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Preventable mortality in the Russian Federation: a retrospective, regional level study
Zlatko Nikoloski1, Vladimir M Shkolnikov2, Elias Mossialos1
1Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
The Lancet Regional Health. Europe
|May 14, 2023
Summary
Preventable mortality in Russia declined overall, but regional disparities persist. Smoking and nurse availability correlate with higher rates, suggesting targeted health system improvements are needed, especially in Siberia and the Far East.
Area of Science:
- Public Health
- Health Services Research
- Demography
Background:
- Avoidable mortality, encompassing treatable and preventable deaths, serves as a key health system performance indicator.
- Preventable mortality reflects the impact of public health policies, while treatable mortality relates to medical interventions.
- The evaluation of preventable mortality at the regional level in the Russian Federation is underexplored.
Purpose of the Study:
- To assess preventable mortality trends and regional variations in the Russian Federation from 2014-2018.
- To identify key correlates of preventable mortality, including behavioral risk factors and healthcare access.
- To provide evidence for targeted public health interventions to reduce avoidable deaths.
Main Methods:
- Calculated total preventable mortality rates for males and females in each oblast using the Russian Fertility and Mortality Database (RusFMD).
- Analyzed contributions of specific preventable causes of death to overall rates.
- Employed panel fixed effects modeling to examine relationships between preventable mortality and correlates (2014-2018).
Main Results:
- Overall preventable mortality in Russia decreased from 548 to 301 per 100,000 person-years between 2000 and 2018.
- While deaths from cancer, cardiovascular, and alcohol-related diseases declined, those from diabetes and HIV increased.
- Significant regional heterogeneity was observed, with higher rates concentrated in Siberia and the Far East; smoking and nurse availability were significant correlates.
Conclusions:
- Strengthening the healthcare system, particularly in rural and remote oblasts, can reduce preventable mortality.
- Targeted smoking reduction programs are crucial for mitigating preventable deaths.
- Addressing regional disparities in health outcomes is essential for improving national health system performance.
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