HEALTH IN RUSSIA Russian Health Profile Eugene Shubnikov, MD, National Supercourse Director for Russia and coordinator for the FSU, Novosibirsk, Russia for Supercourse’s Program, Pittsburgh, USA This lecture is based on my presentation on January 31, 2002 at Epidemiology class of Professor R.LaPorte and Ass. Professor T.Songer (School of Public Health, University of Pittsburgh, Pittsburgh,PA, USA). After following discussion we decided to move forward on a Former Soviet Union Supercourse. The idea is that we would have one person available in each country to collect health indicator information. Both WHO and the World Bank have this information, but is not very user friendly, in that it is in tables, ours will be in Power Point slides. Also, we can update the National Supercourses as the data themselves are updated, thus our data will be more timely. By having the health indices in a user friendly format, e.g. PowerPoint, we can get it into the classrooms of the world very quickly. Also, it will be rapidly updated. Our system this is different than WHO and World Bank, in that it is a graphic format, simple and timely. We do not complete with them, we compliment them.

Russian regions At this moment Russia has 7 main administrative units with about 90 smaller territorial units. Russia has a territory of about 1709 million of hectares and the forest cover two/third of the land or 1178,6 million of hectares.

Population Statistics by gender and age AGES 1898 100 1 1 FEMALE MALE                                                              2 2 3 4 4 5 5 6 6 1.The decreasing of births during 1914-1918 years of war(small in numbers generations) . 2. The entry of small in numbers generations into the reproductive age, the expropriation of 1928-1932 years, the starvation of 1933 year. 3. The prohibition of abortions in 1936 year and steps to the stimulation of birth rate. 4. The decreasing of birth rate during the period of the war of 1941- 1945 years. 5. «Baby-boom» after the Second World War . 6. The decreasing of birth rate lower the level of generation’s substitution (less than 2 births per 1 woman). 7. The effect of new family policy of 1983 year and anti-alcohol company of M.Gorbachev. 8. The decreasing of birth rate after 1989 year. 7 7 8 8 1998 Total population: 144 819 000

Crude Birth Rate Per thousand persons Your Comments                                       Despite the decreasing of birth rate after 1989 year Russia has birth rates compatible to birth rates in Germany - 9,3 in 1999, Spain - 9,6 in 1999, Italy - 9,1 in 1999. 1266,8 thousands of Russians were born in year 2000. More than a million of newborns per year. Your Comments

Life Expectancy at Birth (years)                                                              The average life expectancy in Russia now is 65,27 years which is considerably lower than in all developing countries from 10 (Denmark - 75,7) to 15 (Japan - 80) years. There is a big difference in life expectancy among women (72,2 years) and men (only 59,0 years) in Russia. Your Comments

Crude Death Rate Per thousand persons Your Comments                                                                             In comparison to other countries, most certainly the mortality indicators are poor. Russia has had a very high total mortality rate - 1513.8 per 100,000 population in 1995(1). In 1998 the rate became lower - 1376 cases per 100,000 population, but in 2000 it became even bigger than in 1995 and still almost twice that in the USA(776.1 cases per 100,000 population) and in Germany (764.1). 1.World Health Statistics. Annual 1996 Edition (1998) (http://www.jinjapan.org/stat/stats/02VIT23.html) Your Comments

Main reasons of the deaths Per 100 000 persons The leading cause of death in Russia is cardiovascular diseases - 849.4 cases per 100,000 population, again twice higher than in the USA and Germany. The second leading cause of death in Russia is accidents - 219.9 cases per 100,000 population including suicides (39.1). The third leading cause of death is malignant neoplasm - 205.5 cases per 100,000 population at 2000 (1). Clearly much of the mortality in Russia is avoidable. 1.Health at Russia, Goskomstat, Moscow, 2001 Your Comments

