Research Article |
Corresponding author: Anastasiya I. Pyankova ( apyankova@hse.ru ) © 2024 Anastasiya I. Pyankova, Timur A. Fattakhov, Mikhail B. Denisenko.
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation:
Pyankova AI, Fattakhov TA, Denisenko MB (2024) Years of Life Lost due to Premature Mortality in Russia, 1990-2021. Population and Economics 8(4):92-122. https://doi.org/10.3897/popecon.8.e112749
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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.
premature mortality, years of life lost, COVID-19, causes of death, WHO Global Health Estimates, burden of diseases
In 1947, American epidemiologist Mary Dempsey introduced Potential Years of Life Lost (PYLL) as a measure of premature mortality from tuberculosis [Dempsey, 1947]. Potential years of life lost or, as it is sometimes referred to in the Russian-language literature, ‘premature years of life lost’, is calculated as the sum of deaths in each age group multiplied by the number of years that members of the group did not live to reach a specific cut-off age, after which death is no longer considered premature. In general terms, the formula for calculating PYLL is as follows:
(Formula 1)
where: x – age of death or midpoint of the age group; k – lower cut-off age of ‘premature deaths’; L – upper cut-off age of ‘premature deaths’; dx – the number of deaths at age x.
To estimate the years of potential life lost, it is first necessary to address the question: What age is the cut-off, after which all deaths are considered premature? Researchers determine the cut-off age of premature death based on current and projected mortality dynamics and research objectives. There is no consensus in practice regarding the cut-off age for premature death: Eurostat sets it at 70, and the OECD at 75 (as of 2019). Depending on practical objectives, premature deaths can be calculated starting from birth, or over age 15, or for persons of working or reproductive age. In 1948, Thomas Greville, in his review of M. Dempsey’s paper, proposed an alternative way of calculating ‘potential years of life lost’. As weights for those who died at a certain age, the life expectancy corresponding to this age will be used from the standard life table [Greville, 1948]. In this case, Formula 1 can be re-written as follows:
(Formula 2)
where: Ex – life expectancy of those surviving to age x, k – lower cut-off age of ‘premature deaths’; L – upper cut-off age of ‘premature deaths’, dx – the number of deaths at age x.
Then W. Haenszel proposed to calculate standardised values to allow a correct comparison of populations with different age-sex structures [Haenszel, 1950].
However, the selected cut-off age is arbitrary, making it difficult to compare results across studies. Meanwhile, the ‘potential years of life lost’ (PYLL) has been widely used and implemented in public health statistics in many countries, including the USA [National Center for Health Statistics, 2017], Canada [Statistics Canada, 2022], European Union member states, and the Organisation for Economic Co-operation and Development [OECD, 2022].
In the early 1990s, a response to this situation was provided by the Global Burden of Disease (hereafter GBD) project, which estimated a modified indicator, Years of Life Lost (YLL), that does not use the upper and lower cut-off age for ‘premature mortality’. The lower cut-off age equals 0, and the upper one equals the top age in the standard life table. In general, the formula for calculating YLL can be written as follows:
(Formula 3)
where: Ex – life expectancy of those surviving to age x, ω – top age in the standard life table, dx – the number of deaths at age x.
In the first 1990 GBD estimates, the standard life table for men and women differed. For women, a table was adopted with the highest life expectancy at birth, which at that time was 82.5 years for Japanese women, and for men, with a life expectancy at birth of 80 years. The 2010 revision used a unified life table with life expectancy at birth equal to 86 years for both sexes. The GBD project is currently being implemented by the Institute for Health Metrics and Evaluation (hereafter GBD IHME). Its guidelines only describe the principle of generating a standardlife table – using the lowest observed age-sex-specific death rates for territories with a population of more than five million inhabitants in 2016 – but the resulting table is not provided. It is also not given in the next edition of 2024, only mentioning that the principle of its generation has been retained.
Since the early 2010s, the World Health Organisation (hereafter WHO) has sought to collaborate on population health estimates with the GBD IHME. However, estimates of years of life lost due to premature mortality published by the two organisations differ, sometimes significantly. Their complex relationship has been described in detail in [Mathers, 2020]. Since 2017, IHME has used its own population estimates and age-specific fertility rates [Schumacher et al., 2024], which differ from those of the UN Population Division and, by extension, from the WHO Global Health Estimates (hereafter GHE WHO). Within its framework, WHO uses a different standard life table, also subject to periodic revision in response to changes in projected life expectancy in the UN population projections. In the 2013 revision, WHO used a table with a maximum projected life expectancy of 91.9 years by 2050 [World Health Organisation, 2013]. The subsequent revisions specified that the standard life table is based on the lowest age-specific death rates projected by 2045-2050 in a country and proposed a life table with life expectancy of 89.9 years [World Health Organisation, 2020], while the most recent revision used a life table with life expectancy at birth of 92.6 years [World Health Organisation, 2024]. Whenever the UN population projections are updated, so will the standard life table used in the Global Health Estimates and published as part of the revised guidelines, which will require a recalculation of past estimates.
The main difference between WHO and IHME in their approaches to the standard life table is that WHO uses the lowest projected age-specific death rates, whereas IHME uses observed age-specific death rates. Another difference is that, unlike the IHME, the WHO publishes an abridged standard life table, which allows the results to be reproduced
As a result, WHO and IHME estimate the burden of premature mortality for all countries based on ‘years of life lost’ (YLL), whereas national estimates could be based on different methodological approaches (parametric or non-parametric) and indicators (YLL or PYLL). An important purpose of its use is to fully assess losses from various causes of death. ‘Years of life lost’, being one possible measure of the ‘burden’ [Rubo, Czuppon, 2023], that society bears because of premature deaths, is easily integrated into health planning systems, and helps translate mortality losses into economic losses [Gökler, Metintaş, 2022;
In this paper, the authors aimed to trace the evolution of the structural characteristics of years of life lost in Russia from 1990 to 2021. They sought to identify those contributing to the significant gap in premature mortality losses between Russia and the WHO European Region. Additionally, the authors aimed to highlight the importance of national estimates by comparing their findings with estimates produced by international organizations, such as the Global Burden of Diseases (GBD) by the Institute for Health Metrics and Evaluation (IHME) and the Global Health Estimates (GHE) by the World Health Organization (WHO).
In the context of ‘years of life lost’ indicators, the significance of deaths at younger ages is greater than that of deaths at older ages, when compared to the classical mortality measures. Therefore, the contribution of younger ages to the resulting value of this indicator is greater than, for example, to life expectancy or standardised death rates (SDR), where no weights per se are assigned to ages. The earlier the death, the greater the number of years of life lost prematurely.
The high value of the rate(s) of years of life lost for the infant age group compared to the age-specific death rates is a notable observation (Fig.
Age-specific years of life lost and death rates per 1,000 men and women, Russia, 2019. Source: authors’ calculations based on the data described in the “Methods and data” section.
