Premature Death in the New Independent States (1997) / Chapter Skim
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Spatial, Age, and Cause-of-Death Patterns of Mortality in Russia, 1988-1989
Spatial, Age, and Cause-of-Death Patterns of Mortality in Russia, 1988-1989
Pages 66-119
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From page 66... ...
, the age patterns of mortality in Russia and the Baltic states are unusual and different from the widely used neutral West model life table pattern (Coale and Demeny, 1966; Coale et al., 1983~. Given the size and diversity of Russia, and in particular the spatial mortality differentials noted above, the questions arise of how many different age patterns of mortality exist in Russia, and how they compare with mortality patterns found elsewhere around the world.
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From page 67... ...
Differences in underlying age patterns of mortality are then investigated through the use of cluster analysis for the mathematical grouping of provincial life tables, which results in a set of "typical" age patterns of mortality for males and females for different
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From page 68... ...
Quintiles of life expectancy and cause-specific death rates are also given in the annex. For the analysis of age patterns of mortality, 2-year multiple decrement life tables for 1988-1989 were calculated.
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From page 69... ...
69 ·_4 a' o Cq a' Cq a' a' a' VO to Cq a' · _4 o C)
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From page 70... ...
, and among urban populations it is 10 years less, based on the average of provincial life tables (Table 3-1~. Much higher death rates among males due to neoplasm, cardiovascular disease, and injuries contribute significantly to these differentials, which are similar across all provinces and administrative units of Russia (see Annex 3-1~.
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From page 71... ...
In the lower-mortality regions (Central Blackearth, Volga, and North Caucasus) , urban mortality from cardiovascular disease is higher than rural in many provinces.
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From page 72... ...
The unusually high variation in life expectancy in an industrialized country such as Russia is due to high mortality in these more remote regions of the country. High mortality is particularly evident in the less-populated regions of the Eastern Siberian and Far Eastern regions, in both rural and urban areas, with life expectancies between 55.7 and 63.7 years for males and 65.1 and 73.5 years for females.
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From page 73... ...
The last days of one of these "condemned" villages are chronicled by a contemporary author in the novel Farewell to Matyora (Rasputin, 1991~. Regional Variation in Cause-Specific Mortality In the Far Eastern region, cause-specific mortality rates are generally high from injury, cardiovascular disease, and neoplasm.
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From page 74... ...
The relation between mortality rates from injury and cardiovascular disease is on the order of 0.45 for three of the four subpopulations studied, although for urban males, the correlation between those rates is only 0.16. Yet given the regional variations in mortality patterns documented in this chapter, it is not sufficient to pay particular attention to areas of high mortality and assume a similar underlying cause-of-death structure.
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From page 75... ...
, resulting in the widely used four regional families of model life tables. To find typical mortality patterns, Coale and Demeny visually analyzed several hundred mortality patterns.
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From page 76... ...
Results of this test were the correct classification of the entire set of male life tables and the misclassification of only 2 among 279 female life tables, proving that this method is suitable for the classification of life tables by the shape of the mortality curve. Application of Cluster Analysis to Russian Provincial Life Tables To determine whether there were natural clusters of age patterns of mortality in Russia, and the number of such clusters, we first used the same method of classification as that used in the test on model life tables.
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From page 77... ...
/.'\.; , , . ~ ~ O J / " ,' -0.5 -1.0 ~ -- 15 30 40 50 ~0 70 80 FIGURE 3-la Cluster age patterns of mortality, males, Russia, 1988-1989.
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From page 78... ...
-0.0 0 1 o.e .o.1 , -1.0 -0.2 ..1 ~ -0.3 o 10 ~ 05 I ~ , - , C:luste.r 6 ~Caucasus Autonol'Iies~ IARe I ..... n n '\\t _o,, -1.0 FIGURE 3-lb Cluster age patterns of mortality, females, Russia, 1988-1989.
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From page 79... ...
Age and Cause-of-Death Components of Cluster Mortality Patterns In general, health and social conditions influence the shape of the mortality curve through causes of death. It is known that violent deaths induce a "hump" on the male mortality curve, indicating excess younger adult mortality.
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From page 80... ...
between the Russian average and three representative male and female clusters. The contribution of cause of death to the constitution of age profiles of adult mortality is significant at ages 1 to 55 for injuries, at ages 35 and above for cardiovascular disease, at ages 45 and above for neoplasm, and at ages 45 and above for males and 50 for females for respiratory disease.
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From page 81... ...
. Thus, differences in the shape of mortality curves in Russia are associated primarily with mortality due to injuries for males and with cardiovascular disease and neoplasm for females.
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From page 85... ...
En tn ~ ~ o - ~ Ore O AL : Ct -- -1 .
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From page 88... ...
A "central hump" signifying elevated mortality in the middle adult ages is a second and more universal attribute for Russian rural provinces, and compares with concavity, or no deviation, in the urban clusters. For the rural clusters, the excess mortality in intermediate adult age groups differs in size among the clusters.9 Analysis of the components of life expectancy by cause of death further defines the patterns of rural and urban mortality.
