MOSCOW December 8, 2005 – Despite strong economic growth, Russia is facing an alarming population decline, due in large part to untimely deaths from heart disease, traffic accidents, and alcoholism, says a World Bank report released today. A continuation of current trends means a shrinking adult workforce, destabilization of families, growing regional disparities, and national security risks, warn Bank experts. Dying Too Young: Addressing Premature Mortality and Ill Health Due to Non Communicable Diseases and Injuries in the Russian Federation explores the socioeconomic impact of a sharp rise in ailments such as heart disease, cancer, traffic injuries, alcohol poisoning, suicides, and violence. These non-communicable diseases (NCDs) are taking an insidious toll on Russian workers. “This report sheds light on the nature of non-communicable diseases and injuries as the leading killers in the Russian Federation, its associated risk factors, and their socioeconomic implications,” explains Patricio Marquez, Lead Health Specialist in ECA and Team Leader for the study. The new report outlines options to prevent NCDs and mitigate their impact so that people, particularly men, can live longer and so that ill health does not take a toll on the welfare of the population and on the country’s economy. Current life expectancy for men and women in Russia stands at 66, while for men it is 58.
A key finding is that policies to reduce deaths from non-communicable diseases and accidents to the current level among wealthy Western European countries (the EU-15) by 2025 could confer socioeconomic benefits equivalent to close to 30 percent of the 2002 Russian GDP. Catching up with the EU-15 in terms of life expectancy (currently averages 79 years for men and women), would require that a reduction in Russia’s annual mortality of 4.6 percent per year for non communicable diseases and 6.6 percent for injuries. In terms of per capita benefits, this would translate into an increase in per capita GDP of between US$2,856 and $9,243 by 2025. The Russian Ministry of Health and Social Development is preparing a federally targeted program to prevent and control early death, ill health, and disability caused by these killers. Dying Too Young applauds these efforts, but cautions that much more needs to be done to build capacity and mobilize sufficient resources needed for a scaled up response. The study recommends a nationwide program to prevent premature deaths and ill-health focused on three main areas: (1) federal-level policies and strategies, (2) priority sub-programs in regions, and (3) measures to improve road safety and emergency services. “The poor health of Russia’s economically active adult population – its human capital – challenges sustainable development. Armed with this knowledge, it is essential that health experts act now, at the local, regional and federal levels” says Marquez.
Short, brutal lives for Russia’s men are taking a toll on society and families Russia is one of the few middle-income countries in the world where life expectancy is falling. Life expectancy in Russia is 12 years less than it is in the US, a startling gap for a fellow-member of the G-8. Between 1992 and 2003, the Russian population declined by 6 million people to an estimated 143 million. If current low fertility and high mortality trends continue, the Russian Federation will lose approximately 18 million people by 2025. Russian men are particularly at risk, they live16 years less on average than men in Western Europe and 14 years less than Russian women. The large difference by sex suggests that specific behavioral factors are implicated, rather than factors related to the external environment or adequacy of health care. If current ill health and disability continue, the healthy life expectancy of Russian males will fall to 53 years. According to Dying Too Young, since the late 1990s, the burden of chronic illness on families is estimated to have contributed to an annual loss of 5.6% of per capita income per year negatively affecting household incomes. |
The success of policies at the federal level should be measured by the effectiveness of the legislative framework, institutional capacity, and federal oversight. Policies for controlling excessive alcohol consumption, enforcement of existing policies for smoke-free worksites and public places, and targeted taxes would help prevent NCDs in Russia. The report also suggests that public campaigns in support of responsible drinking, wearing seat-belts and driving sober could reduce fatal car accidents. The report recommends replicating Russia’s Countrywide Integrated Non-communicable Disease Intervention Program, or “CINDI” experience, by awarding grants to stimulate innovative health promotion and disease prevention initiatives at the regional level. Some of the CINDI programs include Quit&Win smoking cessation program covering 28 million people and a regional health surveillance program that surveys risk factors every five years. This has helped to develop a reliable database on chronic disease risk factors among people living in the Pitkaranta region. Road safety should be tackled both federally and regionally, by setting up a monitoring framework with easy-to-measure indicators and by providing technical assistance. In turn, each region should develop its own road safety strategy and inter-institutional emergency medical network. These are particularly important for a country that ranks No.1 in the world for road accidents, with 12 accidents for every 10,000 vehicles. Russia’s traffic mortality ratio is 20.6 deaths per 100,000 people in comparison with 11:100,000 in other G-8 countries. “Reducing NCDs and injury-related mortality rates among Russian working-age adults will have a major macroeconomic and social impact, with benefits far outweighing initial outlays to cover the cost of health promotion and disease prevention activities,” concludes Marquez.
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