E. (2019). Smertnost’ i prodolzhitel’nost’ zhizni v Rossii za polveka [Mortality and life expectancy in Russia for half a century]. Orgzdrav: novosti, mneniya, obucheniye, 5(2), 10-21. DOI: 10.24411/2411-8621-2019-12003. (In Russ).

Von Gaudecker H., Scholz, R. (2007). Differential mortality by lifetime earnings in Germany. Demographic Research, 17, 83-108. DOI: 10.4054/demres.2007.17.4

Zakharov S.V. (2019). Naseleniye Rossii 2017: dvadtsat’ pyatyy ezhegodnyy demograficheskiy doklad [Russia’s population: 25 annual demographic report]. Moscow: Izdatel’skiy dom NIU VSHE. (In Russ).

Published
2021-10-14
How to Cite
ShchurA., & TimoninS. (2021). Center-peripheral differences in life expectancy in Russia: a regional analysis. Demographic Review, 7(5), 63-83. https://doi.org/10.17323/demreview.v7i5.13198
Section
Original papers