Seminar "Modern demography" Topic: Epidemiological research on the Russian mortality phenomenon. Presentation by Vladimir M. Shkolnikov

Epidemiological research on the Russian mortality phenomenon.
Vladimir M. Shkolnikov
International laboratory for population and health of HNU HSE.

Russia alongside with other countries of the former USSR represents the most remarkable and mysterious anomaly against the background of global mortality trends. 

Population data can only diagnose the situation in the most general terms. For example, a demographic analysis shows that during the 70s-2000s Russia has developed an adverse type of mortality combining high CVD mortality in the age of 50+ with especially high mortality from alcohol-dependent and external causes in the “flowering working ages”. Only in the 2010s, with a delay of 40 years, did Russia embark on the path of the cardiovascular revolution. 

What is wrong with Russia and its population? How are Russians so different from people in other countries, that is expressed in such high death rates from such a wide range of medical causes? 

Demographic statistics gives inaccurate and very incomplete information about such important factors as alcohol consumption and smoking and does not say anything at all about psychological stress and depression, dangerous diseases, physical mobility and cognitive function, self-assessments of health, blood pressure, heart rate, about blood lipids, muscle strength, metabolic rate, lung function, and so on.

Epidemiological studies that study the prevalence of health problems and risk factors provide this information. 

To what extent do the health disorders and risk factors explain the gap with other countries and the huge differences in mortality by sex, region, nature of work, and level of education? Due to the so-called ecological fallacy, a typical demographic analysis by year, regions and types of residence may incorrectly reflect associations, and causal mechanisms operating at the level of real people. This is done by epidemiological studies linking the characteristics of individuals with the risk of death. 

Epidemiological studies in Russia began in the 1970s, together with the onset of rising mortality, and were significantly intensified in the late 1990s and early 2000s, when enormous losses from excess mortality began to be recognized by many. 

At the seminar, it will be talked about some key epidemiological studies and it will reveal their methodology, taking into account the peculiarities of the Russian situation. We will see that some of the results allow us to identify the causes of high mortality, and a number of other result indicate the impossibility of associating high mortality with (seemingly) obvious factors.