DOCSLIB.ORG

World Bank Document

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
World Bank Document DYING TOO YOUNG Public Disclosure Authorized Addressing Premature Mortality and Ill Health Due to Non-Communicable Diseases Injuries in the Russian Federation THE POOR HEALTH STATUS of Russia’s economically active adult population—its human capital—challenges sustainable economic growth and social development. President Vladimir Putin, in his annual address to the Federal Assembly of the Russian Federation in May 2004 and more recently in the State-of-the-Nation Address on April 25, 2005, DYING TOO YOUNG criticized the failure of health care reform to produce significant results, as evidenced by Russia’s lagging behind many countries in key health Public Disclosure Authorized indicators. Life expectancy in Russia at 66 years, he noted, is 12 years Addressing Premature Mortality and less than it is in the United States, 8 years less than in Poland, and 5 years less than in China—a situation President Putin attributed to Ill Health Due to Non-Communicable Diseases “the high death rate in the working-age population.” and Injuries in the Russian Federation Dying Too Young aims to heighten understanding of the nature and characteristics of non communicable diseases and injuries as the leading killers in the Russian Federation, its associated risk factors, and their Public Disclosure Authorized social and economic implications. The study outlines specific options and offers recommendations for addressing this problem, and projects the health and economic gains that could result from a comprehensive program of action. Improving adult health would contribute to improved health status of the population, quality of life, labor productivity and sustainable economic growth in the country. Public Disclosure Authorized Europe and Central Asia Human Development Department The World Bank DYING TOO YOUNG Addressing Premature Mortality and Ill Health Due to Non-Communicable Diseases and Injuries in the Russian Federation Europe and Central Asia Region Human Development Department Russia Country Management Unit The World Bank TABLE OF CONTENTS Preface ............................................................................................................................................ ix Acknowledgments .......................................................................................................................... xi Abbreviations .................................................................................................................................. xii EXECUTIVE SUMMARY .................................................................................................................. xiii The Demographic Decline and the Health Deficit .......................................................................... xiii Determinants of the Demographic Decline and the Health Deficit ................................................ xv What Are The Consequences Of The Demographic Decline And The Health Deficit?.................. xviii What Strategies and Interventions Prevent Non-Communicable Diseases and Injuries? .................. xx Is Russia Doing Enough to Confront Non-Communicable Diseases and Injuries? ........................ xxi What Additional Actions Can Russia Take? .................................................................................... xxi What Health Improvements Could Result From an Intensified Program of Action? ...................... xxii What Are the Potential Economic Benefits of Mortality Reduction In Russia?................................ xxii Conclusion ...................................................................................................................................... xxiii Chapter 1. The Demographic Decline and the Health Deficit................................................ 1 A Framework for Understanding the Demographic and Health Conditions in Russia .................. 1 The Shrinking of the Russian Population ........................................................................................ 2 Declining Fertility Rates .................................................................................................................. 4 High Mortality Rates ........................................................................................................................ 7 Mortality among Population Groups................................................................................................ 7 Life Expectancy and Economic Development ................................................................................ 10 Impact of Life Expectancy on Human Development ...................................................................... 13 Population Migration........................................................................................................................ 13 The Aging of the Population............................................................................................................ 14 Total Dependency Ratios ................................................................................................................ 15 What Are the Consequences of the Demographic Decline and the Health Deficit?...................... 15 Chapter 2. The Burden of Ill Health and Disability .................................................................. 19 Healthy Life Expectancy.................................................................................................................. 19 Comparison of Disability Levels...................................................................................................... 20 Policy Implications .......................................................................................................................... 21 Chapter 3. Determinants of the Demographic Decline and the Health Deficit ................ 25 Deaths and DALYs Lost Attributable to Leading Causes .............................................................. 25 The Leading Individual Causes of Death........................................................................................ 27 Policy Implications .......................................................................................................................... 32 Chapter 4. What Are the Major Risk Factors for NCDs and Injuries? ................................ 35 Major Individual Health Risk Factors .............................................................................................. 35 Interaction among Risk Factors ...................................................................................................... 44 Policy Implications .......................................................................................................................... 45 iii Chapter 5. The Impact of NCDs and Injuries on Health Care Costs.................................... 49 Study Method .................................................................................................................................. 49 Results ............................................................................................................................................ 50 Policy Implications .......................................................................................................................... 51 Chapter 6. How Do NCDs and Injuries Affect the Russian Economy? .............................. 55 Conceptual Framework .................................................................................................................. 55 What Effect has Adult Ill Health had on the Economic Outcome of the Population? .................... 56 Policy Implications .......................................................................................................................... 61 Chapter 7. What Strategies and Interventions Prevent NCDs and Injuries? .................... 65 International Evidence on Effective Interventions to Control Individual Risk-Factors Associated with the Onset of NCDs and Injuries............................................................................ 67 The Government’s Role in Disease Prevention .............................................................................. 70 Role of Private Employers .............................................................................................................. 70 Chapter 8. How Is Russia Responding to NCDs and Injuries? ............................................ 73 Recent Organizational Reforms ...................................................................................................... 73 The Legal Framework for Action Against NCDs and Injuries ........................................................ 74 Institutional Weaknesses in Preventing and Controlling NCDs ...................................................... 76 What Are the Main Problems? ........................................................................................................ 76 Some Good Practices in Russia...................................................................................................... 77 Steps to Advance NCD Prevention and Control Efforts.................................................................. 80 Policy Implications .......................................................................................................................... 80 Chapter 9. What Additional Actions Can Russia Take?.......................................................... 83 The Rationale for a Comprehensive Program ...............................................................................
