State of Russia in the surrounding world. Analytical book 

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Health of the Russian population

Prokhorov B.B.

The quality of population health convincingly reflects the living standards and serves as an indicator of adaptation of a certain groups to their environment.

Certain idea about the quality of public health in our country can be obtained by comparing the data of medical statistics in Russia and in the USA. It shows that infant mortality 2 times, total standardized male mortality 1.55 times and female mortality 1.35 times, male mortality from malignant tumors 1.27 times, male mortality from circulatory system diseases 1.87 times and female mortality 1.98 times, mortality from traumas and poisonings in males 1.85 times and in females 1.65 times higher in Russia than in the USA. Especially drastic contrast is observed in male mortality from tuberculosis. In Russia this value is 17 times higher. Again, in Russia mortality from hepatitis 7.5 times, from dysentery 12.5 times, and from tuberculosis 4.2 times higher than those in the States. These data reflect noticeably worse public health in Russia in comparison with that in the USA, even though the USA is not a world leader in the public health.
The dynamics of public health quality allows us to estimate the average total life expectancy. In 1965 average life expectancy in Russia was lower than that in the USA by only less than 3 years. In 1989 this value was 8.3 years for men and 4.2 for women. Possibly, it was related to the general economic stability of the society, social security of the population, and well-developed health care system. Later the situation in Russia sharply deteriorated. In 1997 spread in life expectancy between USA and Russia was 12 years in males and 6 years in females that may also be explained by social causes of the temporal character.

In last 7 years (from 1990 to 1996) certain changes occurred in distribution of reasons that make people seek medical assistance. Total disease rate gradually grew until 1995. In 1990 it was 651.2 cases per 1000 adults and it reached 678.8 in 1995. Total disease rate decreased by 4.5% in 1996 in comparison with that in 1995. During this period, the number of visits to physicians related to most common diseases of respiratory organs decreased almost by 10%. The proportion of these diseases in the total number of diseases was 41,1% in 1996 and 51.6% in 1990. Number of visits to health care providers related to the diseases of respiratory organs started to decline starting with 1992. This trend was accompanied by a peculiar substitution of common respiratory pathologies by other, mostly more severe forms. For example, in the period from 1990 to 1996, number of registered incidents of blood pathologies and circulatory disorders grew by 2.2 times. Number of diseases of urinary and reproductive systems as well as number of endocrine diseases and metabolic disorders increased almost by 1.6 times; number of diseases of the nervous system and sense organs increased by 31.8%. Number of cancer patients constantly increases. During last 7 years their number increased by 27%. The growth of heart and coronary pathology incidents continued and number of people seeking medical help because of these diseases increased by 25% during this period. One of the alarming indicators of social and epidemiological problems in the country is the growth of number of tuberculosis incidents starting with 1992. During last seven years the number of registered incidents increased by 98.5% and in 1996 the their rate was 67.5 per 100 thousand that correspond to the level of 1972.

In Russia number of sexually transmitted diseases grows threateningly fast. In 1990 7800 syphilis incidents was recorded, in 1994 the number increased to 121000 cases, in 1995 to 255 000 cases, and in 1996 it reached 376 000 cases. The rate of the syphilis per 100 thousand was 5.3 in 1990, 81.7 in 1994, 172.1 in 1995, and 254.2 in 1996.

Like in many other countries, AIDS is a special problem in Russia. Unfortunately, the prognosis of epidemiologists was supported and distribution of the human immunodeficiency virus (HIV) continues very fast. In 1995 only 195 HIV-infected people were detected in Russia, in 1996 this number grew to 1535, and in 1997 it reached 3853.

The reaction of population to the social and economic events related to drastic changes in political and economical life in Russia in nineties may be estimated as a social stress. Indicators of population health for 19921994 show that the most important deterioration of public health occurred during this time period.

Groups of population most vulnerable psychologically and economically do not withstand the problems, that results in serious coronary diseases, growth of alcoholism rate, and suicides. Crash of banks and financial pyramids is accompanied by infarcts, suicides, conflicts among criminal groups with lethal outcomes, etc. Sociological studies conducted in Moscow showed that the level of individual stress increased sharply in the

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