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From page 89... ...
Very high mortality from injuries at ages 1-4 and 20-54; early increased cardiovascular mortality at ages 20-44; high mortality from respiratory diseases at ages 55 and over. Very low mortality from neoplasm and mortality from cardiovascular disease contribute equally to very low mortality at ages 55 and over.
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From page 90... ...
Early increased risk of cardiovascular disease at ages 35-54, low mortality from neoplasm at ages 35+, and low cardiovascular mortality at ages 60+. Mortality from respiratory disease is high at young ages and moderately high among the elderly.
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From page 91... ...
Since the age patterns of mortality of these clusters are similar, we can aggregate their members in one cluster stretching from northwest to southeast across the center of European Russia, and therefore labeled as "Middle European." In contrast, the aggregation of two pairs of female clusters with similar age patterns (urban clusters 1 and 2, rural clusters 3 and 4) has no clear geographic interpretation.
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From page 92... ...
92 my- ~ _ Y to .
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From page 93... ...
5 3 By to o _ ~ ° ~ ~C: E ~DDU ~ ._ ~ ~ ._ D 0 a, u)
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From page 95... ...
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From page 96... ...
,,"1 ,~ 1 1 30 40 50 Cl.3 Rural Siberia ~ 60 70Age 80 FIGURE 3-4a Comparison of Russian male mortality patterns with West model life table. RUSSIAN REGIONAL MORTALITY PATTERNS RELATIVE TO WORLD MORTALITY EXPERIENCE In the previous section, cluster profiles are compared with average Russian mortality.
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From page 97... ...
2 . , 0 10 20 30 40 50 60 70 Age I 80 FIGURE 3-4c Comparison of Russian female mortality patterns with West model life table.
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From page 98... ...
that Russian mortality patterns do not resemble any regional family of the model life tables of Coale and Demeny, the U.N. tables, or other regional life tables, including standard life tables for developing regions (Heligman et al., 1993~.
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From page 99... ...
However, all have the common feature of a sharp peak in mortality at ages 15- 19. This trait of Russian mortality cannot be found in any regional model life table.
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From page 100... ...
are an even better fit to the Russian female shape than any of the model life tables and most closely replicate the early sharp peak. On the worldwide scale of comparison, the principal characteristics of the Russian urban female mortality profiles are not unique.
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From page 101... ...
Rather, the most outstanding feature of those patterns is their largely rural or urban character. The classification of provincial life tables into numerous clusters representing typical age patterns of mortality results in largely urban or rural clusters.
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From page 102... ...
In the predominant male and female urban mortality patterns, there is low mortality up to ages 50-55 and high mortality thereafter, relative to the Russian average. Features of typically urban age patterns are low mortality from injuries up to age 55 and from respiratory disease in infancy and in older adult ages, relative to the Russian average.
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From page 103... ...
However, the French life tables of the 1960s and 1970s are an even better fit to the Russian female shape than any of the model life tables and most closely replicate the early sharp peak of mortality at ages 15-19. Thus in general, the age patterns of mortality found in Russia are not unique.
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From page 104... ...
Demeny 1966 Regional Model Life Tables and Stable Populations. Princeton, NJ: Princeton University Press.
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From page 105... ...
NOTES 1. The following eight large classes of cause of death were used in the calculation of the life tables: Class I, infectious and parasitic diseases; Class II, neoplasms; Class VII, cardiovascular diseases; Class VIII, diseases of the respiratory system; Class IX, diseases of the digestive system; Class XVI, symptoms, signs, and ill-defined conditions; and Class XVII, injury and poisoning.
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From page 106... ...
4. Nine regional model life table families were produced (four Coale-Demeny and five U.N.
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From page 108... ...
Q e(0) Males - R Northern Region Arhangelsk Karelia KOMI Murmansk Vologda 64.4 63.7 63.5 64.9 64.2 3 178.8 4 201.2 4 209.1 2 153.8 4 181.9 2 938.0 4 1059.0 4 953.2 1 977.3 ~ , ~, 4 367.1 5 390.5 5 349.4 5 347.7 5 341.4 60.9 61.8 60.8 Central Region Bryansk Ivanovo Jaroslav Kalinin Kaluga Kostroma Moscow Obl.
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From page 110... ...