Load more

Recommended publications
  • Russia's Peacetime Demographic Crisis
    the national bureau of asian research nbr project report | may 2010 russia’s peacetime demographic crisis: Dimensions, Causes, Implications By Nicholas Eberstadt ++ The NBR Project Report provides access to current research on special topics conducted by the world’s leading experts in Asian affairs. The views expressed in these reports are those of the authors and do not necessarily reflect the views of other NBR research associates or institutions that support NBR. The National Bureau of Asian Research is a nonprofit, nonpartisan research institution dedicated to informing and strengthening policy. NBR conducts advanced independent research on strategic, political, economic, globalization, health, and energy issues affecting U.S. relations with Asia. Drawing upon an extensive network of the world’s leading specialists and leveraging the latest technology, NBR bridges the academic, business, and policy arenas. The institution disseminates its research through briefings, publications, conferences, Congressional testimony, and email forums, and by collaborating with leading institutions worldwide. NBR also provides exceptional internship opportunities to graduate and undergraduate students for the purpose of attracting and training the next generation of Asia specialists. NBR was started in 1989 with a major grant from the Henry M. Jackson Foundation. Funding for NBR’s research and publications comes from foundations, corporations, individuals, the U.S. government, and from NBR itself. NBR does not conduct proprietary or classified research. The organization undertakes contract work for government and private-sector organizations only when NBR can maintain the right to publish findings from such work. To download issues of the NBR publications, please visit the NBR website http://www.nbr.org.
    [Show full text]
  • Russia's Emerging Global Health Leadership
    a report of the csis russia and eurasia program and the csis global health policy center Russia’s Emerging Global Health Leadership 1800 K Street, NW | Washington, DC 20006 Tel: (202) 887-0200 | Fax: (202) 775-3199 Editor E-mail: [email protected] | Web: www.csis.org Judyth Twigg Authors Alexei Bobrik Jenilee Guebert Julia Komagaeva Denis V. Korepanov Judyth Twigg April 2012 CHARTING our future Blank a report of the csis russia and eurasia program and the csis global health policy center Russia’s Emerging Global Health Leadership Editor Judyth Twigg Authors Alexei Bobrik Jenilee Guebert Julia Komagaeva Denis V. Korepanov Judyth Twigg April 2012 CHARTING our future About CSIS—50th Anniversary Year For 50 years, the Center for Strategic and International Studies (CSIS) has developed practical solutions to the world’s greatest challenges. As we celebrate this milestone, CSIS scholars continue to provide strategic insights and bipartisan policy solutions to help decisionmakers chart a course toward a better world. CSIS is a bipartisan, nonprofit organization headquartered in Washington, D.C. The Center’s 220 full-time staff and large network of affiliated scholars conduct research and analysis and de- velop policy initiatives that look into the future and anticipate change. Since 1962, CSIS has been dedicated to finding ways to sustain American prominence and prosperity as a force for good in the world. After 50 years, CSIS has become one of the world’s pre- eminent international policy institutions focused on defense and security; regional stability; and transnational challenges ranging from energy and climate to global development and economic integration.
