What Russians are dying from

Prepared by Ekaterina Shutova 

For what reasons Russians most often die and in which country people live the longest, in his lecture on "Gazeta.Ru" said Vasily Vlasov, MD, Professor at the Higher School of Economics, President of the interregional public organization "Society of Evidence–Based Medicine Specialists".

Since this is quite common, and this does not distinguish our country from the rest of the world, we usually turn to what makes us different. We often talk about violent deaths and deaths from alcohol poisoning in young and middle age, especially among men. But these are not the main reasons for the death of Russians.

That is why the main efforts to reduce mortality are directed to the obvious – to the main cause of mortality, that is, mortality from heart and vascular diseases. Alas, narrowly focused actions are ineffective and are not economically justified. It is in the kitchen that you can selectively paint the ceiling – it is cheap and the effect is noticeable. In order to reduce the mortality rate, it is necessary to increase the general well-being of the people, their living conditions. This is the method that has worked in developed countries.

Russians still too often (in comparison with citizens of prosperous countries) die at a young and middle age. The peak occurs at 50-65 years (at this age, most Russians die).

Women live longer. The reason for this phenomenon is unclear all over the world, but it is known that the longer and better people live, the smaller the difference between male and female mortality (although in countries where they live very short, men and women die at about the same age). In Russia, the difference between male and female mortality was, alas, great.

Why do women live longer? The hypothesis is this: before menopause, women are protected from diseases by their hormones. But there is another hypothesis: women, including in Russia, tend to be less aggressive, less self-destructive behavior. 

At the beginning of 2014, I predicted a period of a new increase in mortality in our country in 2014+ years. I really hope that the increase in mortality that has begun will be shallow and short-lived. The more "normal" in the "Western" sense our life will be, the longer we will live. This is the main pattern. If we have a "normality" like in Sharia or in the USSR, then, unfortunately, everything will go downhill again.

Since 1964, the mortality rate has stopped decreasing, and a modern type of high mortality has begun to form. It is high because of reasons that are no longer associated with traditional diseases - primarily infectious and killing a quarter of people in early childhood, and the rest – mostly before the age of 40. In developed countries since the middle of the XX century, and in most transition countries, including China, an "epidemiological transition" has been taking place since the end of the century. This means that people no longer die en masse from infections and do not die in great numbers in childhood. 

The structure of mortality in our country looks like in a "western" country, but people are dying in large numbers. The reasons for this are not entirely clear, but the most plausible explanations are dirty, dangerous environment, poor quality of products, their shortage, poor nutrition, poor housing conditions, dangerous production. Crime. Suicides. We really still have a lot of deaths from homicides and suicides. It is not surprising that at the same time people drink a lot and die a lot simply from vodka poisoning.How can we increase life expectancy in Russia?

The vector set by the English and French Revolutions is the only means known to mankind. And Japan has become a country of long life to the extent that it has mastered this vector of change. Only by changing people's lives according to this type – safety, the quality of the environment, nutrition, confidence in the future, reducing the level of violence – state and criminal – it is possible to ensure that people live a long and healthy, happy life.

People live the longest in Japan, Spain, Australia, Switzerland, Italy and Singapore. They live the least in countries such as Somalia, Nigeria, Mali, and Uganda.

This is most likely determined by the migration of more active young people to the capital and higher incomes. Many things, including housing conditions, are better in Moscow than in most of the country.

But it is difficult to compare regions. Some of them are known for their unreliable statistics. For example, the North Caucasus is known for false births and distorted death data. This tradition has come to us since Soviet times – during the USSR there was a fictitious "Caucasian longevity", used to promote the "achievements of socialism". 

Some of the Russian regions have a high mortality rate due to the fact that the old population lives in these regions.

A person tries to "treat" himself in bizarre ways. For example, bossy people believe that if you do not report suicides, then people will not kill themselves. This is nonsense, of course.

People practice murderous smoking, because the death of smokers does not come immediately after smoking, but after years, as if in a natural way. It is impossible to notice with the human eye that one dies at 50, and the other at 60. If smokers died at the age of 20, the situation would change. Then death from smoking would become noticeable.

It is important that risks can be avoided in various ways, but they are not obvious either to others or to successful people themselves. So, it's hard to explain why some drivers on the roads never get into accidents. Even the police don't stop them. It is impossible to categorically assert that those who stayed to swim in Egypt after the terrorist attack risk their lives more than those who abandoned everything and fled the country. Aircraft crashes are often reported, but cars are rarely reported. About pedestrians who died under the wheels – even less often. In Soviet times, information about accidents and catastrophes was classified, and elderly people now think that after the collapse of the USSR, life has become more dangerous.

People are limited in their ability to understand their lives. That is why it is important that they have equal opportunities to receive a minimum income, disability assistance, quality medical care – even if these people are not smart enough to lead a healthy lifestyle. It's very difficult. Scientists who give recommendations about a healthy lifestyle have limited knowledge so far. As a result, even the basic dietary recommendations are approximate, and some of the scientific recommendations are recognized as erroneous after 10-20 years.Hence another conclusion: it is necessary to finance medical science in order to understand people's health and learn how to preserve it.

For example, despite the recommendations of the World Health Organization, there are no surveys of the health status of the population in our country, and we do not know how well Russians eat, what kind of food they lack. The lack of scientific knowledge about the nutrition of our people is being replaced by the import of foreign problems, for example, hatred of McDonald's, although it has nothing to do with the nutrition of the vast majority of Russians.

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24.11.2015