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T.P. Sabgayda
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
Summary. Mortality of the Russian population has
been declining in recent years, posing a question of whether avoidable
mortality in different age groups equally responds to changes in public
health. Answers to this question are relevant for planning measures to
further reduce mortality.
The aim of the study was to analyze avoidable mortality
in different age groups, compare death dynamics at different stages of
social and economic changes in Russia (increased mortality in 1989-1994
and 1998-2003; reduced mortality in 2005-2011).
Methods. The standardized death rates in six age groups
of men and women (5-14, 15-19, 20-29, 30-39, 40-49 and 50-64 years)
were analyzed on the basis of official statistics. Avoidable mortality
was evaluated in line with the European approach: preventable mortality
is mortality of people aged 5-64 from 38 preventable death causes and
classes divided into three groups according to the three levels of
prevention.
Results. After 2005, the avoidable mortality has been
falling at a faster rate than the unavoidable one. From 2005 to 2011,
the highest decrease in avoidable mortality was reported in children,
the smallest - among average working ages. Mortality from preventable
causes of the first and third groups (depending on primary prevention
and quality of care) significantly reduced; however, mortality from the
second group of causes (depending on timely disease detection) did not.
Conclusions. Active implementation of measures to
reduce mortality in Russia led to unequal changes in avoidable mortality
in different age groups. The results demonstrate that resuming practice
of disease control implemented directly by large industry businesses or
associations is feasible. It is possible that administration of
organizations be responsible for regular medical checkups of their
employees.
The feasibility of regular population checkups is questionable due to
lack of improvements in timeliness of detection of malignant neoplasms
in Russia.
Keywords: avoidable mortality; age-specific mortality;
preventable death causes; prevention effectiveness; assessment of health
system performance; mortality risk factors.
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