Premature Death in the New Independent States (1997) / Chapter Skim
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Mortality in the New Independent States: Patterns and Impacts
Mortality in the New Independent States: Patterns and Impacts
Pages 156-183
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From page 156... ...
The fertility levels of the former Soviet countries span most of the range of variation observed around the world. While the European populations of the former Soviet republics have largely completed the "demographic transition" from natural to controlled fertility, the Central Asian populations are either in the early or intermediate stages of the transition.
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From page 157... ...
DATA ISSUES Statistics on Mortality in the NIS Countries The statistical agencies of the ex-Soviet countries share a common heritage of standard procedures and definitions imposed by the former State Committee on Statistics (Goskomstat) across the territories that comprised the Soviet Union.
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From page 158... ...
This necessitates adjustment of the official infant mortality data for the former Soviet countries; the adjustments adopted for the present analysis are described in a subsequent section. Since the introduction of compulsory cause-of-death certification in 1925, cause-of-death data have been routinely compiled in the civil registration systems of the former Soviet countries.
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From page 159... ...
MEASUREMENT ISSUES Because infants as a group are the focus of particular concern with regard to health priorities, infant mortality warrants inclusion in the present analysis. Given the unusual definitions and measurement errors associated with former Soviet statistics on infant mortality, as discussed above, it was necessary to adjust the reported infant mortality rates to facilitate their meaningful analysis.
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From page 160... ...
Table 5-1 contains the adjusted and original infant mortality rates. As compared with our previous, uniform adjustment, the regionally differentiated approach is more satisfying in that greater adjustments are applied to the Central Asian republics, together with Azerbaijan, where the data are faultier, while the smallest adjustments are applied in Lithuania and Estonia, where the data are more reliable.
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From page 161... ...
This facilitates comparison by applying a common standard to the various former Soviet countries and also excludes mortality in extreme old age, where measurement errors are apt to be more pronounced. MORTALITY LEVELS OF THE NIS COUNTRIES An overview of the mortality levels in various republics of the former Soviet Union is provided in Table 5-2.
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From page 162... ...
First of all, the high magnitude of loss of life across this group of countries is striking. As of 1989, among males in all these countries, along with females in Azerbaijan and the Central Asian republics, years of life lost from ages
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From page 163... ...
In Moldova and the Southern Tier republics, levels of years of life lost among men are greater by half than the corresponding figures for women. The rural populations of Azerbaijan and the Central Asian republics are notable for their low sex differentials in years of life lost relative to the other republics in Table 5-2.
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From page 166... ...
Our ten cause-of-death categories reflect our subdivision of two broad cause classes that figure prominently in the mortality patterns of the former Soviet republics: diseases of the respiratory system and external causes of death. Respiratory system diseases are often treated as a typical "Third World" category because they include many illnesses, such as pneumonia and bronchitis, that are Biologically similar to infectious diseases; we distinguish such diseases from other respiratory conditions of more degenerative character, such as emphysema.
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From page 167... ...
With regard to sex differentials, our results indicate that these are nearly always in favor of women.8 The cause categories associated with the greatest excess of male over female years of life lost are accidents, diseases of the circulatory system, and homicides/suicides in the Russian and other European repub 1 lCS. 1979-1989 TRENDS We have at our disposal some data on the distribution of deaths by broad cause categories that can be analyzed relative to the 1989 data to shed some light on regional mortality trends in the former Soviet Union around the end of its existence.
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From page 168... ...
Resp..62.44 3.06 3.10.11.97 Other Resp..46.41 .32 .66.36.47 Accidents4.843.10 1.43 2.672.922.86 Homicide/Suicide2.151.23 .18 .751.09.83 Other Classified1.13.81 1.31 1.30.891.63 Congen./Perinatal1.311.23 1.46 1.61.931.64 NOS, Old Age.46.19 .30 .08.02.01 Alcoholic Pois..81.27 .01 .13.16.09 Alcohol.12.03 .01 .02.17.08 Infectious1.17.88 4.73 4.27.351.50 Degenerative6.295.64 4.70 4.425.074.50 Total17.8113.49 14.42 15.7611.6213.42 Females Infectious Dis..20.20 1.15 1.01.10.35 Neoplasm1.341.35 .90 .951.401.31 Circulatory2.301.79 1.95 1.941.472.01 Infect. Resp..35.30 2.84 2.69.05.73 Other Resp..15.15 .21 .42.12.15 Accidents1.31.77 .47 .85.76.98 Homicide/Suicide.48.29 .07 .20.25.27 Other Classified.78.62 1.04 1.03.681.55 Congen./Perinatal1.03.92 1.07 1.21.871.22 NOS, Old Age.17.08 .27 .07.04.01 Alcoholic Pois..22.06 .00 .04.03.04 Alcohol.03.01 .00 .00.06.04 Infectious.55.50 3.99 3.70.161.08 Degenerative3.633.14 2.84 2.892.873.32 Total8.106.46 9.95 10.375.768.58 NOS = not otherwise specified.
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From page 170... ...
Resp..56.341.671.52.08 Other Resp..39.33.24.52.24 Accidents4.662.741.442.562.29 Homicide/Suicide2.051.14.24.88.87 Other Classified1.12.781.051.04.91 Congen./Perinatal1.401.332.212.34.92 NOS, Old Age.49.18.23.09.01 Alcoholic Pois..80.24.01.19.13.08 Alcohol.12.03.01.03.19.07 Infectious1.07.733.082.38.32I. ~ ~ Degenerative6.345.735.204.915.054.65 Total17.5212.9513.7014.7210.6111.96 Females Infectious Dis..18.16.86.69.09.25 Neoplasm1.391.42.981.121.441.44 Circulatory2.241.752.001.661.391.6t Infect.
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From page 172... ...
Resp..71.67 4.41 3.79.16 1.21 Other Resp..64.59 .41 .77.53 .56 Accidents5.334.15 1.40 2.714.35 3.66 Homicide/Suicide2.431.52 .09 .671.56 .93 Other Classified1.18.91 1.59 1.47.87 1.90 Congen./Perinatal1.14.97 .76 1.30.95 1.58 NOS, Old Age.38.21 .36 .07.04 .01 Alcoholic Pois..85.33 .00 .08.22 .11 Alcohol.11.03 .00 .02.12 .09 Infectious1.331.24 6.30 5.10.40 1.82 Degenerative6.205.45 4.08 4.085.16 4.42 Total18.6315.03 14.99 16.1713.87 14.86 Females Infectious Dis..25.30 1.43 1.17.13 .43 Neoplasm1.211.20 .78 .811.34 1.23 Circulatory2.481.92 1.89 2.171.66 2.22 Infect. Resp..51.49 4.20 3.33.08 .99 Other Resp..21.21 .28 .53.21 .20 Accidents1.511.01 .53 .891.16 1.21 Homicide/S uicide.53.35 .04 .17.36 .32 Other Classified.81.70 1.33 1.25.71 1.91 Congen./Perinatal.88.74 .64 .951.02 1.22 NOS, Old Age.18.11 .42 .06.07 .02 Alcoholic Pois..26.08 .00 .02.05 .05 Alcohol.03.01 .00 .00.03 .07 Infectious.76.79 5.63 4.50.21 1.43 Degenerative3.703.12 2.67 2.983.00 3.45 Total8.587.04 11.56 11.346.74 9.76 NOS = not otherwise specified.
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From page 174... ...
174 MORTALITY IN THE NEW INDEPENDENT STATES: PATTERNS AND IMPACTS TABLE 5-6a Years of Life Lost by Broad Cause-of-Death Category, NIS Countries, 1979 and 1989 (Total Population) Russia Ukraine Lithuania Moldova Azerbaijan Males, 1989 Infectious Dis..44.40.24.53 1.o / Neoplasm2.222.201.981.94 1.44 Circulatory3.423.093.092.56 3.27 Respiratory.85.77.461.43 3.38 External4.343.524.003.68 1.61 Other2.232.261.843.27 3.06 Total13.4912.2411.6213.42 14.42 Males, 1979 Infectious Dis..76.64.471.34 1.86 Neoplasm1.981.831.861.33 1.58 Circulatory3.573.272.612.88 3.08 Respiratory1.911.641.133.78 6.03 External5.723.884.864.19 2.28 Other2.182.412.333.80 3.72 Total16.1213.6813.2617.31 18.56 Females, 1989 Infectious Dis..20.17.10.35 1.15 Neoplasm1.351.381.401.31 .90 Circulatory1.791.731.472.01 1.95 Respiratory.45.38.18.89 3.05 External1.05.891.011.25 .54 Other1.621.631.602.79 2.38 Total6.466.175.768.58 9.95 Females, 1979 Infectious Dis..43.34.231.03 Neoplasm1.341.311.351.10 Circulatory1.981.971.392.42 Respiratory1.19.98.723.01 External1.36.911.071.56 Other1.631.671.703.20 Total7.937.176.4612.32 14.04
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From page 176... ...
176 MORTALITY IN THE NEW INDEPENDENT STATES: PATTERNS AND IMPACTS TABLE 5-6b Years of Life Lost by Broad Cause-of-Death Category, NIS Countries, 1979 and 1989 (Urban Population) Russia Ukraine Lithuania Moldova Azerbaija Males, 1989 Infectious Dis..39.37.24.441.42 Neoplasm2.262.221.962.061.60 Circulatory3.463.133.092.593.59 Respiratory.67.60.321.011.91 External3.873.113.162.821.68 Other2.292.301.853.053.49 Total12.9511.7310.6111.9613.70 Males, 1979 Infectious Dis..70.60.371.141.92 Neoplasm2.101.962.011.711.77 Circulatory3.613.292.742.873.55 Respiratory1.581.38.792.213.81 External5.043.483.973.342.31 Other2.292.522.243.913.84 Total15.3213.2312.1215.1817.20 Females, 1989 Infectious Dis..16.14.09.25.86 Neoplasm1.421.481.441.45.98 Circulatory1.751.701.391.692.00 Respiratory.34.28.12.491.56 External.95.79.80.92.49 Other1.661.681.532.322.39 Total6.276.075.377.128.29 Females, 1979 Infectious Dis..41.35.18.811.39 Neoplasm1.451.461.431.361.18 Circulatory1.961.971.352.012.16 Respiratory.95.81.481.493.42 External1.18.84.861.13.98 Other1.691.761.672.862.81 Total7.637.195.999.6711.95
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From page 178... ...
178 MORTALITY IN THE NEW INDEPENDENT STATES: PATTERNS AND IMPACTS TABLE 5-6c Years of Life Lost by Broad Cause-of-Death Category, NIS Countries, 1979 and 1989 (Rural Population) Russia Ukraine Lithuania Moldova Azerbaija Males, 1989 Infectious Dis..57.47.24.61 1.89 Neoplasm2.122.192.021.89 1.23 Circulatory3.343.063.142.53 2.85 Respiratory1.261.05.691.77 4.82 External5.664.465.924.59 1.49 Other2.092.191.863.48 2.71 Total15.0313.4213.8714.86 14.99 Males, 1979 Infectious Dis..87.71.651.45 1.81 Neoplasm1.741.691.711.15 1.35 Circulatory3.493.262.502.87 2.48 Respiratory2.602.021.604.65 8.10 External7.414.636.444.76 2.16 Other1.972.262.543.73 3.59 Total18.0814.5715.4418.60 19.49 Females, 1989 Infectious Dis..30.22.13.43 1.43 Neoplasm1.201.241.341.23 .78 Circulatory1.921.801.662.22 1.89 Respiratory.70.56.291.20 4.49 External1.361.121.521.54 .57 Other1.551.591.793.15 2.39 Total7.046.536.749.76 11.56 Females, 1979 Infectious Dis..49.34.331.15 1.35 Neoplasm1.151.141.25.98 .77 Circulatory2.062.001.432.61 1.63 Respiratory1.711.231.133.83 6.99 External1.801.031.481.83 1.51 Other1.541.561.803.41 3.54 Total8.767.307.4213.82 15.79
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From page 180... ...
Perhaps the most obvious aspect of the mortality profiles of the former Soviet countries is their diversity. In the Southern Tier countries examined in this analysis, Azerbaijan and the Central Asian republics, there remains substantial progress to be made in combatting diseases of infectious character.
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From page 181... ...
Silver 1986 Infant mortality in the Soviet Union: Regional differences and measurement issues. Population and Development Review 12(4)
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From page 182... ...
2. For example, the formula used by Goskomstat in calculating infant mortality rates corresponds better to the annual probability of dying in the first year of life than does the practice of our own National Center for Health Statistics of dividing deaths under age 1 in a given calendar year by births in the same period.
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From page 183... ...
With advancing age, the urban mortality rates increase in greater measure than the rural rates, so that by the early 30s, the urban rates exceed the corresponding rural rates; this situation persists over the remainder of the age range. Thanks to the rural-urban fertility differential, the proportions urban in Azerbaijan's population increase with age, so that the national average mortality schedule weights the rural and urban subdivisions most heavily at precisely the ages at which their mortality rates exceed those of their counterparts.
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