1. Public Health
and
Health Care in Russia
Rotary Club Meeting
Moscow University
Boris Denisov
Lab of Population Economics and Demography
May 12, 2014

2. I will talk on:
● How important is health
● Changes in a health metric
● Few words on alcohol addiction
● Could you trust the fgures published in
Russia
● Estimate Russian health care system

3. UN Health Definition
WHO (1946)
Health is a state of complete physical, mental, and
social well-being and not merely the absence of
disease or infirmity

4. Determinants of Health, WHO(2003)
● Social gradients
● Stress (including stress in the workplace)
● Early childhood development
● Social exclusion
● Unemployment
● Social support networks
● Addiction
● Availability of healthy food
● Availability of healthy transportation

5. Health Care
● Personal
● Familial
● Social
● State/Gov-t > MoH

6. The United Nations in April released some of the
results of what is thought to be its largest global
survey ever, part of a worldwide initiative called
MyWorld2015.
People from all around the world were asked
which six factors, out of 16 possibilities, would
improve their lives and those of their
families.
http://data.myworld2015.org/?

10. The UN definition is hardly operational,
most widely used health metric
is
life expectancy at birth
despite it is a measure of mortality

11. Life expectancy at birth, males, selected countries
(WB estimates)
1960 1970 1980 1990 2000 2010
50
55
60
65
70
75
80
Белоруссия Германия Нидерланды
Польша Республика Корея Россия
Сербия * США Украина
Финляндия Швейцария Швеция
Эстония Япония

13. Selected LT indicators 1897-2010, Russia
1897 1926 1956 1986 2010 2010-1897
females
Life expectance at birth: 31.69 45.61 70.43 74.25 74.79 43.10
LE at age 15 45.17 51.64 52.22 61.03 60.60 15.43
LE at age 49 21.14 25.25 29.25 28.83 29.22 8.08
Survival probabilities: from 0 to 15 0.51188 0.67603 0.93337 0.97601 0.98900 0.47712
From 0 to 49 0.37166 0.54831 0.86904 0.93209 0.92534 0.55368
From 15 to 49 0.72607 0.81107 0.93108 0.95500 0.93563 0.20956
males
Life expectance at birth: 29.43 40.23 61.99 64.78 62.95 33.52
LE at age 15 44.46 46.68 52.22 51.97 48.83 4.37
LE at age 49 20.33 21.07 23.29 22.44 21.20 0.87
Survival probabilities: from 0 to 15 0.48041 0.64299 0.91991 0.96616 0.98557 0.50516
From 0 to 49 0.34447 0.48796 0.79068 0.83938 0.79490 0.45043
From 15 to 49 0.71703 0.75889 0.85952 0.86878 0.80654 0.08951

14. Selected LT indicators 1897-2010, Russia
1897 1926 1956 1986 2010 2010-1897
females
Life expectance at birth: 31.69 45.61 70.43 74.25 74.79 43.10
LE at age 15 45.17 51.64 52.22 61.03 60.60 15.43
LE at age 49 21.14 25.25 29.25 28.83 29.22 8.08
Survival probabilities: from 0 to 15 0.51188 0.67603 0.93337 0.97601 0.98900 0.47712
From 0 to 49 0.37166 0.54831 0.86904 0.93209 0.92534 0.55368
From 15 to 49 0.72607 0.81107 0.93108 0.95500 0.93563 0.20956
males
Life expectance at birth: 29.43 40.23 61.99 64.78 62.95 33.52
LE at age 15 44.46 46.68 52.22 51.97 48.83 4.37
LE at age 49 20.33 21.07 23.29 22.44 21.20 0.87
Survival probabilities: from 0 to 15 0.48041 0.64299 0.91991 0.96616 0.98557 0.50516
From 0 to 49 0.34447 0.48796 0.79068 0.83938 0.79490 0.45043
From 15 to 49 0.71703 0.75889 0.85952 0.86878 0.80654 0.08951

15. Addiction
Two slides from Prof. V. Vlassov, head of Russian
section of Cochrane Collaboration, presentation at
Gorbachev Foundation
Cochrane Collaboration (cochrane.org) – is a global
independent network of health practitioners, researchers,
patient advocates and others, responding to the challenge
of making the vast amounts of evidence generated
through research useful for informing decisions about
health.

16. 0
10
20
30
40
50
60
1965 1975 1985 1995 2005
Deathrateper100,000
60
62
64
66
68
70
72
Lifeexpectancy,years
Life expectancy
Alcohol poisoning
per 100,000
R= - 0.94
Source : VM Shkolnikov

18. Despite no visible progress in survival and
health Russia has pretty well system of
health and demographic observations.
But it has some tricks.

19. HIV prevalence
Number of persons with positive immune blot test for HIV
antibodies:
2010 2011 2012
persons 503 724 564 710 613 243
per 100 000 352,6 395,0 428,2
Prevalence is the proportion of a population found to have a
condition, typically a disease or a risk factor such as smoking or
seat-belt use.

20. Different states have different priorities

21. Finally, in not only my opinion:
● Unlike health itself health care system
in Russia degrades
● It needs reform
● Reform is hardly likely within current
framework
● The are some positive signs at an
individual level

22. The End

23. Q&A Now
To continue
denisov@demography.ru or
http://boris-denisov.blogspot.com/
https://www.facebook.com/boris.denisov