Years of Life Lost due to Premature Mortality in Russia, 1990-2021

Abstract

According to the Global Burden of Disease, in Russia in 2019, the standardised rate of years of life lost from premature mortality reached its lowest value since the early 1990s. Still, it was 1.5 and 1.3 times higher than the similar rates for men and women in the WHO European Region. The authors sought to trace the evolution of the structural characteristics of years of life lost in Russia from 1990 to 2021 and identify the factors that led to such a significant gap in the level of losses from premature mortality. Estimates of the absolute number of years of life lost (YLL), age-specific (AYLL) and age-standardised rates (ES1976) of years of life lost (SYLL) for each sex were made based on Rosstat data for 1990-2021 on the distribution of deaths by sex, by five-year age groups (0, 1-4, 5-9...85+), and causes of death (statistical form C-51). A table for life expectancy at birth at 92.6 years was used as a standard life table. Redistribution of garbage codes of causes of death and correction for polymorbidity were not performed. Estimates of years of life lost are comparable to WHO estimates for Russia in absolute values by sex and age, while only partially so by causes of death. From 1990-2019, SYLL declined in both sexes, by a quarter. In 2019, SYLL for men was 374 per 1,000, 2.3 higher than that for women. Increased losses during the COVID-19 pandemic levelled up these gains. The maximum inequality in years of life lost for both sexes was characteristic of external causes of death (ECD) and respiratory diseases (RD), while the minimum, of neoplasms (NP). From 1990 to 2021, SYLL declined in both sexes from CD, NP, ECD, and RD. In the pre-pandemic period, there was an increase in losses from digestive diseases (DD), infectious diseases (ID) and a group of all other classes of causes of death. The approach we used enabled us to focus more on causes of death with a low standardised death rate (SDR), such as HIV, liver disease, and pancreatic conditions. While these causes contribute less to the SDR, deaths from them typically occur at a younger age, thus raising the total number of years of life lost. The analysis allowed us to reevaluate the impact of COVID-19, accountable for 1/7 and 1/5 of all years of life lost for men and women in 2021, respectively. Therefore, if women’s life expectancy decline was more significant than men’s, the SYLL for men during both years of the pandemic was higher than that for women.