Mortality in Russia: problems and ways forward
https://doi.org/10.21045/2782-1676-2025-5-4-7-26
Abstract
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.
Keywords
mortality,
premature mortality,
life expectancy,
alcohol consumption,
tobacco smoking,
demographic policy,
prevention of noncommunicable diseases
Supporting agencies: the study had no sponsorship.
About the Authors
V. V. Ustyuzhanin
HSE University
Russian Federation
Russian Federation
Vadim V. Ustyuzhanin – Junior Researcher of the Center for stability and risk analysis
Moscow
D. A. Khaltourina
Russian Research Institute of Health
Russian Federation
Russian Federation
Daria A. Khaltourina – PhD in History sciences, Head of The Department of Risk Factor Prevention and Communication Technologies in Healthcare
Moscow
S. I. Rybalchenko
Institute for Scientific and Public Expertise
Russian Federation
Russian Federation
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
Moscow
A. V. Korotayev
HSE University
Russian Federation
Russian Federation
Andrey V. Korotayev – Grand PhD in Historical sciences, Professor, Director of the Center for stability and risk analysis
Moscow
References
1. Rosstat (2023) Statistical data showcase. https://showdata.gks.ru/finder/.
2. NES (2023) Russian database on fertility and mortality (RosBRiS). http://demogr.nes.ru/index.php/ru/demogr_indicat/data.
3. Max Planck Institute for Demographic Research, University of California, Berkeley, and French Institute for Demographic Studies (2023) Human Mortality Databse (HMD). www.mortality.org.
4. Preston S.H., Heuveline P. and Guillot M. (2001) Demography: Measuring and modeling population processes. Oxford: Blackwell Publishers.
5. Lee R.D. and Carter L.R. (1992) Modeling and forecasting US mortality, Journal of the American statistical association, 87(419), p. 659–671. https://doi.org/10.1080/01621459.1992.10475265.
6. Martinez R. et al. (2019) Reflection on modern methods: years of life lost due to premature mortality — a versatile and comprehensive measure for monitoring non-communicable disease mortality, International journal of epidemiology, 48(4), p. 1367–1376. https://doi.org/10.1093/ije/dyy254.
7. R Core Team (2024) R Statistical language (4.5.1).
8. Ustyuzhanin V. (2025) demor: Basic functions for demographic analysis (1.0.6). https://vadvu.github.io/demor/.
9. Razvodovsky Y.E. (2015) The effect of beverage type on fatal accidents rate in Russia, Alcoholism and psychiatry research: Journal on psychiatric research and addictions, 51(1), p. 31–40.
10. Zaridze D. et al. (2009) Alcohol and cause-specific mortality in Russia: a retrospective case–control study of 48 557 adult deaths, The Lancet, 373(9682), p. 2201–2214.
11. Razvodovsky Y.E. (2010) Beverage specific alcohol sale and mortality in Russia, Alcoholism, 46(2), p. 63–75.
12. Nemtsov A.V. (2009) Alcoholic history of Russia: The modern period. Moscow: LIBROCOM Book House.
13. Khalturina D.A., Korotaev A.V. (2010) Alcohol catastrophe: how to stop the extinction of Russia, in Alcohol catastrophe and the possibilities of state policy in overcoming alcohol supermortality in Russia / ed. by D.A. Khalturina, A.V. Korotaev. Moscow: Lenand/URSS, p. 5–58
14. Avdeev A. et al. (1998) The reactions of a heterogeneous population to perturbation. An interpretative model of mortality trends in Russia, Population: An English Selection, p. 267–302.
15. Men T. et al. (2003) Russian mortality trends for 1991–2001: analysis by cause and region, Bmj, 327(7421), p. 964.
16. Notzon F.C. et al. (1998) Causes of declining life expectancy in Russia, Jama, 279(10), p. 793–800.
17. Shkolnikov V. et al. (1998) Causes of the Russian mortality crisis: evidence and interpretations, World development, 26(11), p. 1995–2011.
18. Shkolnikov V., McKee M. and Leon D.A. (2001) Changes in life expectancy in Russia in the mid 1990s, The Lancet, 357(9260), p. 917–921.
19. Shkolnikov V. et al. (2004) Mortality reversal in Russia: the story so far, Hygiea Internationalis, 4(1), p. 29–80.
20. Andreev E.M. (2002) Possible causes of fluctuations in life expectancy in Russia in the 90s, Questions of Statistics, 11, p. 3–15.