    [Show full text]
  • Policy Pathways to Health in the Russian Federation
    IR-04-021 / June 2004 Policy Pathways to Health in the Russian Federation Edited by Landis MacKellar, Elena Andriouchina, and David Horlacher IIASA Policy Pathways to Health in the Russian Federation Edited by Landis MacKellar, Elena Andriouchina, and David Horlacher IR-04-021 June 2004 Interim Reports on work of the International Institute for Applied Systems Analysis receive only limited review. Views or opinions expressed herein do not necessarily represent those of the Institute, its National Member Organizations, or other organizations supporting the work. International Institute for Applied Systems Analysis – Laxenburg, Austria Telephone: +43 2236 807 – Telefax: +43 2236 71313 – Web: www.iiasa.ac.at Contents 1. Introduction ............................................................................................................... 1 2. Welcoming.................................................................................................................. 4 Welcoming remarks, Landis MacKellar ...................................................................... 4 Welcoming remarks, Natalia Rimashevskaya.............................................................. 6 3. Workshop Proceedings ........................................................................................... 10 Issues Overview, Landis MacKellar .......................................................................... 11 Russian Mortality Fluctuations since 1980, David A. Leon ....................................... 28 Health Care Provision and Financing,
    [Show full text]
  • Health Systems in Transition: Learning from Experience
    Cain and Lessof Figueras, McKee, Health systems in transition: learning from experience The period following the break-up of the Soviet Union has brought enormous political and socioeconomic change to the European Region. The health sector has not been spared the effects of transition, and the countries emerging from the process have each engaged to varying degrees in health system reform. It is at last possible to reach some judgement about how this process has unfolded, to identify successes Health systems in transition: and failures, and to understand better the scale and nature of the Health systems in remaining challenges. This book draws on the experience and lessons learned in the Region over the past ten years of transition in key health systems areas, such as health care fi nancing, the restructuring of hospitals, public health, gains in health system quality, fostering citizens’ rights and mobilizing communities for health. It serves as a transition: valuable resource for policy-makers, academics and donor institutions working in the Region. learning from experience The editors Josep Figueras is Head of the Secretariat and Research Director of the European Observatory on Health Systems and Policies and Head of the WHO European Centre for Health Policy as well as visiting professor at the London School of Hygiene & Tropical Medicine. Martin McKee is Research Director of the European Observatory on Health Systems and Policies and Professor of European Public Health at the London School of Hygiene & Tropical Medicine as well as Co-Director of the School’s European Centre on Health Societies in Transition. Edited by Jennifer Cain is Project Offi cer for the European Observatory on Health learning from experience Systems and Policies.
    [Show full text]
  • Mental Health Indicators in Russia
    STAKESIN RAPORTTEJA 13 / 2007 OLGA SAKHAROVA, ISAAC GUROVICH, KRISTIAN WAHLBECK Mental Health Indicators in Russia A Study of the Availability of European Indicators for the MINDFUL Project Sosiaali- ja terveysalan tutkimus- ja kehittämiskeskus postimyynti: Stakes / Asiakaspalvelut PL 220, 00531 Helsinki puhelin: (09) 3967 2190, (09) 3967 2308 (automaatti) faksi: (09) 3967 2450 • Internet: www.stakes.fi This paper arises from the MINDFUL project, which has received funding from the European Union, in the framework of the Public Health Programme (Grant N:o 2003119). © Authors and STAKES Layout: Christine Strid ISBN 978-951-33-2025-6 (soft cover) ISSN 1236-0740 (soft cover) ISBN 978-951-33-2026-3 (PDF) ISSN 1795-8210 (PDF) STAKES, Helsinki 2007 Valopaino Oy Helsinki 2007 Mental Health Indicators in Russia Foreword The current study is the first attempt to compare mental health indicator data from the Russian Federation with data from the EU Member States. The study indicates that data availability in the Russian federation is on a comparable level with availability in the EU Member States, and that international comparisons are feasible. Mental health is becoming an extremely important resource in society. Developing information societies and the form of production specific to them requires actors with various mental capabilities, such as creativity, innovativeness and inventiveness, as well an ability to learn and produce new information. Flexibility and an ability to have an impact are also required. Given that mental disorders currently impact significantly on the resources of communities through both state budgets and the financial potential of individual families, the approach to the future should engage in a policy of mental health promotion and disorder prevention.