Since deaths at younger ages are considered more significant in estimating years of life lost than those at older ages, the proportion of causes of death with a lower mean age of death (such as external causes, digestive diseases, and infectious diseases) is higher in SYLL compared to the SDR (Table
Structure of age-standardised years of life lost (SYLL) and death rates (SDR) by major causes of death classes , Russia, 2019, %
Men | Women | |||
SYLL | SDR | SYLL | SDR | |
All causes | 100 | 100 | 100 | 100 |
Circulatory diseases | 38.1 | 44.2 | 36.6 | 45.8 |
External causes of death | 17.6 | 11.3 | 9.3 | 5.1 |
Neoplasms | 16.2 | 17.5 | 20.9 | 17.6 |
Other classes of causes of death | 13.4 | 14.6 | 18.9 | 21.5 |
Digestive diseases | 6.7 | 5.6 | 7.7 | 5.9 |
Respiratory diseases | 4.3 | 4.5 | 2.6 | 2.2 |
Infectious diseases | 3.8 | 2.3 | 3.9 | 1.9 |
Notably, in women, the proportion of neoplasms in the SYLL structure is higher than the share of this cause in the SDR, indicating greater premature loss. ‘Years of life lost’ allows us to address and adapt the health system’s priorities in a slightly different way.
There are two measures for estimating the burden of disease due to premature mortality: years of potential life lost (represented by Formula 1 or Formula 2) and years of life lost (represented by Formula 3). This has led to some confusion in terminology within the Russian research community. Presumably several studies have taken the revised 2010 GBD methodology, which uses a standard life table with life expectancy at birth of 86 years for Japanese women, in terms of ‘years of potential life lost’ [
In those Russian studies where PYLL was estimated, the cut-off age for premature mortality varied. In some of them, the retirement age was chosen as the cut-off age [
Only a few studies have been identified using ‘years of life lost’ (YLL) and standard life table with a life expectancy at birth of 86 years [Tulenkov, 2015] or 91.9 years [Pyankova, Fattakhov, 2017; Fattakhov, Mironova, 2021]. However, these studies focus either on a specific cause of death (road traffic accidents), a particular region (Arkhangelsk Oblast), or specific population group (estimation of years of life lost of women in custody). Their results are difficult to compare in the Russian context, much less internationally.
The cut-off age for determining premature mortality may vary using the “years of potential life lost” measure based on Formula 1. In contrast, Formula 2 considers the cut-off age of premature mortality alongside the standard life table. When estimating “years of life lost,” only the standard life table may change. To show the possible range of estimates both according to the approach chosen and within one of those, namely, the standard life table, we estimated YLL due to premature mortality based on years of potential life lost (Formula 1) and years of life lost (Formula 3) and using two standard life tables for Russia for 2021 (Table
The number of years of life lost (YLL) and years of potential life lost (PYLL) across all causes of death and from ischaemic heart disease (IHD) using different standard life tables, Russia, 2021, million person-years
Both sexes | Men | Women | ||||
Total | incl. IHD | Total | incl. IHD | Total | incl. IHD | |
2021 (Life table with life expectancy and сut-off age for premature mortality = 89.99) | ||||||
YLL | 53.2 | 9.2 | 30.3 | 5.3 | 22.9 | 3.87 |
PYLL | 47.0 | 7.75 | 28.0 | 4.8 | 19.0 | 2.95 |
YLL/PYLL | 1.13 | 1.19 | 1.08 | 1.11 | 1.20 | 1.31 |
2021 (Life table with life expectancy and cut-off age for premature mortality = 92.65) | ||||||
YLL | 57.1 | 9.9 | 32.5 | 5.7 | 24.6 | 4.2 |
PYLL | 53.4 | 9.1 | 31.0 | 5.4 | 22.4 | 3.6 |
YLL/PYLL | 1.07 | 1.09 | 1.05 | 1.06 | 1.10 | 1.14 |
First, the number of years of life lost (YLL) are higher than the years of potential life lost, as illustrated by the YLL/PYLL ratio, which is everywhere greater than 1 in Table
The greater the differentiation of the subject of study, the greater the variation in estimates depending on the selected measure and its varying parameters. A minimum variation in years of life lost estimates is among men from all causes of death, while the maximum variation is among women from IHD .
In summary, the presented range of estimates indicates that the results are sensitive to the selection of the measure and its varying parameters and, consequently, the importance of their explicit description.
Annual absolute number (YLL), age-specific (AYLL) and standardised rates of years of life lost (SYLL) were calculated by sex and cause of death for Russia from 1990 to 2021 using the following formulas:
Absolute number of years of life lost,
(Formula 4)
Age − specific years of life lost rate,
(Formula 5)
Age standardised years of life lost rate,
(Formula 6)
where D (c,s,x,t) – number of deaths from a specific cause c at age x of the sex s in year t; E (x) – life expectancy at age x from the standard life table; N (s,x,t) – population size of sex s, at age x in year t; S (x) – proportions of relevant age groups in the total population taken as the standard (1976 European standard for the age-sex structure of the population).
The standard life table used was from WHO’s Global Health Estimates project, with a life expectancy at birth of 92.6 years [World Health Organisation, 2024] (Table
Calculations are based on Rosstat data for 1990-2021 on the age-sex distribution of deaths by causes of death (statistical form C-51) separately for men and women, by five-year age groups (0, 1-4, 5-9, ..., 85+) for the main causes-of-death classes (circulatory diseases (I00-I99); neoplasms (C00-D48); external causes of morbidity and mortality (V01-Y98); diseases of the respiratory system (J00-J99); diseases of the digestive system (K00-K93); certain infectious and parasitic diseases (A00-B99); COVID-19 (U07,1); other classes of causes of death
In Russia, the total number of years of life lost has been steadily declining for both men and women since 2005, following fluctuations in the 1990s and early 2000s. The 1990 figures were overcome in 2014 for women and in 2016 for men. The decline continued until 2019, when the lowest values were recorded for both sexes, at 43.5 million person-years.
Age groups contributed differently to the changes in the absolute number of years of life lost. From 1990 to 2021, young men experienced a decrease in losses, while those aged 35 and older experienced an increase in the absolute loss (Figure
Age contribution to changes in the years of life lost between different periods for Russian men. Source: authors’ calculations based on the data described in the “Methods and data” section.
Absolute values by age do not indicate the process’s intensity, as the number of deaths in any age group depends on the size of that group.