21. Ozerova O.V. (2009) Alcoholism and mortality in modern Russia, Telescope: Journal of Sociological and Marketing Research, (2), p. 39–42.
22. Mäkelä K. et al. (1981) Alcohol, Society, and the State. 1-a Comparative Study of Alcohol Control. Addiction Research Foundation, Toronto, Ontario, Canada.
23. WHO (2010) World health statistics 2010. World Health Organization.
24. Makarentseva A.O. (2023) Achievements of perinatal reform and the potential for further reduction of infant mortality in Russia, Demographic Review, 10(3), p. 62–81. https://doi.org/10.17323/demreview.v10i3.17970.
25. French Institute for Demographic Studies (France) and Max Planck Institute for Demographic Research (Germany) (2023) The Human Cause-of-Death Database (HCD). www.causeofdeath.org.
26. Vishnevskii A.G. and Shchur A.E. (2019) Mortality and life expectancy in Russia over half a century, Demographic Review. https://doi.org/10.24411/2411-8621-2019-12003.
27. Preston S.H. (1975) The Changing Relation between Mortality and level of Economic Development, Population Studies, 29(2), p. 231–248. https://doi.org/10.1080/00324728.1975.10410201.
28. United Nations (2024) World Population Prospects 2024. https://population.un.org/wpp.
29. The World Bank (2023) The World Bank databank: World Development Indicators. https://databank.worldbank.org/ (Accessed: May 25, 2022).
30. Shchur A.E., Sokolova, V.V. and Timonin S.A. (2023). Midlife mortality in Russia at the beginning of the 21st century: is there any reason for optimism? Demographic Review, 10(4), p. 4–51. https://doi.org/10.17323/demreview.v10i4.18807.
31. Vishnevskii A.G. (2014) Mortality in Russia: the second epidemiologic revolution that never was, Demographic Review, 1(4), p. 5–40.
32. Kolosnitsyna M.G., Kossova T.V. and Sheluntsova M.A. (2019), Factors of the life expectancy increase: country-level cluster analysis, Demographic Review, 6(1), p. 124–150. https://doi.org/10.17323/demreview.v6i1.9114.
33. Zamyatnina E.S. (2022) The structure of directly related alcohol mortality in Russia from 2011 to 2021, Demographic Review, 9(2), p. 102–118. https://doi.org/10.17323/demreview.v9i2.16208.
34. WHO (2023) Global Health Observatory indicators. https://www.who.int/data/gho/data/indicators.
35. Razvodovsky Y.E. (2010) Beverage-specific alcohol sale and cardiovascular mortality in Russia, Journal of environmental and public health, 2010.
36. Razvodovsky Y.E. (2011) Heart Disease Mortality in Russia, Alcoholism, 47, p. 75–90.
37. Razvodovsky Y.E. (2015) The Differential Effects of Beverage Type on Alcohol Poisoning Mortality in Russia, Journal of Alcoholism & Drug Dependence [Preprint].
38. Razvodovsky Y.E. (2015) The effect of beverage type on alcoholic psychoses rate in Russia, Alcohol and alcoholism, 50(2), p. 200–205.
39. Razvodovsky Y.E. (2009) Beverage-specific alcohol sale and suicide in Russia, Crisis, 30(4), p. 186–191.
40. Razvodovsky Y.E. (2014) Beverage Specific Effect of Alcohol on Pancreatitis Mortality in Russia, Alcoholism and psychiatry research: Journal on psychiatric research and addictions, 50(2), p. 111–121.
41. Nemtsov A.V., Nechaev A.K. (1991) Alcohol consumption and violent deaths, Issues of narcology, (1), p. 34–36.
42. Rehm J. and Hasan O.S. (2020) Is burden of disease differentially linked to spirits? A systematic scoping review and implications for alcohol policy, Alcohol, 82, p. 1–10.
43. Neufeld M. et al. (2020) Alcohol policy has saved lives in the Russian Federation, International Journal of Drug Policy, 80, p. 102636.
44. WHO (2019) Alcohol policy impact case study. The effects of alcohol control measures on mortality and life expectancy in the Russian Federation. Copenhagen: WHO Regional Office for Europe.
45. Neufeld M. and Rehm J. (2018) Effectiveness of policy changes to reduce harm from unrecorded alcohol in Russia between 2005 and now, International Journal of Drug Policy, 51, p. 1–9.
46. Khalturina D.A. (2006) Reduction in alcohol production saved the lives of 66 thousand Russians in the first 7 months of 2006, Narcology, 5(12), p. 75–76.