    [Show full text]
  • Socioeconomic Inequalities in Health and Health Care Access in Central and Eastern Europe and the CIS: a Review of the Recent Literature
    W WHO European Office for Investment for Health and Development Working paper 2005/1 Socioeconomic inequalities in health and health care access in central and eastern Europe and the CIS: a review of the recent literature Sarah Walters University of Cambridge Marc Suhrcke WHO European Office for Investment for Health and Development November 2005 ABSTRACT: Since 1989 countries in eastern Europe and the former Soviet Union have experienced a period of rising income inequality and structural change in health and social security systems. Concerns have arisen that inequalities in health may have accompanied these reforms. In light of this, the main purpose of this report is to assess socioeconomic inequalities in health and health care access in the region. We review studies published between 2001-2005 that examined the association between socioeconomic status and health and health care access over the period of transition across the region. We focus primarily on morbidity and mortality from noncommunicable disease because this has become the main burden of ill-health in the region. The studies present overwhelming evidence that socioeconomic inequalities in health exist in the region and that the poor are disadvantaged in terms of self-rated health status, mortality, noncommunicable disease, health behaviours and access to health care. Where data are available there is also evidence that the trend in inequality in health and in health care access rose over the course of economic transition. There are significant gaps in the literature and in the data sources for research on this topic in central and eastern Europe and the CIS. These include a shortage of longitudinal data that would facilitate monitoring of trends and a shortage of standardized data collection instruments that would facilitate cross-country comparative research.
    [Show full text]
  • Trends in Health Systems in the Former Soviet Countries
    Cover_WHO_nr35_Mise en page 1 7/10/14 09:30 Page 1 35 After the break-up of the Soviet Union in 1991, the countries that emerged from it faced myriad TRENDS IN HEALTH SYSTEMS IN THE FORMER SOVIET COUNTRIES SOVIET THE FORMER IN SYSTEMS TRENDS IN HEALTH challenges, including the need to reorganize the organization, financing and provision of health and Martin McKee Erica Richardson Bernd Rechel, services. Over two decades later, this book analyses the progress that twelve of these countries Trends in health 35 (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan) have made in reforming their health systems. systems in the former Building on the health system reviews of the European Observatory on Health Systems and Policies Observatory Observatory (the HiT series), it illustrates the benefits of international comparisons of health systems, Soviet countries Studies Series describing the often markedly different paths taken and evaluating the consequences of these choices. This book will be an important resource for those with an interest in health systems and policies Edited by in the post-Soviet countries, but also for those interested in health systems in general. It will be Bernd Rechel of particular use to governments in central and eastern Europe and the former Soviet countries Erica Richardson (and those advising them), to international and non-governmental organizations active in the Martin McKee region, and to researchers of health systems and policies. The authors Bernd Rechel is Researcher at the European Observatory on Health Systems and Policies and Honorary Senior Lecturer at the London School of Hygiene &Tropical Medicine, United Kingdom.
    [Show full text]
  • The Demise of Russian Health Capital: the Continuity of Ineffective Government Policy
    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS THE DEMISE OF RUSSIAN HEALTH CAPITAL: THE CONTINUITY OF INEFFECTIVE GOVERNMENT POLICY by Jarad L. Van Wagoner March 2007 Thesis Advisor: Anne L. Clunan Thesis Co-Advisor: Robert E. Looney Approved for public release; distribution unlimited THIS PAGE INTENTIONALLY LEFT BLANK REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED March 2007 Master’s Thesis 4. TITLE AND SUBTITLE The Demise of Russian Health Capital: The Continuity 5. FUNDING NUMBERS of Ineffective Government Policy 6. AUTHOR Jarad L. Van Wagoner 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Naval Postgraduate School REPORT NUMBER Monterey, CA 93943-5000 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSORING/MONITORING N/A AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the author and do not reflect the official policy or position of the Department of Defense or the U.S.