The estimates of years of life lost in absolute terms are closest to the WHO Global Health Estimates, which exceed the results of this study by 0.5% to 1.6%, depending on sex and year. The proximity of the estimates is probably due to the use of a unified standard life table. This contrasts the estimates by the Institute for Health Metrics and Evaluation (hereinafter IHME
Absolute number of years of life lost due to premature mortality in Russia as estimated by certain organisations, million person-years
1990 | 2000 | 2010 | 2019 | 2021 | |
WHO Global Health Estimates (2024) | |||||
Total | – | 65.93 | 55.83 | 44.00 | 57.80 |
Men | – | 42.13 | 34.64 | 26.54 | 32.79 |
Women | – | 23.80 | 21.19 | 17.47 | 25.01 |
Institute for Health Metrics and Evaluation (2024) | |||||
Total | 45.31 | 62.34 | 54.18 | 41.71 | 55.11 |
Men | 26.76 | 39.46 | 33.55 | 24.83 | 31.03 |
Women | 18.55 | 22.87 | 20.63 | 16.88 | 24.08 |
This study | |||||
Total | 47.80 | 65.17 | 55.47 | 43.47 | 57.08 |
Men | 28.33 | 41.47 | 34.32 | 26.18 | 32.47 |
Women | 19.47 | 23.70 | 21.14 | 17.28 | 24.61 |
When comparing the WHO estimates and the results of this study by age and sex, the following can be noted. In 2000, WHO estimates were higher than ours in most age groups for both men and women, except for the oldest group (70+). By 2021, they were lower for those aged 0 to 30-49 and higher for those aged 50-70+. However, the differences do not exceed 15%, although they increase over time. The IHME estimates for all age groups are lower than our study’s, but not by more than 15%, and only occasionally slightly higher in the 70+ age group (Table
The situation is quite different if we compare the WHO estimates by sex and cause of death with the findings of this study. For some causes of death, such as neoplasms or cerebrovascular diseases, the differences are not large, while for others, the estimates are dramatically different, such as for HIV-related deaths, intentional self-harm, including suicide, and certain other causes among men (Table
As a result, the findings of this study are comparable with the WHO estimates for Russia in terms of absolute values by sex and age, while only partially so by cause of death.
In 2019, the standardised rate of years of life lost for men was 374 per 1,000, which was 2.3 times higher than for women. During 1990 and 2021, the period including the two years of the COVID-19 pandemic, SYLL for men decreased only marginally, by 8%, while for women no positive variation was seen at all (Fig.
0–14 | 15–29 | 30–44 | 45–59 | 60–75 | 75+ | |
Men | ||||||
2021/1990 | 0.3 | 0.6 | 1.0 | 0.9 | 1.0 | 0.9 |
2019/1990 | 0.3 | 0.6 | 1.0 | 0.8 | 0.8 | 0.7 |
2021/2000 | 0.3 | 0.3 | 0.6 | 0.6 | 0.8 | 0.8 |
2019/2000 | 0.3 | 0.3 | 0.6 | 0.5 | 0.6 | 0.7 |
Women | ||||||
2021/1990 | 0.3 | 0.8 | 1.3 | 1.0 | 0.8 | 0.9 |
2019/1990 | 0.3 | 0.7 | 1.2 | 0.8 | 0.7 | 0.8 |
2021/2000 | 0.3 | 0.5 | 0.9 | 0.7 | 0.7 | 0.8 |
2019/2000 | 0.3 | 0.5 | 0.8 | 0.6 | 0.6 | 0.7 |
Dynamics of the age-standardised rate of years of life lost from premature mortality by sex per 1,000 population and their ratio in Russia. Source: authors’ calculations based on the data described in the “Methods and data” section.
Excluding the pandemic period, some improvements can be observed: between 1990 and 2019, there was a 25% and 28% decrease in the SYLL for men and women, respectively (Figure
The level of losses due to premature mortality in Russia varies significantly by sex; in some years (2005-2006), the SYLL for men was 2.6 times higher than for women. However, after the maximum gap in the mid-2000s, there was a convergence of rates between the sexes due to a faster decline in losses among men. A more intense increase in SYLL among women compared to men during the COVID-19 pandemic led to an even greater reduction of the gap. As a result, in 2021, women’s SYLL was 2.1 times lower than men’s.
Before 2019, a decline in age-specific rates of years of life lost was observed in almost all age groups among both men and women; however the intensity of the decline was uneven across ages (Table
Changes of the age profile of years of life lost, per 1,000 population in each age group, Russia. Source: authors’ calculations based on the data described in the “Methods and data” section.
Age-specific rates of years of life lost decreased most intensely in infancy and childhood (0-14 years) among both men and women. The variations in this age group were the most stable. In the group of young adults aged 15-29, the decline was also intense. In 30-44-year-olds, the progress in reducing losses from premature mortality was least significant. Thus, over 1990-2019, AYLL in this age group did not change for men, while for women these even increased relative to 1990. The dynamics of AYLL at ages 45-59 and 60-75 for men and women are similar: the rates for men have decreased by 20% by 2019 in both groups relative to 1990 and by 50% and 40% relative to 2000, respectively; for women, by 30% and 40% relative to 1990, and by 40% in both groups relative to 2000. By 2019, in the oldest age group of men 75+, the age-specific rate(s) declined by 30% relative to both 1990 and 2000; and a comparable decline was observed in women.
However, comparing the variation in age-specific rates of years of life lost, including the years of the COVID-19 pandemic, with the 1990 baseline, we find a backslide in the reduction of losses in the group of young adult men and women (30-44 years). It is most pronounced for the youngest women, as well as for women aged 45-59 years. Comparing with 2000, while excluding the 1990s, there was some progress for men, especially in the 30-44 and 45-59 age group characterised by their riskiest behaviours. For young women aged 30-44, the reduction was small, with rates declining by 10% between 2000 and 2021.
The causes-of-death structure of the SYLL is sex-specific. In 2019, circulatory diseases (hereinafter referred to as CD), external causes of death (hereinafter referred to as ECD) and neoplasms (hereinafter referred to as NP) collectively accounted for 72% of the SYLL in men. For women, the top three causes of death, accounting for 76% of the SYLL, are slightly different: CD, NP, and group of other classes of causes of death. Respiratory (hereafter RD) and digestive (hereafter DD) diseases as well as infectious diseases (hereafter ID) together accounted for 15% of the SYLL for men and 14% for women in 2019 (Table
Age-standardised years of life lost rate by cause of death per 1,000 population, and its structure, 2019
men | % | women | % | men/women | |
All causes | 374 | 100 | 161 | 100 | 2.3 |
Circulatory diseases | 142 | 38 | 59 | 37 | 2.4 |
External causes of death | 66 | 18 | 15 | 9 | 4.4 |
Neoplasms | 61 | 16 | 34 | 21 | 1.8 |
Other classes of causes of death | 50 | 13 | 30 | 19 | 1.6 |
Digestive diseases | 25 | 7 | 12 | 8 | 2.0 |
Respiratory diseases | 16 | 4 | 4 | 3 | 3.7 |
Infectious diseases | 14 | 4 | 6 | 4 | 2.3 |
In 2019, the highest gender inequality in SYLL was observed in external causes of death and respiratory diseases, with male rates exceeding female rates by a factor of 4.4 and 3.7 , respectively. In contrast, the least inequality was found in neoplasms and the ‘all other causes’ group, where male rates were 1.8 and 1.6 times higher than female rates.
