Regional Differences in Life Expectancy in Russia Through the Lens of Epidemiological Transition

An immense territory of Russia with several climatic zones and, accordingly, a fundamentally different styles of life, inevitably results in pronounced varieties in the levels and structure of mortality across the regions of the country. Since the scale and sustainability of differences in mortality in Russia can be considered an entire epidemiological epoch, the evaluation of them through the lens of epidemiological transition seems methodologically appropriate. Regional differences are regarded as a kind of projection of evolution in time, though taking into account modern realities. The analysis of regional differences in mortality is based on such indicators as life expectancy, structure of mortality, i.e., predominantly endogenous to exogenous causes of death ratio, as well as the average age of death from predominantly endogenous causes calculated on the basis of life tables by cause of death. The study showed that according to the periodization of epidemiological transition only Moscow and St. Petersburg are at the final phase of the 3rd stage and are moving to the 4th stage of epidemiological development. Meanwhile, the burden of exogenous and preventable pathologies precludes the completion of the 3rd stage in the regions with high life expectancy according to Russian criteria. The stadial nature of epidemiologic development of Russian regions is currently conditioned by socio-economic and medical determinants, with more pressing medical determinants in regions with high and medium levels of life expectancy and socio-economic factors prevailing in regions with low life expectancy.