Per thousand persons in age groups Age-specific death rates by sex and age (2000) Per thousand persons in age groups Age 0 ~ 4 5 ~ 9 10 ~ 14 15 ~19 20 ~24 25 ~29 30 ~34 35 ~39 Male 4.4 0.6 0.6 2.2 5.0 6.0 7.0 9.1 Female 3.3 0.4 0.3 0.8 1.2 1.4 1.8 2.4 Age 40 ~44 45 ~49 50 ~54 55 ~59 60 ~64 65 ~69 70 + Total Male 12.6 17.7 24.4 33.7 45.0 60.4 101.9 17.4 Female 3.4 5.1 7.6 11.5 15.9 25.7 78.8 13.6 To estimate better the impact of high mortality rates in Russia, I may say that in 2000 about 2 million and 225 thousands of Russians died compare to 1 million and 266 thousand of newborns. Your Comments

Deaths by major causes of death (2000) In % Causes Total Total 100% Diseases of the circulatory system(S.) 55,3 Neoplasms 13,4 External causes of mortality 14,3 Diseases of the digestive system 2,9 Diseases of the respiratory S. 4,6 Certain infectious and parasitic diseases including tuberculosis 1,6 Others 6,56 Unfortunately, in Russia morbidity and mortality from cardiovascular and other non-communicable diseases are high and with no evidence that they are declining (1). 1. Glazunov I.S. Necessity of elaboration of policies and strategies of cardiovascular and other non-communicable diseases prevention//Diseases prevention and health promotion (www.mediaspera.aha.ru). 1998, N1. Your Comments

Maternal Mortality Ratio Per 100 000 of life births                                                                                                                   This health indicator is probably one which has considerable positive dynamics since 1990 year. Your Comments

Infant Mortality Rate Per 1000 of life births Your Comments                                                                                                                                                         This rate more than twice higher than in USA (6,9 in 1999) and more than 3 times higher than in Germany (4,5 in 1999). Your Comments

Economics and Health Indicators - Inpatient care beds (2000): 11,6 per 1,000 population - Number of Physician(2000): 4,8 per 1,000 - GNP(1998) : 2,260 dollars per capita - Total expenditure on Health(2000): 2,2 per cent to GNP ( including physical training expencies) According to the number of beds and number of physicians Russia should have very good rates for main health indicators. There is only one country with the bigger rate - Belorussia - 478 physicians per 100000 population. But the problem seems to be in low level of expenditures on Health in Russia. Your Comments

Morbidity Ranking Disease Incidence Rate 4461,7 1540,7 31947,0 3208,9 The Top health events causing morbidity are: Disease Incidence Rate Infectious diseases 4461,7 Diseases of nervous system 1540,7 Diseases of respiratory system 31947,0 Eyes diseases 3208,9 Ears diseases 2208,2 For some health indicators Russia still has good rates. For example for the incidence rates for AIDS - 39,1 per 100000 population (together with HIF infectious only). But for some health indicators as Tuberculosis Incidence, Russia has 3 times higher rates compare to USA and Japan. Active Tuberculosis becomes very important Health problem during the last years. Totally about 380 000 people now in Russia (2000) suffer from active tuberculosis. Circulatory system diseases 1718,0 Skin diseases 4433,5 Traumas,poisons,external reasons 8679,5 Per 100 000 persons Your Comments

This lecture is based on Population data: http://dmo.econ.msu.ru/demografia/Demographie/Population/Pyramides/pyr_tot.htm Statistical data: Health in Russia, Russian Goskomstat, 2001,Moscow, 356P. (info@gks.ru or http://www.info.gks.ru) World Bank Data: http://www.worldbank.org/depweb/english/modules/basdata/bdata/dataeurobasic.htm This presentation is also the result of scientific exchange inside of Supercourse team from Pittsburgh University ( head is professor R.LaPorte) and Russain/FSU Internet prevention group (more than 100 participants).

Useful Internet links related to health profiles in different Countries WHO Regional Office for Europe WHO World Health Statistics Annual WHO web site The list of country-specific resources on public health World Bank project "Development Gateway” World development indicators and tables http://www.who.dk/document/e72504.pdf Send Your Link

Thank you for taking health profile Tour for Russia Would you like to create your own country’s Health profile? Send Your Countries Data’s Set and your lecture will be opened during next week! Would you like to add your own slides to Russian Health profile? Please be sure that your original materials and data will be posted only with the mention of your name. Send Your Slides with new or updated information