Over the entire period, taking into account the years of the COVID-19 pandemic, both sexes saw a reduction in losses from such ‘large’ (in terms of level and contribution to the standardised rates) classes of causes of death as CD, neoplasms, external causes of death, and respiratory diseases. Before the pandemic, the greatest reduction in losses among women was characteristic (in descending order) of RD, external causes of death, CD, only then followed by neoplasms, while among men the least progress in the reduction of losses was achieved from CD.
From 1990-2019, the SYLL declined for both sexes from such ‘large’ (in terms of level and share in the SYLL) classes of causes of death as CD, neoplasms, external causes of death, and respiratory diseases. Before the COVID-19 pandemic, the most significant reduction in SYLL among women occurred (in descending order) from RD, external causes of death, CD, and among men – from RD, external causes of death, neoplasms. Losses among women from neoplasms decreased less intensively, and among men – from CD.
Classification of the major causes of death by the evolution pattern and contribution to the age-standardised years of life lost rate (SYLL) before the pandemic
1990–2019 Evolution | |||||
Men | Women | ||||
Reduction | Growth or slight reduction | Reduction | Growth or slight reduction | ||
Proportion of SYLL, 2019 | Three major causes (>70% of SYLL) | CD, ECD, NP | - | CD, NP | All other classes |
Other causes | RD | All other classes, DD, Infectious | ECD, RD | DD, Infectious |
The pandemic years had a different impact on the long-term trends of SYLL by these causes of death. For example, the pandemic did not interrupt the systematic and steady decline in SYLL from neoplasms; SYLL from external causes of death, which had been declining since the early 2000s, stagnated during the pandemic; SYLL from circulatory diseases, which had also been declining gradually since the early 2000s, went up; and SYLL from respiratory diseases raised sharply.
The greatest years of life lost from premature mortality are caused by circulatory diseases (Fig.
Age-standardised years of life lost rate for men and women, Russia, per 1,000 population. Source: authors’ calculations based on the data described in the “Methods and data” section.
The reduction in neoplasm losses has been persistent (Figure
External causes of death are the second-largest class of causes of death for men and the fourth for women (Figure
Most of the progress in the reduction in premature mortality from respiratory disease occurred between 2003 and 2019, but the COVID-19 pandemic set back mortality rates among women to the level of the early 2000s. The setback among men because of the pandemic did not appear as impressive as among women due to the initially significantly higher loss rates among men. Over 1990-2019, the gender gap in loss rates increased smoothly, peaking in 2005 at 4.1 times, but the apparent reduction was not sustainable. Thus, in 2019, as in the previous 10 years, it remained one of the highest (3.7 times) compared to other major classes of causes of death, excluding external causes.
Over 1990-2019, an increase in losses occurred from such classes of causes of death as digestive diseases, infectious diseases, and other causes-of-death classes (Figure
The only causes-of-death class that showed an increase, albeit wave-like, of losses over the 1990-2021 is that of digestive diseases. The SYLL for this cause for both sexes more than doubled over the period, including the COVID-19 pandemic, when the increase in losses accelerated dramatically. The increase in losses from this class begins at age 30 for both men and women and is characteristic of each subsequent age group. There was a reduction before age 30, but the level of losses before that age was low, which did not affect the SYLL trend. Liver diseases, pancreatic diseases, cholelithiasis and cholecystitis, and peptic ulcer account for 80% of all DD losses. However, they demonstrate both different levels of losses and a variety of trends. Thus, cholelithiasis and peptic ulcer disease have both a low standardised coefficient of years of life lost compared to the other two DD causes, and its steady reduction until 2013, after which there was an upward or stagnant trend. Liver diseases, including alcoholic liver diseases, and pancreatic diseases were characterised by a wave-like increase in losses over 30 years: the SYLL for men increased from 3 to 3.5 times, for women, from 2.5 to 4 times.
Infectious diseases are a noteworthy cause-of-death class, as they show different trends for men and women. Men, for example, experienced a sharp increase in the SYLL until 1999, after which there was first an unstable and then an increasingly pronounced decline, including during the pandemic. Whereas for women, a steady SYLL increase began after 1999 and continued until 2017, after which its reduction began, extending, as in men, through the pandemic period. However, underlying these dynamics are asynchronous variations in the two major causes of death in this class, HIV, and tuberculosis. From 1990 to 2005, the SYLL from tuberculosis increased for men and especially for women, with the increasing by 2.6 and 4.5, respectively. After 2005, there was a steady reduction in losses from this cause of death. However, from 2000, the standardised rates of years of life lost to HIV for both sexes began to grow exponentially, peaking in 2018. Thus, the driver of the increase in losses among women was the growing HIV epidemic, with a low level of losses from tuberculosis. In contrast, the driver of the decrease in losses for men was an intense reduction in losses from tuberculosis starting from a very high level (Table
The group comprised of other causes of death is a heterogeneous one (see Footnote 3 for its composition), which includes all other 13 causes of death apart from the six major ones and COVID-19. In 2019, this group of causes of death ranked third in terms of proportion of the standardised rates of years of life lost for women, ahead of external causes of death, and fourth for men. For women, there was a gradual reduction in the rate of loss from this group from 1994; for men, it started later, from 2003. The reduction continued until 2011, when the trend reversed, accelerating after 2014. Concerns about the origins of the increase in mortality from causes within this group were raised by researchers earlier [Andreev, 2016; Vasin, 2015]. However, the COVID-19 pandemic introduced a dramatic change in the dynamics of losses from this group of causes, when the rates of years of life lost increased dramatically among both men and women (Fig.
Losses from premature mortality because of COVID-19 in the first year of the pandemic in men were 25.3 person-years per 1,000 men and in women, 13.5 person-years per 1,000 women; in the second year it increased by a factor of 2.6 and 3.6, respectively. In 2021, losses from COVID-19 in men were high (66 person-years per 1,000) and comparable to those from the entire class of external causes of death. However, in terms of the structure, they accounted for 1/7 of all years of life lost among men. Among women, COVID-19 losses were lower (49 person-years per 1,000) than among men, but they accounted for 1/5 of all years of life lost by women in 2021, which was comparable to the sum of losses from the two classes of causes of death, neoplasms and external causes of death.
One limitation of this study that affects its methodological comparability with the WHO and IHME estimates is the different approach to the redistribution of deaths coded with ‘garbage’ codes for cause of death. The WHO and IHME estimates involve the redistribution of deaths from this group of causes by meaningful causes of death. The list of ‘garbage’ codes for causes of death used by these organisations and the approach to allocating their numbers to other headings differ. In the context of GBD estimates, the list of ‘garbage’ codes of causes of death is subdivided into four levels according to the degree of their impact on the quality of mortality statistics by cause and the possibility of their more accurate attribution to the cause of death of a higher taxonomic level. In Russia, it is estimated that the proportion of deaths from major ‘garbage’ codes of causes of death (levels 1 and 2) increased from 8% in 1990 to 15% in 2017 [Abbafati et al., 2020]. In our study, there was no redistribution of deaths that were assigned a cause-of-death code that could be considered poorly defined or ‘garbage,’ which may affect the estimates of losses by cause of death. Given the negative upward trend in the proportion of these causes of death, their role is expected to increase.
