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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ph</journal-id><journal-title-group><journal-title xml:lang="ru">Общественное здоровье</journal-title><trans-title-group xml:lang="en"><trans-title>Public Health</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2782-1676</issn><issn pub-type="epub">2949-1274</issn><publisher><publisher-name>ФГБУ «ЦНИИОИЗ» Минздрава России</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21045/2782-1676-2025-5-4-7-26</article-id><article-id custom-type="elpub" pub-id-type="custom">ph-331</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ТЕОРИЯ ОБЩЕСТВЕННОГО ЗДОРОВЬЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PUBLIC HEALTH THEORY</subject></subj-group></article-categories><title-group><article-title>Смертность в России: постановка проблемы и пути решения</article-title><trans-title-group xml:lang="en"><trans-title>Mortality in Russia: problems and ways forward</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3800-1108</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Устюжанин</surname><given-names>В. В. </given-names></name><name name-style="western" xml:lang="en"><surname>Ustyuzhanin</surname><given-names>V.  V. </given-names></name></name-alternatives><bio xml:lang="ru"><p>Устюжанин Вадим Витальевич – младший научный сотрудник Центра изучения стабильности и рисков</p><p>г. Москва</p></bio><bio xml:lang="en"><p>Vadim V. Ustyuzhanin – Junior Researcher of the Center for stability and risk analysis</p><p>Moscow</p></bio><email xlink:type="simple">vvustiuzhanin@hse.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1230-9385</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Халтурина</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Khaltourina</surname><given-names>D.  A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Халтурина Дарья Андреевна – кандидат исторических наук, начальник Управления профилактики факторов риска и коммуникационных технологий в здравоохранении</p><p>г. Москва</p></bio><bio xml:lang="en"><p>Daria A. Khaltourina – PhD in History sciences, Head of The Department of Risk Factor Prevention and Communication Technologies in Healthcare</p><p>Moscow</p></bio><email xlink:type="simple">khaltourina@mednet.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рыбальченко</surname><given-names>С.   И.</given-names></name><name name-style="western" xml:lang="en"><surname>Rybalchenko</surname><given-names>S.   I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рыбальченко Сергей Игоревич – кандидат экономических наук, генеральный директор; председатель, Комиссия Общественной палаты РФ по демографии, защите семьи, детей и традиционных семейных ценностей</p><p>г. Москва</p></bio><bio xml:lang="en"><p>Sergei I. Rybalchenko – PhD in Economic sciences, director general; Chairperson, Civic Chamber Commission on Demography and the Protection of Family, Children and Traditional Family Values</p><p>Moscow</p></bio><email xlink:type="simple">srybal@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3014-2037</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коротаев</surname><given-names>А.  В.</given-names></name><name name-style="western" xml:lang="en"><surname>Korotayev </surname><given-names>A.  V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Коротаев Андрей Витальевич – доктор исторических наук, профессор, директор Центра изучения стабильности и рисков</p><p>г. Москва</p></bio><bio xml:lang="en"><p>Andrey V. Korotayev – Grand PhD in Historical sciences, Professor, Director of the Center for stability and risk analysis</p><p>Moscow</p></bio><email xlink:type="simple">akorotayev@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Национальный исследовательский университет «Высшая школа экономики»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>HSE University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Research Institute of Health</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>АНО «Институт научно-общественной экспертизы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute for Scientific and Public Expertise</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>19</day><month>12</month><year>2025</year></pub-date><volume>5</volume><issue>4</issue><fpage>7</fpage><lpage>26</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Устюжанин В.В., Халтурина Д.А., Рыбальченко С. ., Коротаев А.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Устюжанин В.В., Халтурина Д.А., Рыбальченко С. ., Коротаев А.В.