Межрегиональное неравенство в продолжительности жизни в России и его составляющие по возрасту и причинам смерти
Significance. During the recent decades, Russia has experienced significant shifts in mortality. Considering the heterogeneity of the Russian regions, it is important to analyze how those shifts were experienced at the regional level and how they influenced the inter-regional mortality inequality.
Purpose. To evaluate how the inter-regional mortality inequality in Russia changed during the period 1989-2016; to measure contribution of different age groups and causes of death into the inter-regional mortality inequality in Russia and changes in those contributions over time.
Methods. In the current study, we used gap in life expectancy between the two groups of regions as the main measure of inter-regional inequality. The first group included regions with the highest levels of life expectancy inhabited altogether by 15% of the total Russian population. The second group included regions with the lowest levels of life expectancy, which also altogether accounted for 15% of the total Russian population. The contribution of different age groups and causes of death into the gap in life expectancy between the two groups was estimated with the stepwise replacement decomposition technique.
Results. Life expectancy inequality between regions increased substantially in the 1990s. The recent period of mortality improvements in Russia did not result in any significant changes in the inter-regional inequality. In 2016, the difference between the two 15%-groups of regions performing the best and the worst in terms of life expectancy amounted to 9.6 years in males. Mortality inequality in ages 15-39 contributed 2.6 years to this gap, in ages 40-64 – 4.2 years, and in ages over 65 – 2.9 years. In females the gap amounted to 5.3 years; 1.2 years, 2.0 years, and 2.0 years contributed by age intervals 15-39, 40-64, and 65 years and over respectively. Among the causes of death, the major contribution in inequality is attributable to external causes of death at the young and middle ages and circulatory diseases at the middle and elderly ages.
Conclusions. Decreased contribution of external causes of death in the young and middle ages, and circulatory diseases in the middle age had a positive effect on the inter-regional inequality in life expectancy after 2005 contributing to its decline. At the same time, mortality decline in the elderly contributed to divergency in life expectancy across regions. Those positive changes in the elderly mortality towards reduction, which are associated with the beginning of cardiovascular revolution in Russia, did not equally affect the Russian regions.