The poor quality of estimates for ages over 85 for both sexes should be acknowledged as a data limitation, which is reflected in the reduced years of life lost in this age group and probably leads to some underestimation of losses at older ages. This is apparently due to the overestimation of the denominator, the population size, in this age group and, consequently, underestimated coefficients for these ages. This issue with the quality of Russian statistics was highlighted on numerous occasions [
Notwithstanding the above-mentioned limitations, the study demonstrated that its findings are comparable with the WHO estimates for Russia in terms of absolute values, sex, and age. However, this is only partially the case in terms of causes of death, due to the non-distribution of ‘garbage’ causes of death and a slightly different grouping of causes of death in the WHO Global Health Estimates. It is therefore recommended that further steps be taken to improve the accuracy of estimates of years of life lost due to premature mortality and to enhance the international comparability of estimates. These should include a study of the role of ‘garbage’ codes of causes of death and an assessment of their impact on the quality of mortality statistics in Russia.
Furthermore, it has been demonstrated that a reduction in the standardised rates of years of life lost for both men and women did occur during the pre-pandemic period, while maintaining a two-fold gender gap in favour of women. However, the losses incurred during the pandemic negated these gains. It has been demonstrated that the greatest gender inequality in the extent of losses is observed in external causes of death and respiratory diseases, indicating that men still exhibit a relatively low level of self-preservation behaviour. Furthermore, it is notable that throughout the period, there was a wave-like increase in losses among both sexes from digestive diseases.
The study has shown that the heterogeneous group ‘other causes of death’ has become increasingly important in recent years, accounting for more than 1/3 of all years of life lost by women in 2021. The growth of losses from this group, which began in 2011, is also due to causes that can be classified as ‘garbage’ or poorly defined causes of death, which reflects a growing problem of quality of Russian mortality statistics by cause of death. However, the increase in losses within this group from quite definite causes of death (diseases of the nervous system, mental disorders and behavioural disorders, endocrine system, nutritional and metabolic disorders) may be due to quite different reasons:
The ‘years of life lost’ enabled a more detailed examination of causes of death with a low SDR relative to the ‘large’ classes of causes of death, where deaths occur at an earlier age, thus increasing the contribution of these causes to the total years of life lost. To illustrate, the pronounced surge in losses from infectious diseases, notably HIV, commences at ages 25-29 to peak at ages 35-39. This pattern is similar, except for a five-year shift, to that observed in losses from digestive diseases, particularly those of liver and pancreas.
The ‘years of life lost’ also provided new insights into losses from ‘major’ causes such as COVID-19. During the pandemic, women’s life expectancy declined more than men’s, dropping by 3.66 years compared to a 2.73-year decrease for men. However, throughout both years of the COVID-19 pandemic, SYLL was lower for women than for men.
Besides, the study examines the differences between two nonparametric methods for assessing years of life lost due to premature mortality: years of potential life lost (YPLL) and years of life lost (YLL). While these methods have been well developed and are widely used internationally, their distinction has not yet been clearly established in domestic research.
Moreover, even within a single approach (such as years of life lost), the results can vary significantly based on the standard life table used, the type of death rates included (projected or observed), the criteria for determining “garbage” codes for causes of death, and how the deaths coded as such are re-classified. These factors contribute to variability in estimates of losses from premature mortality and can lead to the identification of different priority risk groups, both in terms of age and causes of death.
Danilova I (2021) Problems of comparability of data on causes of death over time within the framework of ICD-10. URL: https://demogr.hse.ru/data/2021/05/16/1382799417/Danilova_ICD_130521.pdf [Accessed on 29.10.2024]
Hoyert DL (2023) Maternal mortality rates in the United States, 2021. NCHS Health E-Stats. https://doi.org/10.15620/CDC:124678
Krasilnikov IA, Ivanova AE, Semenova VG, Sabgaida TP, Evdokushkina GN (2014) Methodological recommendations for the use of the indicator “Years of potential life lost” (YPLL) to substantiate priority health problems of the Russian population at the federal, regional and municipal levels. URL: https://mednet.ru/images/stories/files/materialy_konferencii_i_seminarov/2010/kadry2014/sessiya/metod.pdf [Accessed on 29.10.2024]
National Center for Health Statistics (2017) Years of potential life lost before age 75 for selected causes of death. by sex. race. and Hispanic origin: United States. Selected years 1980–2016. National Center for Health Statistics. https://www.cdc.gov/nchs/hus/contents2017.htm#018
OECD (2022) Potential years of life lost (indicator). OECD. https://doi.org/10.1787/193a2829-en
Statistics Canada (2022) Statistics Canada. Table 13–10–0157–01 Mortality and potential years of life lost. by selected causes of death and sex. five-year period. Canada and Inuit regions. Statistics Canada. https://doi.org/10.25318/1310015701-eng
Vikulova OK (2019) Diabetes mellitus registry: results of work 2018. requirements for filling. critical errors. URL: https://www.endocrincentr.ru/sites/default/files/all/EVENTS2019/NEWSSUM/13.03.19 Prof.komissia/VIK_Exp_13.03.19.pdf [Accessed on 29.10.2024]
WHO (2014) WHO methods and data sources for global burden of disease estimates 2000-2011. Geneva. World Health Organization
WHO (2020a) Global Health Estimates 2020: Disease burden by Cause. Age. Sex. by Country and by Region. 2000-2019. Geneva. World Health Organization; https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys
WHO (2020b) WHO methods and data sources for global burden of disease estimates 2000-2019. Geneva. World Health Organization/ http://www.who.int/gho/mortality_burden_disease/en/index.html (дата обращения 29.10.2024)
https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2021_daly_methods.pdf?sfvrsn=690b16c3_1WHO (2024) WHO methods and data sources for global burden of disease estimates 2000-2021. Geneva. World Health Organization. URL: https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2021_daly_methods.pdf?sfvrsn=690b16c3_1ghe2021_daly_methods.pdf (who.int) (дата обращения 29.10.2024)
A.I. Pyankova, M.B. Denisenko – This work is an output of a research project implemented as part of the Basic Research Program at the National Research University Higher School of Economics (HSE University).
T.A. Fattakhov – The study was carried out within the framework of research work «The reproduction of the population in socio-economic development».
