This semester I’m using data from the fantastic Russian Fertility and Mortality Database for a term paper on mortality. Since the Russian mortality crisis has been analyzed to death (…sorry) by demographers more capable than I, I’m focusing on the less-studied mortality improvement that Russia has seen since 2003. As a lover of the Russian regions and the peripheries of empire more generally, I haven’t been able to resist looking at the data geographically. Though my term paper is far from finished, I thought I would share some of the interesting geographic trends I’ve found.
By the time the Soviet Union collapsed in 1991, life expectancy had been in decline for more than 20 years, interrupted by a short period of improvement in the mid-to-late 1980’s, likely attributable to Gorbachev’s alcohol prohibition policy. In Russia (and in other former Soviet States, but most severely and prolongedly in Russia), this decline in life expectancy became much worse during the turmoil of the early 1990’s. Much ink has been spilled on the causes of this sharp drop, but it’s generally agreed that increased alcohol consumption underlies it. Life expectancy recovered a bit in the mid-1990’s, but took another nosedive with the Asian financial crisis of 1998. It didn’t begin to improve again until three years into Putin’s reign, in 2003, and since then, we’ve seen the first sustained improvement in mortality in Russia since about 1965. Whether it truly signals the end of the mortality crisis is unknown; I favor the optimistic idea that it does, and is a mark of the onset of the ‘cardiovascular revolution,’ the drastic reduction in cardiovascular disease that marks the next big mortality transition after a society conquers severe mortality from communicable diseases.
Okay, so, on to the pictures. Don’t tell the real demographers, but I analyzed the data in R and then put the regional summaries into my old friend Excel for this post.
Note: The North Caucasus Federal District was created in 2010; prior to that, its component subjects were part of the Southern Federal District. For ease of comparison, I analyzed the 2003 data using current district divisions.
Things that aren’t surprising about this chart: in terms of mortality, it is much, much better to be a Russian woman than a Russian man. One of the characteristics of the mortality crisis was a large excess of male death at adult ages, and Russia still has one of the largest gender gaps in life expectancy in the world – in 2003, it was 13.3 years, and in 2012, 11.5 years.
Things that are surprising: in terms of mortality, the best place to live in Russia is not Moscow or St. Petersburg, and not one of the oil-rich donor regions, but the relatively poor and politically fraught North Caucasus. This is true through time and for both sexes. The Southern Federal District, which is adjacent to the North Caucasus, is generally second-best (though the Central District, which includes Moscow, edges it out by a tenth of a year for women in 2012); Siberia and the Far East are the worst.
The easiest explanation for the North Caucasus’ great showing is that alcohol use may be lower in these more Muslim regions. While the relationship between alcohol use and Islam is far from straightforward in the former Soviet space, and data is spotty, this seems to be broadly true. (And it seems broadly true that alcohol use is highest east of the Urals.) It’s telling that this effect could counteract poverty, rurality, and political and social instability – all of which tend to raise mortality – so dramatically in the North Caucasus.
This is a bit harder to interpret, but here’s a look at the top 20 performers (sorted by male life expectancy in 2012):
The shades of orange, blue and green represent quartiles for each indicator; the darkest shades represent the top quartile (21 regions) and the lightest, the bottom. So we can see there’s quite a bit of overlap; 15 of the top 20 regions by men’s 2012 life expectancy are also tops for 2012 women, and 14 were also tops for both sexes in 2003. The North Caucasus clearly dominate, along with Moscow and Petersburg, but Chechnya is a curious case, as the only region for which women’s life expectancy didn’t improve from 2003-2012; in 2012, it’s in the bottom quartile for women. (This could be a data quality issue.)
In general, we can see from the light green shadings at right that none of the North Caucasus regions had particularly large gains in life expectancy, particularly for women, during this period. This makes some sense, since they were already doing so well – in fact, it’s a bit more surprising that Moscow and Petersburg started out in the top quartile of life expectancy and also had gains on life expectancy in the top quartile.
In case you’re wondering, the region with the lowest life expectancy is generally Tuva, although Chukotka was slightly worse for women in 2012. Thankfully, both men and women in Tuva gained over six years of life from 2003-2012, making it a top performer in that respect.
The overall story here is, I think, one of optimism: not only is life expectancy improving for everyone, but large geographic and by-sex differentials are closing. The least healthy regions are making large gains relative to the smaller, but still significant, gains seen by healthier regions. Men are gaining the most; while in 2003, male life expectancy hit 65 in only three regions, in 2012 it did so in nineteen. In Russia as a whole, men’s 2003 life expectancy was 81.5% of women’s; in 2012, it was 85%.
Public health challenges such as drug-resistant tuberculosis and still-high rates of cardiovascular disease, as well as recent economic uncertainty, may slow the mortality decline, but the universality of the positive trend so far is a heartening sign that Russia’s health will continue to improve.
All data in this post sourced from:
Russian Fertility and Mortality Database. Center for Demographic Research, Moscow (Russia). Available at http://demogr.nes.ru/index.php/ru/demogr_indicat/data (data downloaded on March 6, 2015).