47. Khaltourina D. and Korotayev A. (2015) Effects of specific alcohol control policy measures on alcohol-related mortality in Russia from 1998 to 2013, Alcohol and Alcoholism, 50(5), p. 588–601.
48. Babor T.F. and Babor T. (2010) Alcohol: no ordinary commodity: research and public policy. Oxford University Press.
49. Cooper M.L. (1992) Alcohol and increased behavior risk for AIDS, Alcohol Research, 16(1), p. 64.
50. Kalichman S.C. et al. (2007) Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings, Prevention science, 8, p. 141–151.
51. Shuper P.A. et al. (2010) Causal considerations on alcohol and HIV/AIDS — a systematic review, Alcohol & Alcoholism, 45(2), p. 159–166.
52. Pokrovskiy V.V., Ladnaya N.N. and Pokrovskaya A.V. (2017) HIV/AIDS reduces the number of Russians and their life expectancy, Demographic Review, 4(1), p. 65–82.
53. Leon D.A. et al. (2007) Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study, The Lancet, 369(9578), p. 2001–2009.
54. Leon D.A. et al. (2010) Non-drinking alcohol in Russia: consumption and health effects. What do we know? in The alcohol catastrophe and the possibilities of state policy in overcoming alcohol over-mortality in Russia / ed. by D. A. Khalturina, A. V. Korotaev. Moscow: Lenand/URSS, p. 152–171.
55. Tomkins S. et al. (2007) Prevalence and socio‐economic distribution of hazardous patterns of alcohol drinking: study of alcohol consumption in men aged 25–54 years in Izhevsk, Russia, Addiction, 102(4), pp. 544–553.
56. Holdin V.N., Paronian I. D., Chumicheva V. B. (2014) On the nature and scale of the illegal alcohol market in one of the districts of the Moscow region (opinion of the population of the district), (3), pp. 47–67.
57. Gil A. et al. (2018) Availability of nonbeverage alcohols in 50 Russian cities in 2015–2017, Revue d’Épidémiologie et de Santé Publique, 66, p. S356.
58. Marquez P.V. et al. (2006) Die Early: Problems of high morbidity and premature mortality from non-communicable diseases and injuries in the Russian Federation and ways to solve them. Moscow: The World Bank/Alex.
59. Arkhangelsky V.N. et al. (2013) In 10 years it will be too late. Demographic policy of the Russian Federation: challenges and scenarios. Moscow: Institute of Scientific and Public Expertise.
60. Kobyakova O.S. et al. (2021) Promising measures to reduce the mortality in Russia: an analytical review, Health Care of the Russian Federation, 65(6), p. 573–580.
61. Yakovlev E. (2018) Demand for Alcohol Consumption in Russia and Its Implication for Mortality, American Economic Journal: Applied Economics, 10(1), p. 106–149. https://doi.org/10.1257/app.20130170.
62. VTsIOM (2022) Smoking in Russia: monitoring. https://wciom.ru/analytical-reviews/analiticheskii-obzor/kurenie-v-rossii-monitoring-2022.
63. Khalturina D.A., Zubkova T. S. (2021) The contribution of smoking to mortality in Russia in 2019, Demographic Review, 8(1), p. 81–105.
64. Kuznetsova P.O. (2019) Smoking as a factor of reduced life expectancy in Russia, Demographic Review, 6(3), p. 31–57.
65. Salagay O.O. et al. (2023) Analysis of the dynamics of the prevalence of tobacco smoking and the incidence of malignant neoplasms in the Russian Federation in 2011– 2021, Public Health, 3(3), p. 4–13. https://doi.org/10.2104-5/2782-1676-2023-3-3-4-13.
66. Gambaryan M. et al. (2018) Effects of tobacco control policy on cardiovascular morbidity and mortality in Russia, European Journal of Public Health, 28(suppl_2), p. 14–16. https://doi.org/10.1093/eurpub/cky148.
67. Shkolnikov V.M. et al. (2020) Time trends in smoking in Russia in the light of recent tobacco control measures: synthesis of evidence from multiple sources, BMC Public Health, 20(1), p. 378. https://doi.org/10.1186/s12889-020-08464-4.
68. The World Bank. (2018) Reducing Tobacco Use Through Taxation in the Russian Federation: A Modelled Assessment of Two Policy Options. World Bank.