Anastasiya Ivanovna Pyankova – Candidate of Sociology, Research fellow, Associate Professor Vishnevsky Institute of Demography, HSE University, Moscow, 109028, Russia. Email: apyankova@hse.ru
Timur Asfanovich Fattakhov – Senior Research Fellow, Population Department Faculty of Economics of Lomonosov Moscow State University, Moscow, 119991, Russia. Email: timur300385@mail.ru
Mikhail Borisovich Denisenko – Candidate of Economics, Department Head, Associate Professor Vishnevsky Institute of Demography, HSE University,109028, Moscow, Russia. Email: mdenissenko@hse.ru
Abridged life table ever used in estimating years of life lost from premature mortality by different organisations in different revisions
Organisation | GHE WHO | GBD IHME | ||||
Year of revision | 2024 | 2020 | 2013 | 2010 | 1990 men | 1990 women |
Neonatal | 92.65 | 89.99 | 91.93 | 86.01 | 79.94 | 82.43 |
Post-neonatal | 92.21 | 89.55 | 91.55 | 85.68 | 78.85 | 81.36 |
1–4 | 89.74 | 87.07 | 89.41 | 83.63 | 77.77 | 80.28 |
5–9 | 85.25 | 82.58 | 84.52 | 78.76 | 72.89 | 75.47 |
10–14 | 80.26 | 77.58 | 79.53 | 73.79 | 67.91 | 70.51 |
15–19 | 75.27 | 72.60 | 74.54 | 68.83 | 62.93 | 65.55 |
20–24 | 70.28 | 67.62 | 69.57 | 63.88 | 57.95 | 60.63 |
25–29 | 65.31 | 62.66 | 64.60 | 58.94 | 52.99 | 55.72 |
30–34 | 60.34 | 57.71 | 59.63 | 54.00 | 48.04 | 50.83 |
35–39 | 55.38 | 52.76 | 54.67 | 49.09 | 43.10 | 45.96 |
40–44 | 50.43 | 47.83 | 49.73 | 44.23 | 38.20 | 41.13 |
45–49 | 45.51 | 42.94 | 44.81 | 39.43 | 33.38 | 36.36 |
50–54 | 40.61 | 38.10 | 39.92 | 34.72 | 28.66 | 31.68 |
55–59 | 35.74 | 33.33 | 35.07 | 30.10 | 24.07 | 27.10 |
60–64 | 30.92 | 28.66 | 30.25 | 25.55 | 19.65 | 22.64 |
65–69 | 26.21 | 24.12 | 25.49 | 21.12 | 15.54 | 18.32 |
70–74 | 21.62 | 19.76 | 20.77 | 16.78 | 11.87 | 14.24 |
75–79 | 17.19 | 15.65 | 16.43 | 12.85 | 8.81 | 10.59 |
80–84 | 13.08 | 11.96 | 12.51 | 9.34 | 6.34 | 7.56 |
85+ | 7.28 | 7.05 | 7.60 | 5.05 | 3.82 | 3.59 |
Comparison of absolute number of years of life lost by sex and age group from the findings of this study with WHO, IHME estimates, million person-years
Men | Women | |||||
---|---|---|---|---|---|---|
WHO | IHME | This Study | WHO | IHME | This Study | |
2000 | ||||||
All | 42.1 | 39.5 | 41.8 | 23.8 | 22.9 | 23.8 |
0–4 | 1.3 | 1.3 | 1.3 | 1.0 | 0.9 | 0.9 |
5–14 | 0.5 | 0.5 | 0.5 | 0.3 | 0.3 | 0.3 |
15–29 | 5.3 | 4.7 | 5.2 | 1.3 | 1.2 | 1.4 |
30–49 | 13.3 | 12.5 | 13.2 | 3.8 | 3.5 | 3.7 |
50–59 | 6.9 | 6.5 | 6.9 | 2.7 | 2.5 | 2.7 |
60–69 | 8.8 | 8.2 | 8.6 | 5.0 | 4.7 | 5.0 |
70+ | 5.9 | 5.8 | 6.0 | 9.7 | 9.7 | 9.8 |
2010 | ||||||
All | 34.6 | 33.5 | 34.4 | 21.2 | 20.6 | 21.2 |
0–4 | 0.9 | 0.9 | 0.9 | 0.7 | 0.7 | 0.7 |
5–14 | 0.2 | 0.2 | 0.2 | 0.1 | 0.1 | 0.1 |
15–29 | 3.3 | 3.3 | 3.4 | 1.0 | 1.0 | 1.1 |
30–49 | 9.9 | 9.7 | 9.7 | 3.2 | 3.2 | 3.2 |
50–59 | 8.0 | 7.8 | 8.0 | 3.4 | 3.2 | 3.3 |
60–69 | 5.6 | 5.3 | 5.6 | 3.2 | 3.0 | 3.2 |
70+ | 6.6 | 6.3 | 6.6 | 9.6 | 9.4 | 9.6 |
2019 | ||||||
All | 26.5 | 24.8 | 26.3 | 17.5 | 16.9 | 17.3 |
0–4 | 0.5 | 0.5 | 0.5 | 0.4 | 0.4 | 0.4 |
5–14 | 0.2 | 0.2 | 0.2 | 0.1 | 0.1 | 0.1 |
15–29 | 1.2 | 1.2 | 1.3 | 0.4 | 0.4 | 0.5 |
30–49 | 7.2 | 6.8 | 7.1 | 2.7 | 2.5 | 2.6 |
50–59 | 5.3 | 5.0 | 5.3 | 2.3 | 2.1 | 2.3 |
60–69 | 6.9 | 6.3 | 6.8 | 3.8 | 3.5 | 3.7 |
70+ | 5.2 | 4.9 | 5.1 | 7.8 | 7.9 | 7.8 |
2021 | ||||||
All | 32.8 | 31.0 | 32.6 | 25.0 | 24.1 | 24.7 |
0–4 | 0.4 | 0.4 | 0.4 | 0.3 | 0.3 | 0.3 |
5–14 | 0.2 | 0.2 | 0.2 | 0.1 | 0.1 | 0.1 |
15–29 | 1.1 | 1.1 | 1.3 | 0.4 | 0.4 | 0.5 |
30–49 | 8.2 | 8.0 | 8.3 | 3.3 | 3.2 | 3.3 |
50–59 | 6.2 | 5.7 | 6.0 | 3.1 | 2.9 | 3.0 |
60–69 | 9.1 | 8.4 | 8.9 | 6.0 | 5.7 | 6.0 |
70+ | 7.7 | 7.3 | 7.4 | 11.7 | 11.5 | 11.4 |
Comparison of absolute number of years of life lost by cause from the findings of this study with WHO estimates, 2021, thousand person-years
Men | Women | |||
---|---|---|---|---|
WHO | This Study | WHO | This Study | |
All causes | 32788 | 32466 | 25009 | 24613 |
Infectious and parasitic diseases | 1723 | 862 | 487 | 423 |
Tuberculosis | 321 | 197 | 86 | 54 |
HIV | 1324 | 552 | 333 | 293 |
Hepatitis | 1 | 54 | 0 | 28 |
All other infectious diseases | 77 | 58 | 67 | 47 |
All respiratory diseases | 7914 | 6312 | 6616 | 6641 |
COVID-19 | 6955 | 4646 | 6232 | 5581 |
Neoplasms | 4535 | 4061 | 3711 | 3270 |
