Mortality in Russia: the second epidemiologic revolution that never was

Abstract

The article looks at different approaches  (the "new phase" of the epidemiologic transition, "the second epidemiologic revolution", a "health transition") to conceptualization of the present stage of mortality reduction, in which  noncommunicable diseases and causes of death resulting from external sources come to the fore. At this stage, which has lasted for at least half a century, revolutionary changes have taken place in most developed countries.  These changes manifest themselves in the drastic expansion of control over non-infectious causes of death, particularly over diseases of the circulatory system, neoplasms, and other noncommunicable diseases, as well as over external causes of death. The consequence of these changes has been the rapid shift of deaths from the abovementioned causes to older ages, an increase in the mean age of death from them and, ultimately, a significant rise in life expectancy. Meanwhile, Russia has been mostly unaffected by these changes and has failed to provide the necessary  growth of control over noncommunicable causes of death. The age distribution of deaths from major classes of causes of death in Russia over the past half-century has not changed, leading to a stagnation in life expectancy and to an increasing lag behind the majority of developed countries with respect to this indicator.  "The second epidemiologic revolution" in Russia is still a matter for the future.