Смертность в России: постановка проблемы и пути решения

Общественное здоровье. 2025. Т. 5. № 4. С. 7–26.

Ustyuzhanin V., Халтурина Д. А., Рыбальченко С. И., Korotayev A.

Introduction. A key factor that substantially reduces life expectancy in Russia is high mortality at working ages. The main risk factors are behavioral: tobacco and alcohol consumption, low levels of physical activity and unhealthy diet. All these factors are amenable to modification. The purpose of the study: to conduct a comprehensive analysis of mortality trends in Russia and, on this basis, to identify priority directions of demographic policy aimed at reducing mortality. Materials and methods. Mortality data were obtained from Rosstat, RosBRiS and the Human Mortality Database. Classical demographic methods were applied: life tables, decomposition of differences in life expectancy, analysis of counterfactual trajectories of life expectancy dynamics using the Lee–Carter model, and estimation of years of life lost. Results. For both men and women, diseases of the circulatory system are the leading cause of premature mortality. Among men, external causes also remain an important cause of premature death. Neoplasms are another major cause of premature mortality for both sexes at ages over 40. In 2019, Russia lost a total of 42,597,000 years of life due to premature mortality, which indicates a substantial potential for reducing mortality at almost all ages. Conclusion. Key measures of medical and demographic policy aimed at reducing mortality should include a new anti-alcohol and anti-tobacco campaign, as well as other programs targeting reductions in mortality from external causes, modifying the system for evaluating government health policies, improving support for patients with chronic diseases, implementing preventive interventions, promoting healthy nutrition and physical activity in the population and strengthening vaccine prevention.

Keywords: демографическая политика, смертность, потребление алкоголя, alcohol consumption, mortality, demographic policy, ожидаемая продолжительность жизни, преждевременная смертность, табакокурение, tobacco smoking, premature mortality, life expectancy