Malignant neoplasms | 4526 | 4010 | 3702 | 3212 |
Other neoplasms | 9 | 50 | 10 | 58 |
Cardiovascular diseases | 9582 | 10943 | 8122 | 8169 |
Hypertension | 127 | 155 | 145 | 167 |
Ischaemic heart disease | 5153 | 5749 | 4183 | 4172 |
Cerebrovascular diseases | 2536 | 2576 | 2822 | 2536 |
Digestive diseases | 1695 | 2009 | 1204 | 1357 |
Peptic ulcer disease | 164 | 193 | 100 | 107 |
Liver diseases | 980 | 1163 | 681 | 773 |
including alcoholic liver disease | 469 | 257 | 226 | 152 |
Cholelithiasis and cholecystitis | 28 | 24 | 41 | 34 |
Pancreatic diseases | 282 | 330 | 130 | 145 |
External causes of death | 3343 | 4701 | 945 | 1194 |
Road injury | 552 | 597 | 184 | 190 |
Accidental poisonings (x40, x43, x46-49) | 122 | - | 39 | - |
All accidental poisonings (x40-44, x45-49) | - | 757 | - | 152 |
Accidental falls | 262 | 188 | 96 | 73 |
Accidents caused by fire | 103 | 92 | 43 | 38 |
Accidental drownings | 174 | 186 | 31 | 34 |
Injuries with undetermined intent | - | 1530 | - | 376 |
Intentional self-harm. including suicide | 1108 | 568 | 237 | 104 |
Interpersonal violence | 362 | 210 | 112 | 62 |
Dynamics of standardised rates of years of life lost by cause of death, person-years per 1,000 persons
1990 | 2000 | 2010 | 2019 | 2021 | 1990 | 2000 | 2010 | 2019 | 2021 | |
---|---|---|---|---|---|---|---|---|---|---|
Men | Women | |||||||||
Total | 496 | 668 | 526 | 374 | 459 | 223 | 268 | 216 | 161 | 223 |
Infectious and parasitic diseases (ID) | 10 | 21 | 17 | 14 | 12 | 4 | 5 | 5 | 6 | 5 |
Tuberculosis | 7 | 17 | 11 | 3 | 3 | 1 | 2 | 3 | 1 | 1 |
Viral hepatitis | 0 | 0 | 1 | 1 | 1 | 0.2 | 0.2 | 0.2 | 0.4 | 0.3 |
HIV | 0 | 0 | 4 | 9 | 7 | 0 | 0 | 1 | 4 | 4 |
Neoplasms (NP) | 93 | 83 | 71 | 61 | 57 | 44 | 42 | 39 | 34 | 32 |
malignant neoplasms (MNP) of lip, oral cavity, pharynx | 4 | 4 | 4 | 3 | 3 | 0 | 0 | 1 | 1 | 1 |
esophageal MNP | 4 | 3 | 2 | 2 | 2 | 1 | 0 | 0 | 0 | 0 |
gastric MNP | 17 | 12 | 9 | 6 | 5 | 7 | 5 | 4 | 2 | 2 |
MNP of small bowel, including duodenum | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Colon MNP | 3 | 4 | 4 | 4 | 3 | 3 | 3 | 3 | 2 | 2 |
Rectum, rectosigmoid, anus MNP | 3 | 4 | 3 | 3 | 3 | 2 | 2 | 2 | 2 | 2 |
MNP of other digestive organs | 8 | 7 | 6 | 7 | 7 | 4 | 3 | 3 | 3 | 3 |
larynx MNP | 3 | 3 | 2 | 1 | 1 | 0.1 | 0.1 | 0.1 | 0.1 | 0.1 |
trachea, bronchi, and lungs MNP | 30 | 25 | 20 | 15 | 14 | 3 | 2 | 2 | 2 | 2 |
MNP of other respiratory organs and intrathoracic organs | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
MNP of bone and articular cartilage | 1 | 1 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
Skin MNP | 1 | 2 | 2 | 2 | 2 | 1 | 1 | 1 | 1 | 1 |
mammary MNP | - | - | - | - | - | 7 | 8 | 7 | 6 | 5 |
cervix MNP | - | - | - | - | - | 2 | 2 | 3 | 3 | 2 |
MNP of other female genitalia, unspecified | - | - | - | - | - | 5 | 5 | 5 | 4 | 4 |
prostate MNP | 2 | 3 | 4 | 4 | 4 | - | - | - | - | - |
MNP of other male genitalia | 0.4 | 0.5 | 0.4 | 0.3 | 0.3 | - | - | - | - | - |
urinary organ MNP | 5 | 5 | 5 | 4 | 3 | 1 | 1 | 1 | 1 | 1 |
MNP of other or unspecified locations | 4 | 6 | 7 | 4 | 4 | 3 | 4 | 4 | 3 | 2 |
Leukaemia | 3 | 4 | 4 | 3 | 2 | 2 | 2 | 1 | 1 | 1 |
Other MNP of lymphatic and hematopoietic tissues | 2 | 0 | 0 | 2 | 2 | 1 | 0 | 0 | 1 | 1 |
Benign neoplasms и misclassified neoplasms | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Circulatory diseases (CD) | 191 | 262 | 221 | 142 | 154 | 102 | 124 | 98 | 59 | 66 |
Hypertensive disease (cardiac and/or renal involvement) | 1 | 4 | 4 | 2 | 2 | 1 | 3 | 3 | 1 | 1 |
Ischaemic heart disease | 107 | 138 | 119 | 74 | 81 | 44 | 52 | 46 | 28 | 32 |
including myocardial infarction | 19.9 | 18.1 | 16.3 | 11.2 | 11.3 | 6.0 | 5.9 | 5.6 | 3.6 | 3.7 |
Cerebrovascular diseases | 58 | 77 | 56 | 35 | 37 | 41 | 50 | 33 | 18 | 20 |
Other heart diseases | 10 | 24 | 32 | 12 | 14 | 4 | 8 | 11 | 4 | 5 |
Respiratory diseases (RD) | 32 | 40 | 26 | 16 | 24 | 11 | 11 | 7 | 4 | 10 |
Pneumonia | 7 | 18 | 16 | 7 | 15 | 4 | 5 | 4 | 2 | 7 |
Digestive diseases (DD) | 13 | 22 | 29 | 25 | 28 | 6 | 9 | 14 | 12 | 14 |
Peptic ulcer disease | 3 | 3 | 3 | 2 | 3 | 1 | 1 | 1 | 1 | 1 |
Liver diseases | 5 | 10 | 18 | 14 | 16 | 2 | 5 | 9 | 8 | 9 |
including alcoholic liver disease | 0 | 2 | 5 | 3 | 4 | 0 | 1 | 3 | 2 | 2 |