</copyright-holder><copyright-holder xml:lang="en">Ustyuzhanin V.V., Khaltourina D.A., Rybalchenko S. ., Korotayev  A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://ph.elpub.ru/jour/article/view/331">https://ph.elpub.ru/jour/article/view/331</self-uri><abstract><p>Введение. Фактор, существенно снижающий продолжительность жизни в России, — это высокая смертность в трудоспособном возрасте. Основными факторами риска являются поведенческие факторы: курение, употребление алкоголя, низкий уровень физической активности, нерациональное питание. Все эти факторы являются устранимыми. Цель исследования: комплексный анализ динамики смертности в России и выделение на этой основе приоритетных направлений медико-демографической политики по снижению преждевременной смертности. Материалы и методы. В качестве источников данных по смертности использовались данные Росстата, РосБРиСа и HMD. Применены классические демографические методы: построение таблиц смертности, декомпозиция различий в продолжительности жизни, построение контрафактических траекторий динамики продолжительности жизни моделью Ли-Картера и оценка потерянных лет жизни. Результаты. Лидирующими причинами как у мужчин, так и у женщин по преждевременной смертности являются болезни системы кровообращения. Для мужчин также важной причиной преждевременной смертности остаются внешние факторы. Другой важной причиной преждевременной смертности для обоих полов в возрастах после сорока лет являются новообразования. Всего в 2019 г. Россия преждевременно потеряла 42,6 млн. человеко-лет, поэтому сохраняется большой резерв для снижения смертности почти что во всех возрастах. Заключение. Ключевыми мерами медико-демографической политики в области снижения смертности должны стать новые антиалкогольная и антитабачная кампании, а также некоторые другие программы, направленные на снижение смертности от внешних причин, вакцинопрофилактику, изменение структуры оценивания государственных мер в области охраны здоровья, поддержку пациентов с тяжелыми заболеваниями, профилактические мероприятия и продвижение здорового питания среди населения.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. A key factor that substantially reduces life expectancy in Russia is high mortality at working ages. The main risk factors are behavioral: tobacco and alcohol consumption, low levels of physical activity and unhealthy diet. All these factors are amenable to modification. The purpose of the study: to conduct a comprehensive analysis of mortality trends in Russia and, on this basis, to identify priority directions of demographic policy aimed at reducing mortality. Materials and methods. Mortality data were obtained from Rosstat, RosBRiS and the Human Mortality Database. Classical demographic methods were applied: life tables, decomposition of differences in life expectancy, analysis of counterfactual trajectories of life expectancy dynamics using the Lee–Carter model, and estimation of years of life lost. Results. For both men and women, diseases of the circulatory system are the leading cause of premature mortality. Among men, external causes also remain an important cause of premature death. Neoplasms are another major cause of premature mortality for both sexes at ages over 40. In 2019, Russia lost a total of 42,597,000 years of life due to premature mortality, which indicates a substantial potential for reducing mortality at almost all ages. Conclusion. Key measures of medical and demographic policy aimed at reducing mortality should include a new anti-alcohol and anti-tobacco campaign, as well as other programs targeting reductions in mortality from external causes, modifying the system for evaluating government health policies, improving support for patients with chronic diseases, implementing preventive interventions, promoting healthy nutrition and physical activity in the population and strengthening vaccine prevention.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>смертность</kwd><kwd>преждевременная смертность</kwd><kwd>ожидаемая продолжительность жизни</kwd><kwd>потребление алкоголя</kwd><kwd>табакокурение</kwd><kwd>демографическая политика</kwd><kwd>профилактика неинфекционных заболеваний</kwd></kwd-group><kwd-group xml:lang="en"><kwd>mortality</kwd><kwd>premature mortality</kwd><kwd>life expectancy</kwd><kwd>alcohol consumption</kwd><kwd>tobacco smoking</kwd><kwd>demographic policy</kwd><kwd>prevention of noncommunicable diseases</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">исследование не имело спонсорской поддержки.</funding-statement><funding-statement xml:lang="en">the study had no sponsorship.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Росстат (2023) Витрина статистических данных. https://showdata.gks.ru/finder/.</mixed-citation><mixed-citation xml:lang="en">Rosstat (2023) Statistical data showcase. https://showdata.gks.ru/finder/.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">РЭШ (2023) Российская база данных по рождаемости и смертности (РосБРиС). http://demogr.nes.ru/index.php/ru/demogr_indicat/data.</mixed-citation><mixed-citation xml:lang="en">NES (2023) Russian database on fertility and mortality (RosBRiS). http://demogr.nes.ru/index.php/ru/demogr_indicat/data.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Max Planck Institute for Demographic Research, University of California, Berkeley, and French Institute for Demographic Studies (2023) Human Mortality Databse (HMD). www. mortality.org.</mixed-citation><mixed-citation xml:lang="en">Max Planck Institute for Demographic Research, University of California, Berkeley, and French Institute for Demographic Studies (2023) Human Mortality Databse (HMD). www.mortality.org.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Preston S.H., Heuveline P. and Guillot M. 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