Mortality and life expectancy in Russia: who is right?
Minister of Health at the ONF forum: Russians live the longest in the world
Health Minister Veronika Skvortsova at the ONF forum, which began on September 6 in Moscow, said that Russians live the longest in the world.
"We have reduced mortality in all social groups. A record decrease in child mortality. And it continues to decline. Our life expectancy has increased dramatically. Today we are on the 1st place among developed countries, and on the 4th place among all countries of the world, since 2005 the duration has started to grow sharply. During this time, life expectancy has increased by 7.7 years for men, and by 4.75 years for women."
Recall that in the report of the ONF, following the results of monitoring the situation, the following conclusion was presented: due to a sharp increase in the mortality of the able-bodied population under 30, the presidential program to increase life expectancy in the country was failed.
Earlier, she said that the satisfaction of Russians with medical services has increased. These words caused a violent reaction in the audience. Angry shouts began, and the leading discussion platform with some difficulty managed to put a lock on.
Meanwhile, Veronika Skvortsova continued and urged to evaluate the work of her department "unbiased".
"for 50 years we have been marking time"
To stop the increase in mortality in Russia, it is necessary to revise statistics, demographers sayAnastasia Berseneva, "Newspaper.
This will be handled by an interdepartmental working group, which the government is asked to create by leading demographers, representatives of the Ministry of Health and Rosstat. They say that the situation with mortality has not changed dramatically for the better for many years, and the current statistics do not reflect reality, which means that it does not help to achieve population growth.
Demographers, representatives and heads of leading institutions of the Ministry of Health, as well as Rosstat employees are preparing an appeal to Deputy Prime Minister Olga Golodets about the need to create an interdepartmental working group in Russia that would deal with mortality data in the country. At the "round table" dedicated to the sad figures of population loss, experts stated the need to change the structure of statistics, in which there are too many general data, and some figures are allegedly even almost specially cleaned up.
"The initiators of this round table were the idea to send a resolution addressed to the Vice-Chairman of the government Olga Golodets with proposals from the expert community to create an interdepartmental working group," explained Igor Lansky, Adviser to the Minister of Health of Russia for Communications.
One of the reasons to gather was the recent news about the increase in the death rate in Russia in the first quarter of 2015. American publications even wrote about it. Dissatisfied with the hype, experts agreed that this figure does not mean anything by itself, but if you look at the situation in dynamics, in comparison with developed countries, the charts will not be in favor of modern Russia.
"The first thing to do is to understand where we are. Fluctuations in 3-4 months don't mean anything, but fluctuations in 100 years say a lot," says Anatoly Vishnevsky, director of the HSE Institute of Demography. He has dozens of graphs: the main causes of mortality, age data, comparisons with other countries, indicators for a hundred years. They show that in the last decade, mortality in Russia has been decreasing slightly, but not at the same pace as in the United States, the European Union and Japan.
The mortality curve in Russia begins to grow sharply from the age of 20, while in Europe, Japan and the USA – after 40 years. The country is losing the most able-bodied age, explains Vishnevsky. The lag in life expectancy from these countries is 10-15 years.
"So far, for a number of ages, mainly for men, we have not returned to the indicators of the 1960s," says Vishnevsky. – The situation is somewhat more favorable in older ages, mainly in women. We can say that these 50 years we have been marking time."
Amateur activity on the groundAt the same time, when the leadership of the state pays attention to some specific causes of mortality, trying to achieve a reduction in statistics, the indicators in the regions begin to be cleaned up, experts said.
In statistics there is a heading "Deaths from uncertain intentions". These are cases when there are no exact pointers that caused the death of a person. For example, whether he intentionally committed suicide or his death was an accident.
"It is only necessary for our authorities to show increased interest in some reason, and the mortality rate from it begins to decrease. For example, governors report on a decrease in the number of suicides, transferring them to the heading "Death from uncertain intentions", and there is also a general classification heading – "Death from unknown causes". The system has adapted to this, but there is a problem," Vishnevsky added. "We know that some subjects are trying to hide crimes: if there are high mortality rates of external causes from uncertain intentions, then there will be low mortality rates from crimes," Ekaterina Kakorina, director of the Department of Monitoring, Analysis and Strategic Development of Healthcare of the Ministry of Health, gave an example.
And in one region, they even somehow set a limit for old-age death – 72 years.
Apparently, 71-year-olds cannot die of old age. "We warn the Ministry of Health about all such cases," she explained to the newspaper.Ru" Head of the Department of Analysis of Population health Statistics of the Research Institute of Organization and Informatization of Healthcare Alla Ivanova.
"Patients just don't go to doctors"There is another fact: now the death certificate is filled out by doctors who already have a lot of workload, although previously the coding of the causes of death was entrusted to special statisticians.
As a result, it is easier for doctors to put death from cardiovascular diseases than to figure out which diseases led to the death of a person. Cards in polyclinics will not help either.
As Kokorina clarified, the diagnosis of "Alzheimer's disease" is not made in polyclinics, doctors say senile dementia. And, for example, diabetes mellitus in Russia is an underestimation by four times, director of the Center for Social Economics David Melik-Huseynov added. Patients simply do not turn to doctors, which means that there can be no question of effective prevention and a significant reduction in mortality. It turns out that statistics do not reflect reality, experts admitted.
"Dear colleagues, what should we do then? We are trying to determine what causes the change in mortality, but it turns out that we can only register the fact of death in no uncertain terms," said Irina Samorodskaya, head of the Laboratory for the analysis of demographic Processes of the Department of Preventive Medicine of the Ministry of Health. "Until we evaluate the personalized data, we won't be able to do anything."
How to reduce mortality if you don't know what they die from"If we do not clearly indicate why we are dying, then we will not be able to do specific measures that will be aimed at reducing mortality.
Maybe our current programs really don't work?" – Kakorina asks a rhetorical question.
"First of all, we must honestly admit that, despite the severity of the problems of high mortality in Russia, it has not been sufficiently studied. And there is no consolidation of all the experts who deal with it. We need to somehow raise the question of the scientific study of this whole problem, and we need some kind of program that should receive funding," Vishnevsky summed up.
If we leave the situation alone, the mortality rate is unlikely to decrease much. According to forecasts, it will be unchanged at best. According to Evgeny Andreev, a leading researcher at the Center for Demographic Research of the Russian School of Economics, mortality in Russia for seven months of 2015, according to preliminary estimates of experts, increased by 1.7% compared to the same period in 2014.
And this is without data on Crimea and Sevastopol. But the Ministry of Health of Russia stated with reference to Rosstat that in the first half of 2015, the mortality rate of the able-bodied population alone decreased by 2.1% compared to the same period last year, from 545.5 to 534.3 cases per 100 thousand population.
"Life expectancy at least does not decrease, most likely, it will not increase, but it will not decrease compared to 2103. The margin of safety that has been accumulated over the previous years affects the preservation of the achieved levels," adds Ivanova.
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07.09.2015