Noncommunicable Disease Mortality in the Russian Federation: From Legislation to Policy

By Levintova, Marya; Novotny, Thomas | Bulletin of the World Health Organization, November 2004 | Go to article overview
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Noncommunicable Disease Mortality in the Russian Federation: From Legislation to Policy


Levintova, Marya, Novotny, Thomas, Bulletin of the World Health Organization


Resume

Mortalite par maladies non transmissibles dans la Federation de Russie : de la legislation a la politique

Les transitions politiques, sociales et economiques qui se sont operees en Europe de l'Est et dans la Federation de Russie sous l'effet du changement de regime entre la fin des annees 1980 et le debut des annees 1990 ont conduit a une augmentation brutale de la mortalite dans l'ensemble de la region, avec plus de 80 % des deces imputables a des causes pouvant faire l'objet d'une prevention, telles que les maladies cardiovasculaires, les facteurs lies au mode de vie et les traumatismes. La Federation de Russie a vecu certains des plus forts declins de population enregistres dans le monde. Des reformes de la sante ont ete mises en oeuvre a l'echelle du pays, mais elles continuent a ignorer l'impact de l'epidemie de maladies non transmissibles (MNT) dans la Federation. Face a ces maladies, seul un engagement plus large de groupes non gouvernementaux organises au sein de la societe civile, beneficiant d'un fort soutien de la legislation federale, pourrait ameliorer les schemas de mortalite russes. L'article examine la Iegislation federale actuelle se rapportant la prevention eta la mattrise des MNT a la lumiere de la crise de mortalite vecue a ce jour et propose des reponses politiques possibles a cette crise.

Resumen

La mortalidad por enfermedades no transmisibles en la Federation de Rusia: de la legislation a la politica

Las transiciones politica, social y economica que trajeron consigo los cambios de regimen en Europa oriental y la Federacion de Rusia entre finales de los anos ochenta y principios de los noventa produjeron un aumento subito de la mortalidad en toda la region; mas del 80% de esas defunciones son atribuibles a causas prevenibles, como las enfermedades cardiovasculares, factores relacionados con el modo de vida y los traumatismos. La Federacion de Rusia ha sufrido una de las disminuciones de poblacion mas marcadas registradas en el mundo. Aunque se han implementado reformas sanitarias en todo el pais, estas siguen ignorando el impacto de la epidemia de enfermedades no transmisibles (ENT) en la Federacion de Rusia. Solo sera posible mejorar las pautas de mortalidad en este pais si se Iogra una participacion amplia de grupos no gubernamentales organizados dentro de la sociedad civil, con el solido respaldo de una legislacion federal contra las ENT. Examinamos la legislacion de la Federacion de Rusia relacionada con la prevencion y el control de las ENT a la luz de la actual crisis de mortalidad, y sugerimos posibles respuestas de politica ante esa crisis.

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Introduction

The mortality crisis in the Russian Federation

There is a growing global awareness about the extensive negative effects of the economic, political and social upheaval that has occurred in the Russian Federation over the past two decades. The changes in demography of this powerful country (e.g. the rise in adult mortality and the decline in life expectancy; Fig. 1 and Fig. 2) pose serious dangers to the stability and future of the Russian Federation within the broader international community (1, 2). Some estimations of the extent of this crisis suggest that the population of the Russian Federation will decline to half of its current level by 2050 (3).

[FIGURES 1-2 OMITTED]

These population changes are mainly due to mortality from preventable causes, such as NCDs (including cardiovascular disease and certain neoplasms), alcohol abuse, road traffic accidents, and intentional and unintentional injuries (4, 5). Although life expectancy in the region has fluctuated over the past 40 years, marked declines occurred following the collapse of the Soviet Union in 1991 and the economic collapse in 1998 (Fig. 1). The life expectancy of adult males fell between 1987 and 1994 by 7.4 years to 57.5 years, rose to 61.

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