DOI: 10.21045/2071-5021-2017-57-5-1

Ivanova A.E., Mikhailov A.Yu.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Contacts: Ivanova Alla, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Ivanova A.E., http://orcid.org/0000-0002-0258-3479
Mikhailov A.Yu., http://orcid.org/0000-0001-9723-6228

Acknowledgments. The study was supported by the Russian Foundation for Basic Research, grant ¹17-02-00234/17: “Effectiveness of demographic policy in the Russian regions and evaluation of its contribution to the demographic development in Russia”.

Conflict of interests. The authors declare no conflict of interest.

Abstract

There are a lot of published works devoted to evaluation of shifts in mortality from individual causes, both at regional level and country as a whole. However, those changes are not usually analyzed from the perspective of the policy effects, which is the purpose of this study.

The selected periods include 2000-2005 (prior to adoption of the targeted measures to reduce mortality rates), 2005-2011 (phase of the combined effects of active policy in healthcare and improved socio-economic situation in the country), 2011-2016 (phase of the continued policy in healthcare against the background of a slowdown in positive socio-economic that resulted in the economic crisis). Data used included official data of the Rosstat, calculated standardized mortality rates (European standard of the age structure) as well as average age of death (based on the life table) for specific causes of death.

The pre-reform period of 2000-2005 was marked by multidirectional processes related to individual causes of death, age groups and regions that manifested as a peculiar stagnation of the mortality (a small increase in males and an equally small decrease in females). In 2005-2011, a strong positive trend towards reduction in mortality took shape. The tendency was of a universal nature; it manifested in both males and females, across all causes of death and all regions without exceptions. After 2011, mortality reduction continued, but with a slower rates compared to ones in 2005-2011 due to negative trends associated with markers typical of population marginalization (diseases of the digestive system and ill-defined conditions, and, additionally, infectious disease in females). Mortality reduction prior to adoption of the Federal measures in healthcare was mainly registered in economically and socially advantaged regions. In 2005-2011, the greatest advantage associated with mortality reduction was reported by regions with unfavorable mortality indicators because those regions have the largest unrealized potential for reducing the loss; therefore, the implemented measures resulted in the maximum effect. In the last period under study no relationship between the achieved by this period rates of life expectancy and rates of its change in 2011-2016 was identified.

The study results are significant to be used for implementing policy aimed at reducing mortality within the context of socio-economic constraints.

Keywords: demographic policy; evaluation; mortality; life expectancy; socio-economic constraints; regional level.

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