69. Levy D.T. et al. (2018) Research full report: the impact of implementing tobacco control policies: the 2017 tobacco control policy scorecard, Journal of Public Health Management and Practice, 24(5), p. 448.
70. Yau R.K. and Marshall S.W. (2014) Association between fire-safe cigarette legislation and residential fire deaths in the United States, Injury epidemiology, 1, p. 1–6.
71. Bakanov K.S. et al. (2025) Road traffic accidents in the Russian Federation in 2024. Moscow: Federal State Institution ʺNC BDD of the Ministry of Internal Affairs of Russia˝.
72. Castillo-Manzano J.I. et al. (2019) The complex relationship between increases to speed limits and traffic fatalities: Evidence from a meta-analysis, Safety science, 111, p. 287–297.
73. De Martel C. et al. (2017) Worldwide burden of cancer attributable to HPV by site, country and HPV type, International journal of cancer, 141(4), p. 664–670.
74. Bogani G. et al. (2020) Assessing the long-term role of vaccination against hpv after loop electrosurgical excision procedure (Leep): A propensity-score matched comparison, Vaccines, 8(4), p. 717.
75. Zaridze D.G., Stilidi I.S. and Mukeriya A.F. (2022) Scientific evidence for the effectiveness of primary and secondary (screening) prevention of cervical cancer, Public Health, 2(4), p. 15–23. https://doi.org/10.21045/2782-1676-2022-2-4-15-23.
76. Jansen E.E. et al. (2020) Effect of organised cervical cancer screening on cervical cancer mortality in Europe: a systematic review, European Journal of Cancer, 127, p. 207–223.
77. Bonjour M. et al. (2021) Global estimates of expected and preventable cervical cancers among girls born between 2005 and 2014: a birth cohort analysis, The Lancet Public Health, 6(7), p. e510–e521. https://doi.org/10.1016/S2468–2667(21)00046-3.
78. Baldo V. et al. (2016) Pneumococcal conjugated vaccine reduces the high mortality for community-acquired pneumonia in the elderly: an Italian regional experience, PLoS One, 11(11), p. e0166637.
79. Marques Antunes M. et al. (2021) Pneumococcal vaccination in adults at very high risk or with established cardiovascular disease: systematic review and meta-analysis, European Heart Journal-Quality of Care and Clinical Outcomes, 7(1), p. 97–106.
80. Demographic Review (2016) How to overcome Russia's lag in life expectancy? Demographic Review, 2(3), p. 154– 201. https://doi.org/10.17323/demreview.v2i3.1778.
81. Zhang J. et al. (2017) Effectiveness of screening modalities in colorectal cancer: a network meta-analysis, Clinical colorectal cancer, 16(4), p. 252–263.
82. Danese E., Montagnana M. and Lippi G. (2020) Combining old and new strategies for colorectal cancer screening, Annals of Translational Medicine, 8(4).
83. Barchuk A.A. et al. (2021) Cancer screening at the level of state programs: review, recommendations and management. Public Health, 1(1), p. 19–31. https://doi.org/10.210-45/2782-1676-2021-1-1-19-31.
84. Mente A. et al. (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease, Archives of internal medicine, 169(7), p. 659–669.
85. Kontsevaya A. et al. (2019) Overweight and obesity in the Russian population: prevalence in adults and association with socioeconomic parameters and cardiovascular risk factors, Obesity facts, 12(1), p. 103–114.
86. Bleich, S.N. et al. (2017) A systematic review of calorie labeling and modified calorie labeling interventions: impact on consumer and restaurant behavior, Obesity, 25(12), p. 2018–2044.
87. Sacco J. et al. (2017) The influence of menu labelling on food choices among children and adolescents: a systematic review of the literature, Perspectives in public health, 137(3), p. 173–181.
88. Gittelsohn J., Trude A.C.B. and Kim H. (2017) Pricing strategies to encourage availability, purchase, and consumption of healthy foods and beverages: a systematic review, Preventing chronic disease, 14.
89. Hyseni L. et al. (2017) Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy? PloS one, 12(5), p. e0177535.
90. World Bank. (2022). 2.12 World Development Indicators: Health systems. URL: https://wdi.worldbank.org/table/2.12
Review
For citations:
Ustyuzhanin V.V., Khaltourina D.A., Rybalchenko S. ., Korotayev A.V. Mortality in Russia: problems and ways forward. Public Health. 2025;5(4):7-26. (In Russ.) https://doi.org/10.21045/2782-1676-2025-5-4-7-26
Views:
56
Email this article 