    [Show full text]
  • Indigenous Peoples' Access to Health Services
    Indigenous Peoples’ United Nations access to Health Services state of the world’s indigenous peoples Indigenous Peoples’ access to Health Services United Nations State of the World’s Indigenous Peoples DESA The Department of Economic and Social Affairs of the United Nations is a vital interface between global policies in the economic, social and environmental spheres and national action. The De- partment works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic, social and environmental data and information on which Member States of the United Nations draw to review common problems and to take stock of policy options; (ii) it facilitates the negotiations of Member States in many intergovernmental bodies on joint course of action to address ongoing or emerging global challenges; and (iii) it advises interested Govern- ments on ways and means of translating policy frameworks developed in United Nations confer- ences and summits into programmes at the country level and, through technical assistance, helps build national capacities. Note The views expressed in this publication do not necessarily reflect those of the United Nations. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country or territory or of its authorities, or concerning the de- limitations of its frontiers. The designations of country groups in the text and the tables are intended solely for statistical or analytical convenience and do not necessarily express a judgement about the stage reached by a particular country or area in the development process.
    [Show full text]
  • HIV/AIDS in Eastern Europe and Central Asia
    HIV/AIDS in Eastern Europe and Central Asia HIV/AIDS in Eastern Europe and Central Asia Ulla Pape Subject: Groups and Identities, Policy, Administration, and Bureaucracy, Political Sociology Online Publication Date: Aug 2019 DOI: 10.1093/acrefore/9780190228637.013.1314 Summary and Keywords Eastern Europe and Central Asia (EECA) is the only region in the world where annual HIV infection rates continue to grow. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), in 2019 approximately 1.4 million people in the region were living with HIV. The main factors that have contributed to the spread of the epidemic over the past two decades include injecting drug use, the stigmatization and marginalization of vulnerable groups, the increasing spread of HIV into the general population, and the lack of evidence-based prevention and treatment programs necessary for controlling the epi­ demic. Limited access to life-saving antiretroviral treatment has intensified the impact of the epidemic in EECA and increased mortality rates among people living with HIV (PLWH). In the post-Soviet space, Russia is experiencing by far the biggest HIV/AIDS epidemic. This can be attributed largely to the government’s failure to introduce evidence-based prevention measures for vulnerable groups, e.g., harm reduction programs, which are recommended by international health organizations. Other countries in the region have been more pragmatic in their approach and introduced harm reductions programs on a broader scale. In Ukraine, the efforts to combat HIV, which led to an initial stabilization of the epidemic in 2012, have been endangered by the military conflict in the eastern part of the country and subsequent internal displacement, which has increased HIV vulnerability.
    [Show full text]
  • The 2010 Europe & Eurasia Health Vulnerability Analysis
    THE 2010 EUROPE & EURASIA HEALTH VULNERABILITY ANALYSIS SIXTH REPORT | MARCH 2010 Table of Contents Acknowledgments . 5 Acronyms. 7 Executive Summary . 9 Introduction. 12 Methodology . 14 Health Vulnerability Index . 17 Population Growth and Fertility . 21 Life Expectancy. 25 Adult Mortality . 28 Under-5 Mortality . 33 Tuberculosis. 35 HIV/AIDS. 40 Health Expenditures. 44 Conclusions: Health Vulnerabilities in the E&E Region . 49 References . 55 Annexes . 59 A. Health Vulnerability Index Indicator Selection . .59 B. Regional Vulnerability and Indicator Maps . .60 C. Country Radar Graphs for E&E Countries and EU-27 . .64 The 2010 Europe and Eurasia Health Vulnerability Analysis 3 4 The 2010 Europe and Eurasia Health Vulnerability Analysis Acknowledgments The Bureau for Europe and Eurasia (E&E) Health Team would like to acknowledge the following USAID staff whose input was invaluable to the production of The 2010 Europe and Eurasia Health Vulnerability Analysis: Sandra Bird, Susanna Baker, Lyndsey Garcia, Carolyn Mohan, Samantha Huffman, Jessica Forrest, Forest Duncan, Paul Holmes, and other E&E Bureau staff.We would also like to thank the summer interns Patricia High, Stacey Brilliant,Amy Bates, Ramona Carey, Lauren Smith, and Sarah Guagliardo, whose excellent work on the E&E health vulnerability analyses in years past continues to contribute to our annual analysis of the region. This year’s report was a collaborative effort. Soumya Alva, Eckhard Kleinau, and Kathy Rowan from the Analysis, Information Management & Communications (AIM) Activity and summer interns Yireh Rivera Mercado and Eliseo Rodriguez were the primary analysts and authors.A very special thank you goes out to Susanna Baker, Lyndsey Garcia, and Paul Holmes, who supervised the team and provided invaluable input throughout the process.
    [Show full text]