Q e(0) Volga Region Astrahan 63.8 4 210.8 4 924.0 4 351.7 4 63.8 Kalmyikia 61.2 5 233.1 5 873.3 3 314.9 2 61.8 Kuibyishevsk 64.9 2 169.2 2 855.5 2 347.7 4 62.8 Penza 65.2 2 184.1 3 861.8 3 315.4 2 63.0 Saratov 64.5 3 175.5 2 917.7 4 333.0 3 62.1 Tataria 65.6 1 183.1 3 832.4 2 288.1 1 63.8 Ulyanovsk 65.2 2 175.1 2 936.8 4 326.5 3 63.0 Volgograd 65.4 1 171.6 2 800.1 1 338.5 3 63.3 Ural Region Bashkiria 65.1 2 178.2 2 839.8 2 280.2 1 63.3 Chelyabinsk 64.9 2 183.0 3 781.7 1 345.5 4 62.9 Kurganskay 64.4 3 200.7 4 812.0 1 362.8 5 62.6 Orenburg 64.9 2 190.7 3 833.6 2 330.1 3 64.5 Perm 64.2 4 212.8 5 912.4 4 309.5 2 60.1 Sverdlovsk 64.2 4 200.9 4 879.4 3 327.0 3 60.7 Udmurtia 64.0 4 223.9 5 885.8 4 269.3 1 61.3 Eastern Siberia Region Buryatia 63.0 5 226.5 5 795.8 1 347.5 4 61.5 Chita 63.4 5 229.4 5 788.4 1 296.4 2 62.0 Irkutskay 62.8 5 244.6 5 850.2 2 326.8 3 59.1 Jakutia 63.0 5 63.5 1 904.5 4 374.5 5 61.1 Krasnoyarsk 63.2 5 204.1 4 830.3 2 337.5 3 60.5 Tuva 59.8 5 344.9 5 756.5 1 381.9 5 55.7
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From page 112... ...
Q e(O) Males - R Far Eastern Region Amurskay 63.7 4 216.6 5 889.3 4 311.6 2 62.1 Habarovsk 62.2 5 233.2 5 1010.3 5 370.7 5 60.1 Kamchatka 62.7 5 218.6 5 1376.2 5 433.8 5 60.2 Magadan 63.1 5 157.6 1 1119.1 5 496.0 5 60.9 Primorski 63.4 5 227.5 5 941.6 5 332.5 3 60.9 Sahalin 62.5 5 233.9 5 1072.2 5 377.5 5 61.9 Summary Statistics Mean 62.7 183.1 870.2 323.3 61.8 Std Deviation 10.5 48.8 142.5 58.2 1.8
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From page 114... ...
Q e(0) Females Northern Region Arhangelsk 74.7 3 45.9 3 619.3 4 145.5 3 73.5 Karelia 74.0 4 52.6 3 667.6 5 151.6 4 73.2 KOMI 73.1 5 62.5 5 667.5 5 151.9 4 72.1 Murmansk 74.6 3 41.6 2 656.6 5 140.2 2 73.7 Vologda 74.6 3 40.4 2 625.9 5 139.9 2 74.5 Central Region Bryansk Ivanovo Jaroslav Kalinin Kaluga Kostroma MoscowObl.
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From page 116... ...
Q e(0) Females Volga Region Astrahan 74.4 3 48.2 3 593.0 3 158.8 4 73.9 Kalmyikia 71.3 5 61.1 5 597.4 4 137.4 2 72.6 Kuibyishevsk 74.6 3 44.2 2 569.8 2 158.4 4 74.3 Penza 75.5 1 45.3 3 561.2 2 134.6 1 75.2 Saratov 74.6 3 43.6 2 602.8 4 149.0 3 74.5 Tataria 75.6 1 45.4 3 534.3 1 128.8 1 75.8 Ulyanovsk 75.1 2 44.2 2 572.3 3 138.3 2 74.3 Volgograd 75.1 2 43.0 2 544.6 1 162.4 5 74.3 Ural Region Bashkiria 74.8 2 51.8 3 546.9 1 130.0 1 75.0 Chelyabinsk 74.6 3 51.3 3 544.0 1 152.4 4 73.7 Kurganskay 74.9 2 54.1 4 533.8 1 152.9 4 74.5 Orenburg 74.8 2 42.3 2 575.8 3 146.1 3 74.9 Perm 73.9 4 62.1 5 611.0 4 136.5 2 71.7 Sverdlovsk 74.1 4 58.1 4 604.1 4 143.8 3 72.6 Udmurtia 74.4 3 63.3 5 587.5 3 119.1 1 73.4 Eastern Siberia Region Buryatia 73.5 5 54.6 4 561.5 2 166.9 5 Chita 73.4 5 54.8 4 580.1 3 149.9 3 Irkutskay 73.2 5 63.6 5 584.4 3 164.4 5 Jakutia 72.2 5 45.3 3 619.7 4 183.9 5 Krasnoyarsk 73.5 5 55.9 4 570.8 2 158.2 4 Tuva 70.0 5 96.8 5 603.6 4 193.7 5
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From page 118... ...
Q e(O) Far Eastern Region Amurskay 73.5 5 54.8 4 657.6 5 139.8 2 71.3 Habarovsk 72.8 5 57.5 4 681.6 5 161.1 5 70.8 Kamchatka 71.9 5 66.1 5 850.3 5 166.5 5 69.8 Magadan 71.6 5 70.5 5 784.6 5 216.0 5 Primorski 73.2 5 64.1 5 671.6 5 157.2 4 71.7 Sahalin 72.4 5 64.2 5 755.5 5 156.5 4 72.2 Summary Statistics Mean 74.3 49.6 589.9 149.2 Std Deviation 1.2 12.4 63.9 18.9 73.4 1.8
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