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Regular version of the site

People Are Healthier Now

The way the Russian population feels


Russians have been estimating their general health as better over recent years, and life expectancy has been growing. Meanwhile, Russia is still falling behind EU countries according to this indicator. Alexander Ramonov, researcher from the HSE Institute of Demography, studied the reasons for this.

Healthy life expectancy calculations are based on the respondents’ evaluations of their own health (Sullivan’s method). Health characteristics vary from ‘very good’ to ‘very bad’. According to the study, the Russian population’s subjective health has increased over the last decade. Meanwhile, the gap between Russia and EU countries is still quite big, according to Alexander Ramonov.

The surveys were conducted as part of the Russian Longitudinal Monitoring Survey – HSE, and as part of EU-SILC (European Union Statistics on Income and Living Conditions) in the European Union. The paper offers estimations of general health by respondents over 20, since at a younger age, feeling bad is a rare thing.

The Problem in Time

Since the mid-2000s, both life expectancy (which exceeded 72 years in 2018) and the correlating indicator of healthy life years (HLY) have been growing in Russia. The gap between Russia and the EU in the second indicator (when respondents evaluated their general health as good or average), has been decreasing.

 Total life expectancy at 20 is the average number of years lived starting from this age.

 Healthy life years is the average number of years lived starting from the same age, with subjective health estimated as satisfactory or good.

 These indicators were calculated for Russia and the EU15 united country model. The latter includes Austria, Belgium, Denmark, Spain, Sweden, and other Western European countries.

 According to the study, the Russian-European gap has decreased both in life expectancy, and in HLY.

In terms of healthy life years, the gap between EU15 and Russia by this indicator has considerably decreased in males and females, Ramonov noted. In males, the gap has shrunk from 16.2 to 13.4 years, and in females from 12.2 to 9.7.

Risk Group

However, despite the obvious progress in healthy life expectancy, Russia is still seriously lagging behind. Two factors may play a role here: excess mortality and bad health.

In males, the effect of excess mortality is particularly high at the age from 40 to 84, the researcher commented. Excess mortality means losses among Russian men as compared to European men of the same age. In women, bad health is a factor after the age of 60.

This means that, while subjectively Russians have started feeling better, the country is still falling behind the EU in terms of the elderly’s health.

Belt of Ill-being

While the health situation is improving and mortality is decreasing, Russia remains heterogeneous in both of these indicators. The picture varies greatly from one region to another.

An analysis of regional mortality data and the results of 2018 Rosstat survey (a sample of 15,000 households) revealed the most problematic areas.

There is a whole swathe of regions with high mortality and bad health around Moscow and the Moscow Region. These are Kursk, Orel, Vladimir, Voronezh, Ryazan, Smolensk, Ivanovo, Kaluga, Tambov, Penza, Yaroslavl and Bryansk regions – most of oblasts (regions) in the Central Federal District.

The standardized mortality rate in these regions (number of deaths per 100,000 of population) exceeds 1,300, while the share of bad health is over 15%, the researcher explained. For comparison, in Moscow, these indicators are 955.3 and 9% respectively.

In addition to the Central Federal District regions, the situation is also poor in the Kurgan and Kemerovo regions.

High death rates may be related to excessive drinking, which explains early mortality from cardiovascular diseases, as well as external death causes (intoxication, car accidents, murders, suicides etc), particularly among able-bodied men.

Low subjective health levels may be related to cardiovascular diseases (heart attacks, ischemia etc), which are ‘typical of older people and are accountable for more than half of the deaths in Russia’, the researcher concluded.


Authors of the study:
Alexander Ramonov, Research Fellow at the HSE Institute of Demography
Author: Olga Sobolevskaya, May 27, 2019