Book
Время демографических перемен: избранные статьи
The articles selectedfor publication focus on the theoretical comprehension of fundamental demographic changesoccurring in the world, on their determinants and consequences. These consequences are universaland run through all levels of social reality, from the family to the global.Great attention is paid to Russian population issues. The author seeks to understand andto explain Russia’s demographic problems in the context of universal and global demographicchanges and challenges. Some articles are devoted to the history and current state of Russianpopulation studies.
The potential audience of the book are researchers representing a broad range of socialscience disciplines, teachers and students, politicians and journalists, and a wide range of readersinterested in population studies and related sciences.
The publication is timed to coincide with the 80th birthday of Anatoly Vishnevsky.
This article discusses the implications of demographic changes for the system of private intergenerational transfers. We consider the basic demographic factors of private intergenerational transfers, including changes of the population age structure, the abundance of divorces and remarriages, the high level of migration activity, the process of nuclearization - and analyze its influence on the system of private intergenerational transfers.
Background
As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016.
Methods
We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).
Findings
Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8–75·9 million [7·2%, 6·0–8·3]), 45·1 million (29·0–62·8 million [5·6%, 4·0–7·2]), 36·3 million (25·3–50·9 million [4·5%, 3·8–5·3]), 34·7 million (23·0–49·6 million [4·3%, 3·5–5·2]), and 34·1 million (23·5–46·0 million [4·2%, 3·2–5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3–3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0–11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862–11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018–19 228).
Interpretation
The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-to-date information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response.
This is the 23rd issue of Annual Series of Analytical reports regularly published by the HSE Institute of Demography since 1993. The recent report conducts the detailed analysis of the current situation in Russia’s demography in the context of its long-term evolution and demographic tendencies as seen through the prism of main demographic processes, such as marriage, birth and death rates, family planning, international and internal (intra-Russian) migration, changes in population, and age structure of Russia’s population. The analysis is based on the official data of the Federal State Statistics service of Russian Federation, ministries and government agencies of Russian Federation, international organizations and national statistics services of other countries as well as local estimates (acquired by using these resources), the results of special sampling studies, and the materials of scholarly publications.
The book is designed for the researchers that work in the field of demography and similar disciplines as well as decision-making employees, workers of government organizations of all levels, and instructors and students of secondary and postsecondary professional schools.
In studies of massive changes in social life, researchers often have to rely on low-quality retrospective data such as memoirs and manipulated government reports as opposed to reliable data such as vital registration. The dissolution of the Soviet Union in 1991 was an unpredictable event with large-scale consequences for the lives of millions of Russians. Beginning in the 1960s, the Soviet Union started to fall into a deep demographic crisis.1 The end of Communism was accompanied by a further increase in total mortality, with unprecedented fluctuations during the next two decades. Several studies were done in a bid to explain this.2
Background
Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016.
Methods
We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone.
Findings
Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates—a measure of relative inequality—increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7–87·2), and for men in Singapore, at 81·3 years (78·8–83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016.
Interpretation
Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled.
Adult mortality has been lower in Kyrgyzstan vs. Russia among males since at least 1981 and among females since 1999. Also, Kyrgyzstan’s mortality fluctuations have had smaller amplitude. This has occurred in spite of worse macro-economic outcomes in Kyrgyzstan. To understand these surprising patterns, we analyzed cause-specific mortality in Kyrgyzstan vs. Russia for the period 1981-2010, using unpublished official data. We find that, as in Russia, fluctuations in Kyrgyzstan have been primarily due to changes in external causes and circulatory causes, and alcohol appears to play an important role. However, in contrast with Russia, mortality from these causes in Kyrgyzstan has been lower and has increased by a smaller amount. As a result, the mortality gap between the two countries is overwhelmingly attributable to external and cardio-vascular causes, and more generally, to causes that have been shown to be strongly related to alcohol consumption. These cause-specific results, together with the existence of large ethnic differentials in mortality in Kyrgyzstan, highlight the importance of cultural and religious differences, and their impact on patterns of alcohol consumption, in explaining the mortality gap between the two countries. These findings show that explanatory frameworks relying solely on macro-economic factors are not sufficient for understanding differences in mortality levels and trends among former Soviet republics.
This article addresses the questions, What do children in urban areas do on Saturdays? What type of organizational resources do they have access to? Does this vary by social class? Using diary data on children’s activities on Saturdays in the Phoenix-Mesa-Scottsdale metropolitan area, the authors describe the different types of venues (households, businesses, public space, associations, charities, congregations, and government/tribal agencies) that served different types of children. They find that the likelihood of using a charity or business rather than a government or tribal provider increased with family income. Also, the likelihood of using a congregation or a government facility rather than business, charity, or household increased with being Hispanic. The authors discuss implications for the urban division of labor on Saturdays and offer research questions that need further investigation.
This article is talking about state management and cultural policy, their nature and content in term of the new tendency - development of postindustrial society. It mentioned here, that at the moment cultural policy is the base of regional political activity and that regions can get strong competitive advantage if they are able to implement cultural policy successfully. All these trends can produce elements of new economic development.