Russians Vulnerable to Ischemia and Stroke
Over the past two decades, the average life expectancy in Russia has increased by 2.3 years for women and 1.4 years for men, according to a recently published paper based on the WHO's Global Burden of Disease (GBD) assessment – a major epidemiological study by a group of international experts, including Vasily Vlassov, Professor of the HSE Department of Health Care Administration and Economy.
In 1990, life expectancy in Russia stood at 64.3 years for men and 74.4 years for women, according to the study which Vlassov co-authored. By 2013, these numbers had increased to 65.7 and 76.7 years, respectively, according to the paper Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition, published in The Lancet. Thus, Russia’s progress in terms of life expectancy and health is part of a global trend.
However, the authors are careful not to sound too optimistic.
First, they stress the fact that the worldwide burden of disease is still very high, and while significant progress has been achieved globally since 2005 in controlling infections such as HIV and malaria – both of which contribute substantially to the burden of disease – they are still prevalent in many countries.
Second, they admit that improved health does not mean a lower demand on healthcare systems.
Conducted for the World Health Organization, the GBD study that the paper in The Lancet is based on summarises the data on health, disease and death in 188 worldwide.
Cardiac, Vascular and Spinal Diseases Top the List in Russia
The Russian data quoted in the paper is consistent with the HSE Institute of Demography's research findings (see Healthy Life Will Last Longer). The authors also note an improvement in the health of Russians due primarily to a decline in infectious and parasitic diseases.
Effective control of infections accounts for the major difference in the burden of disease between developing and developed countries, according to the epidemiological transition theory proposed by Abdel Omran in 1971. Often quoted by researchers, this theory postulates that epidemiological transition occurs when a country transitions from developing to developed nation status – a process accompanied by a redistribution in the primary causes of death: from infections to chronic and age-related degenerative diseases (which include cardiovascular diseases, cancer, spinal pathologies, etc.) Epidemiological transitions are associated with better health care, nutrition, living standards, and other factors.
In Russia, a redistribution in the primary causes of death was first observed in the middle of the last century, but the overall burden of disease remains high even today. According to the paper's authors and many Russian demographers, the situation with chronic diseases – from cardiovascular conditions to cancer – has not improved significantly. The most common health problems in Russia listed in The Lancet include heart conditions, stroke, spinal pathology, lung cancer, depression, alcoholism, and injuries caused by road accidents; a similar situation is observed in Belarus, Estonia, Latvia, Moldova and some other former Soviet republics.
Worldwide, the leading causes of morbidity in 2013, measured by disability-adjusted life years (DALY), included ischemic heart disease, respiratory conditions, cerebrovascular accidents (including stroke), pain in the neck and lower back, and injuries from traffic accidents.
Neurological Problems Affect Women
Certain diseases in Russia appear to be gender-specific; while alcoholism and lung cancer are 'male' diseases, women tend to be more affected by musculoskeletal pathologies, breast cancer, depression and Alzheimer's. Heart attacks and strokes are common to both sexes, yet the trends differ between genders. According to some experts, the incidence of cardiovascular conditions in women over 45 has declined (see Studies Report Uneven Decline in Mortality Rates), and women are generally less likely to complain of feeling unwell.
Meanwhile, a subjective assessment of one's health, included in indicators such as HALE, has improved in Russia in recent years, although estimates of the actual ‘gain in healthy years’ vary.
Life Expectancy Could Be Even BetterAccording to the paper in The Lancet, life expectancy in Russia has only increased by 1.6 years, which is below the worldwide average. Yet some other researchers offer more optimistic estimates. According to Alexander Ramonov, researcher at the HSE Institute of Demography, the number of years after forty during which people report good health increased between 2005 to 2012 from 20.7 to 24.4 years for Russian men and from 25.3 to 28.5 years for Russian women. Thus, positive changes are happening – although obviously not as fast as we would like – compensating for the demographic decline observed in Russia in the 1990s and early 2000s.