Cholelithiasis and cholecystitis | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 |
Pancreatic diseases | 1 | 3 | 4 | 4 | 5 | 1 | 1 | 1 | 1 | 2 |
External causes (ECD) | 112 | 176 | 108 | 66 | 67 | 26 | 40 | 26 | 15 | 15 |
Traffic accidents | 25 | 21 | 15 | 9 | 9 | 6 | 6 | 5 | 3 | 3 |
Suicide | 21 | 33 | 19 | 9 | 8 | 4 | 5 | 3 | 1 | 1 |
Murder | 12 | 22 | 10 | 4 | 3 | 3 | 6 | 3 | 1 | 1 |
Accidental poisonings | 15 | 32 | 17 | 9 | 10 | 4 | 8 | 4 | 2 | 2 |
including alcohol poisoning | 9 | 19 | 9 | 4 | 4 | 2 | 5 | 2 | 1 | 1 |
Injuries with undetermined intentions | 9 | 23 | 20 | 20 | 22 | 2 | 5 | 4 | 4 | 5 |
Accidental drownings | 8 | 10 | 8 | 2 | 3 | 1 | 2 | 1 | 0 | 0 |
Accidental falls | 3 | 6 | 4 | 3 | 3 | 1 | 1 | 1 | 1 | 1 |
Accidents caused by fire | 2 | 5 | 4 | 1 | 1 | 1 | 1 | 1 | 0 | 0 |
Other classes of causes of death (OCCD) | 44 | 64 | 53 | 50 | 119 | 31 | 37 | 27 | 30 | 80 |
Old age | 2 | 4 | 3 | 3 | 3 | 2 | 4 | 3 | 3 | 3 |
Symptoms and misclassified conditions | 6 | 21 | 20 | 14 | 16 | 2 | 5 | 5 | 4 | 4 |
Alcoholic psychosis | 0.1 | 0.4 | 0.3 | 0.1 | 0.1 | 0.0 | 0.1 | 0.0 | 0.0 | 0.0 |
Chronic alcoholism / addiction syndrome | 1 | 2 | 2 | 2 | 1 | 0 | 1 | 1 | 0 | 0 |
COVID-19 | - | - | - | - | 66 | - | - | - | - | 48 |
Dynamics of standardised rates of mortality by sex and causes of death included in the group ‘all other causes of death’, 2011-2021
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, (D50-D89) | M | 29.5 | 28.7 | 29.4 | 33.9 | 35.3 | 35.9 | 34.3 | 39.1 | 36.5 | 37.3 | 33.1 |
W | 24.1 | 24.3 | 24.6 | 27.3 | 28.8 | 28.5 | 28.2 | 28.6 | 30.5 | 28.8 | 26.5 | |
Endocrine, nutritional and metabolic diseases, (E00-E90) | M | 50.5 | 55.7 | 67.3 | 101.8 | 131.4 | 154.3 | 179.9 | 196.1 | 194.8 | 241.9 | 202.0 |
W | 63.2 | 74.0 | 84.9 | 124.3 | 161.8 | 185.3 | 209.9 | 224.2 | 223.8 | 275.2 | 234.5 | |
Mental and behavioural disorders, (F00-F99) | M | 50.4 | 48.7 | 50.5 | 106.9 | 99.0 | 108.8 | 123.4 | 133.3 | 122.0 | 153.4 | 128.6 |
W | 16.7 | 17.2 | 20.2 | 49.7 | 58.6 | 62.1 | 73.0 | 80.0 | 76.2 | 92.6 | 76.2 | |
Diseases of the nervous system, (G00-G99) | M | 164.4 | 156.4 | 179.0 | 270.5 | 396.4 | 517.9 | 600.3 | 629.1 | 585.1 | 685.0 | 655.3 |
W | 85.0 | 83.6 | 102.1 | 173.5 | 262.6 | 361.6 | 435.9 | 466.5 | 424.8 | 508.9 | 518.0 | |
Diseases of the eye and adnexa, (H00-H59) | M | 0.1 | 0.1 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
W | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | |
Diseases of the ear and mastoid process, (H60-H95) | M | 1.2 | 1.0 | 1.1 | 1.1 | 1.2 | 1.4 | 1.5 | 1.4 | 1.3 | 1.0 | 1.2 |
W | 0.8 | 0.8 | 0.7 | 0.8 | 0.7 | 0.6 | 0.9 | 1.0 | 0.7 | 0.6 | 1.1 | |
diseases of the skin and subcutaneous tissue, (L00-L99) | M | 14.7 | 14.2 | 13.7 | 14.9 | 16.1 | 19.9 | 21.5 | 21.3 | 21.9 | 19.7 | 21.0 |
W | 9.5 | 9.9 | 10.8 | 11.4 | 12.5 | 15.9 | 17.2 | 17.0 | 16.9 | 15.9 | 16.1 | |
diseases of the musculoskeletal system and connective tissue, (M00-M99) | M | 9.0 | 9.1 | 9.0 | 11.6 | 17.2 | 20.4 | 22.5 | 25.3 | 27.3 | 27.8 | 25.7 |
W | 12.5 | 12.2 | 11.9 | 15.5 | 21.3 | 25.3 | 26.0 | 29.2 | 30.8 | 34.0 | 32.0 | |
Diseases of the genitourinary system, (N00-N99) | M | 89.7 | 92.2 | 96.2 | 106.9 | 128.4 | 132.4 | 139.7 | 145.5 | 154.4 | 161.6 | 150.0 |
W | 55.5 | 55.9 | 59.1 | 63.5 | 75.2 | 77.1 | 77.8 | 85.0 | 87.6 | 93.5 | 87.7 | |
Pregnancy, childbirth and the puerperium, (O00-O99) | M | – | – | – | – | – | – | – | – | – | – | – |
W | 3.5 | 2.5 | 2.5 | 2.4 | 1.9 | 2.4 | 1.9 | 1.7 | 1.2 | 1.9 | 6.2 | |
Certain conditions originating in the perinatal period, (P00-P96) | M | 67.1 | 87.6 | 80.6 | 71.1 | 63.6 | 55.6 | 48.9 | 45.5 | 43.3 | 42.0 | 43.1 |
W | 49.8 | 70.9 | 63.0 | 56.7 | 47.2 | 43.9 | 39.7 | 34.5 | 34.9 | 32.5 | 30.8 | |
Congenital malformations [abnormalities], deformations and chromosomal abnormalities, (Q00-Q99) | M | 49.5 | 47.0 | 44.5 | 42.5 | 38.4 | 39.6 | 36.4 | 35.1 | 31.5 | 34.1 | 32.9 |
W | 39.9 | 40.5 | 36.7 | 34.9 | 33.1 | 32.0 | 28.1 | 28.4 | 27.6 | 25.7 | 25.7 | |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, (R00-R99) | M | 738.9 | 765.0 | 836.7 | 971.1 | 923.9 | 827.5 | 700.3 | 697.4 | 701.2 | 782.8 | 773.4 |
W | 434.1 | 465.2 | 536.2 | 647.4 | 635.4 | 611.0 | 530.3 | 505.3 | 497.8 | 556.7 | 526.9 |