La crise sanitaire en Russie. II. Évolution des causes de décès: comparaison avec la France et l'Angleterre (1970-1993)

Shkolnikov (Vladimir), Meslé (France), Vallin (Jacques). - Health Crisis in Russia:!. Recent Trends in Life Expectancy and Causes of Death from 1970 to 1993. Since the mid-1960s, the trend of life expentancy at birth in Russia has differed from those of the majority of other Western populations. Until the beginning of the 1980s, life expectancy of women has remained unchanged, andthat of men has declined. Some progress was made following the anti-alcohol campaign launched by Gorbachev in 1985, but it proved to be ephemeral. After 1987, the fall in life expectancy continued for both sexes, and even accelerated in 1993. The decline is not affected by correcting the level of infant mortality which has been underestimated, because the negative trend is linked mainly to a rise in adult mortality rates, particularly among men. Unpublished data on causes of death have made it possible to construct time series for the period from 1970 to 1993 for deaths classified into the 185 causes in the Soviet Classification of Causes of death. Increases in the prevalence of cardio-vascular diseases which the health system was unable to treat have contributed to the long-term negative trend. Deaths from violence were responsible for fluctuations towards the end of the 1980s. Finally, the recent fall in life expectancy in 1993 applies to deaths from all causes and is undoubtedly related to the economic crisis in that year which contributed to the disorganization of the health system.