Tables 3-3a and 3-3b generalize the main findings of the cluster analysis and indicates the geographic spread of the clusters.

Rural-Urban Differentials in the Shape of Cluster Mortality Patterns

The most notable outcome of the cluster analysis is that the resulting classification does not contain largely mixed rural-urban clusters. Male life tables result in two urban and four rural clusters. Female life tables result in three urban and two rural clusters. Of the twelve clusters, only one (female cluster 6) is mixed. This indicates again that the difference in the shape of the mortality curves of the Russian rural and urban populations is principal and significant, and that any mortality profile in Russia must contain some code that distinguishes the age patterns of mortality for these two populations. Such a code must include two attributes: the slope measured by the ratio of younger adult to older adult mortality, and the shape of mortality in the younger and primary adult ages (the rise of the center hump in the age profile).

A distinctive feature of both the male and female urban mortality patterns is low mortality up to ages 50-55 and high mortality thereafter (Figures 3-1a and 3-1b). This feature can be seen in all urban clusters with the exception of male cluster 4. In female cluster 5, this feature is extreme. In the rural clusters, there is relatively high mortality up to ages 50-55 and low mortality thereafter.

A "central hump" signifying elevated mortality in the middle adult ages is a second and more universal attribute for Russian rural provinces, and compares with concavity, or no deviation, in the urban clusters. For the rural clusters, the excess mortality in intermediate adult age groups differs in size among the clusters.9

Analysis of the components of life expectancy by cause of death further defines the patterns of rural and urban mortality. The rural patterns generally differ from the urban in their low adult mortality from neoplasm and cardiovascular disease for older adults and in their high mortality from injuries and respiratory disease and early increased mortality from cardiovascular disease.

Typically urban features are seen in male and female clusters 1 (Figures 3-2a and 3-2d, respectively). Mortality from injuries and from respiratory disease in infancy and in older adult ages is lower than in average Russia. Mortality from neoplasm and cardiovascular disease at older adult ages is higher than in average Russia.

For the rural clusters, certain general features are noted at different ages (Figures 3-2b and 3-2c for males and 3-2e for females). In infancy, a distinctive rural feature is relatively low neonatal mortality (congenital anomalies and perinatal mortality) and relatively high postneonatal mortality (respiratory disease). In early childhood, injuries peak at above-average levels at ages 1-4 in rural areas and not urban areas. The middle-age excess mortality is due not only to injuries, but also to high early mortality from cardiovascular disease. At older adult ages,



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement