Disparities in Health: Equity Aspects of Avoidable Mortality
Authors/Creators
- 1. IDR FCTAS RAS, Moscow, Russia
Description
Health inequity, that is socially determined, and preventable disparities in health, hinders the advancement of life expectancy. In Russia, which has witnessed the collapse of a social system rooted in the principles of social equality in a remarkably brief historical period, both the topic itself and the search for methods to investigate it are of utmost importance. The purpose of the study is to evaluate the manifestations of health inequity through the lens of their social dependence and preventability in terms of avoidable mortality.
Material and methods. The calculation of avoidable mortality is based on the cause classification in ages under 65, proposed by Walter W. Holland in 1993. The analysis was conducted using data for the period between 2000 and 2019.The subsequent period is marked by turbulence. The study used official data provided by Rosstat as its information base. Standardized mortality rates for preventable death causes were calculated using the direct method (European standard population).
Results. The disparity in life expectancy between urban and rural populations, as well as its regional variations, is largely attributable to avoidable mortality. The example of a substantial reduction in the rural-urban gap in avoidable mortality over the first two decades of the 21st century, including a convergence in treatable deaths, suggests that significant progress has been made in addressing health disparities between urban and rural populations within a remarkably short timeframe.
In terms of regional disparities, progress is minimal. The economically prosperous regions of the country have much greater potential for improving the life expectancy of their populations by reducing preventable deaths, compared to poorer regions. In both cases, priority should be given to prevention interventions aimed at lifestyle modification, as the social component of avoidable mortality dominates, and interventions aimed at reducing it are the most cost-effective strategy.
Files
POPECON_article_160866.pdf
Files
(706.2 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:2ca4d9766066045ee950af44aa80cdd1
|
569.5 kB | Preview Download |
|
md5:5cf2dc94993e9cbf58f609be9598dd47
|
136.7 kB | Preview Download |
Additional details
References
- Andreev EM (1979) Prodolzhitel'nost' zhizni v SSSR: differentsial'nyy analiz [Life expectancy in the USSR: differential analysis]. In: Andreev EM, Vishnevsky AG (Eds) Prodolzhitel'nost' zhizni: analiz i modelirovanie [Lifespan: Analysis and Modeling]. Statistika, Moscow, 7-31 (In Russian).
- Andreev EM, Dobrovolskaya VM (1993) Socio-cultural differences in mortality in Russia. Healthcare of the Russian Federation. N 9, pp. 18-21 (In Russian).
- Andreev EM, Kharkova TL, Shkolnikov VM (2005a) Changes in mortality in Russia as related to employment and character of work. Population 3(29): 68-81 (In Russian).
- Andreev EM, Kvasha EA (2005) Infant mortality in various educational groups in the late 1980s and early 1990s. Demoscope Weekly No 201-202 (In Russian).
- Andreev EM, Shkolnikov VM (2018) The relationship between mortality and economic development in Russia and its regions. Demographic Review 5(1): 6-24 (In Russian). https://doi.org/10.17323/demreview.v5i1.7707.
- Andreev EM, Shkolnikov VM, Jasilionis D, Antonova OI (2005b) Striking widening of the educational mortality gap in Russia in the 1990s: components and impact on mortality of the total population. Conference on "Health and Demography in the Former Soviet Union", Harvard University, Davis Center for Russian and Eurasian Studies and the Weatherhead Center for International Affairs, 29-30 April, 2005.
- Arcaya MC, Arcaya AL, Subramanian SV (2015) Inequalities in health: definitions, concepts, and theories. Global Health Action 8(1). https://doi.org/10.3402/gha.v8.27106.
- Bartley M, Ferrie JE, Montgomery SM (2005) Health and labour market disadvantage: unemployment, non-employment, and job insecurity. In: Marmot M, Wilkinson RG (Eds) Social determinants of health, 2 ed. Oxford University Press, Oxford, 78–96. https://doi.org/10.1093/acprof:oso/9780198565895.003.05.
- Bor J, Cohen GH, Galea S (2017) Population health in an era of rising income inequality: USA, 1980–2015. The Lancet 389(10077): 1475–1490. https://doi.org/10.1016/S0140-6736(17)30571-8.
- Conti G, Heckman JJ (2010) Understanding the early origins of the education–health gradient: A framework that can also be applied to analyze gene–environment interactions. Perspectives on Psychological Science 5(5): 585–605. https://doi.org/10.1177/1745691610383502.
- Danilova IA (2018) Regional'nyi analiz smertnosti po prichinam smerti v Rossii [Regional analysis of mortality by causes of death in Russia]. PhD thesis, Мoscow: HSE (In Russian).
- Davis-Kean PE, Tighe LA, Waters NE (2021) The role of parent educational attainment in parenting and children's development. Current Directions in Psychological Science 30(2): 186–192. https://doi.org/10.1177/0963721421993116.
- Demographic development of Russia in the 21st century (2009) Osipova VG, Rybakovskiy LL (Eds). Ekon-Inform, Moscow, 340 pp. (In Russian)
- Demographic present and future of Russia (2012) Kolbanov VF, Rybakovskiy LL (Eds). Ekon-Inform, Moscow, 81-136 (In Russian).
- Fasang AE, Mayer KU (2020) Lifecourse and social inequality. In: Falkingham J, Evandrou M, Vlachantoni A (Eds) Handbook on demographic change and the lifecourse. Edward Elgar Publishing, Cheltenham, UK, 22–39. https://doi.org/10.4337/9781788974875.00009.
- Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G (2006) Indicators of socioeconomic position (part 1). Journal of Epidemiology & Community Health 60(1): 7–12. https://doi.org/10.1136/jech.2004.023531.
- Holland WW (1993) European Community atlas of «avoidable deaths». 2nd edn. Volume II. Commission of the European Communities Health Services Research Series 9. Oxford University Press, Oxford.
- Inequality and mortality in Russia (2000) Shkolnikov VM, Andreev EV, Maleva TM (Eds). Carnegie Moscow Center. М.: Signal, p. 123 (In Russian).
- Ivanova AE (2022) Approaches to assessing reserves to reduce mortality in Russia. Living standards of the population in the regions of Russia 18(2): 177–188 (In Russian). https://doi.org/10.19181/lsprr.2022.18.2.3.
- Ivanova AE, Zemlyanova EV, Mikhaylov AYu, Golovenkin SE (2014) The differences in mortality of adult population of Russia according level of education. Healthcare of the Russian Federation 58(2): 4-8 (In Russian).
- Kawachi I, Subramanian SV, Almeida-Filho N (2002) A glossary for health inequalities. Journal of Epidemiology & Community Health 56(9): 647–52. https://doi.org/10.1136/jech.56.9.647.
- Kislitsyna OA (2017) Socio-economic inequality in health: trends and hypotheses. Social Aspects of Population Health 2(54): 1. https://doi.org/10.21045/2071-5021-2017-54-2-1 (In Russian).
- Krieger N (2012) Who and what is a «population»? Historical debates, current controversies, and implications for understanding «population health» and rectifying health inequities. The Milbank Quarterly 90(4): 634–81. https://doi.org/10.1111/j.1468-0009.2012.00678.x.
- McCartney G, Popham F, McMaster R, Cumbers A (2019) Defining health and health inequalities. Public Health 172: 22–30. https://doi.org/10.1016/j.puhe.2019.03.023.
- Mortensen LH, Diderichsen F, Smith GD, Andersen AM (2009) The social gradient in birthweight at term: quantification of the mediating role of maternal smoking and body mass index. Human Reproduction 24(10): 2629–35. https://doi.org/10.1093/humrep/dep211.
- Nolte E, McKee M (2004) Does healthcare save lives? Avoidable mortality revisited. London: The Nuffield Trust, 139 pp.
- Razvitie chelovecheskogo potentsiala v Rossii skvoz' prizmu zdorov'ya naseleniya [Human potential development in Russia through the prism of public health] (2012) Starodubov VI, Ivanova AE (Eds). Litera, Moscow (In Russian).
- Rodionova LA, Kopnova ED (2020) Gender and regional differences in the life expectancy in Russia. Voprosy Statistiki 27(1): 106-120 (In Russian). https://doi.org/10.34023/2313-6383-2020-27-1-106-120.
- Rybakovsky LL, Kozhevnikova NI (2015) Eastward vector of the demographic development of Russia. Population 1(67): 4-16 (In Russian).
- Shkolnikov VM (1987) Geograficheskie faktory prodolzhitel'nosti zhizni [Geographical factors of life expectancy]. Izvestiya Akademii nauk SSSR. Seriya Geograficheskaya [Proceedings of the USSR Academy of Sciences. Geographical Series] 3: 35-44 (In Russian).
- Smith GD (2011) Epidemiology, epigenetics and the 'Gloomy Prospect': embracing randomness in population health research and practice. International Journal of Epidemiology 40(3): 537–62. https://doi.org/10.1093/ije/dyr117.
- Starodubov VI, Ivanova AE, Semyonova VG, Kondrakova EV, Evdokushkina GN (2003) Mortality trends in Russia in the 1980s and 1990s (a regional level). Healthcare of the Russian Federation 4: 23-27 (In Russian).
- Timonin SA, Danilova IA, Andreev EM, Shkolnikov VM (2017) Recent mortality trend reversal in Russia: are regions following the same tempo? European Journal Population 33: 733–763. https://doi.org/10.1007/s10680-017-9451-3.
- Yanos PT, Czaja SJ, Widom CS (2010) A prospective examination of service use by abused and neglected children followed up into adulthood. Psychiatric Services 61(8): 796–802. https://doi.org/10.1176/ps.2010.61.8.796.
- Zdorov'e naseleniya Rossii v social'nom kontekste 90-kh godov: problemy i perspektivy [The health of the Russian population in the social context of the 90s: problems and prospects] (2003) Starodubov VI (Ed). Medicine, Moscow, 287 pp. (In Russian).