The authorities have set a target of increasing life expectancy. Average life expectancy in Russia is expected to reach 78 years by 2030 and 81 years by 2036. This work is being carried out under the approved Strategy for Action in the Interests of Older Citizens. Scientists from the Institute of Social Demography of the Russian Academy of Sciences (ISD RAS), however, are drawing attention to another problem: Russia has not only one of the world’s widest gaps in life expectancy between men and women, but also an exceptionally high mortality rate among working-age men
The researchers analysed the factors behind excess male mortality among citizens aged 15–19, that is, before the start of active working life, and among those aged 25–54 over more than half a century
The main aim of the study was to examine how the structure of causes of death among men has changed and to compare the impact of different factors on excess mortality among adolescent boys and working-age men.
The authors first conclude that the two age groups have fundamentally different mortality patterns. Among adolescents, the share of deaths from external causes is much higher, including transport injuries, suicides, accidental poisoning and homicide, note Tamara Sabgayda, chief research fellow at the ISD RAS Centre for Health and Self-Preservation Behaviour; Alexander Zubko, leading research fellow at the same centre; and Victoria Semenova, chief research fellow there. Older men have a completely different mortality structure. Among Russians aged 25–54, cardiovascular diseases are the leading cause of death. At the same time, external causes continue to account for a substantial share.
The researchers also identify another important pattern. Mortality among men of active working age rises further during periods of socio-economic upheaval. Men aged 25–54 respond more sharply to different crises than women in either age group and than adolescent boys. They cite the late 1980s and early 1990s as an example, when economic reforms began, shortages and social tensions increased, and a large part of the population became poorer. All of this triggered a rapid increase in male mortality. The 1998 rouble devaluation prompted another spike in mortality among men aged 25–54. From the 2000s onwards, however, a prolonged period of economic growth, driven by high oil prices, rising real incomes, falling unemployment and increased consumption was accompanied by declining mortality among working-age men, the authors note.
Cardiovascular and nervous-system diseases account for a substantial share of excess mortality among working-age men. The first category traditionally includes various conditions associated with blood-pressure disorders, vascular diseases and heart conditions such as arrhythmia and heart failure, as well as cerebrovascular diseases, including stroke, cerebral infarction and intracerebral haemorrhage. Nervous-system diseases include various forms of meningitis and encephalitis, degenerative diseases of the nervous system, including Alzheimer’s disease, multiple sclerosis and others.
Cardiovascular diseases now account for more than one in four deaths among Russian men of working age, the experts say. Only external causes have a larger share, accounting for almost one in three deaths. The proportion of deaths from cardiovascular diseases has changed little. In 1965, these diseases accounted for one-fifth of all deaths among working-age men, the researchers note.
The mortality structure among men aged 25–54 is therefore as follows: external causes have ranked first throughout the period, followed by cardiovascular diseases. Neoplasms ranked third until 2016. They have since been overtaken by diseases of the digestive system, including various ulcers, gastritis, appendicitis, liver diseases, peritonitis and pancreatitis. Half a century ago, digestive diseases ranked sixth, the researchers note. Neoplasms now rank fourth, a significant improvement since cancer was the third most common cause of death among men half a century ago.
In other words, over the past half-century, a significant share of causes of death among a group of men that is particularly important economically and demographically has remained poorly diagnosed, the researchers conclude.
‘Among men of active working age, there was a trend towards rising excess mortality from all causes until the end of the last century, interrupted during the anti-alcohol campaign. Diseases of the respiratory and circulatory systems, digestive diseases, infectious diseases and neoplasms made the largest contributions to this increase. At present, excess mortality among men aged 25–54, as among adolescent boys, is determined by external causes and cardiovascular diseases,’ the researchers report.
According to Rosstat data, there were more than 1,200 deaths per 100,000 people in 2023. More than 556 deaths were attributed to cardiovascular diseases, almost 300 to ischaemic heart disease and 168 to cerebrovascular diseases. By comparison, 74 people died from diseases of the digestive system that year.
Scientists at the ISD RAS associate the increase in mortality from nervous-system diseases with the faster pace of life, growing information overload and a greater number of social challenges, all of which create additional stress for citizens. As for cardiovascular diseases, institutional factors may be involved, the experts suggest, including shortcomings in the organisation of primary healthcare and preventive medicine. The prevalence of unhealthy habits also contributes to excess mortality among adult men.
The researchers are also concerned about the troubling trend of ‘poor diagnosis’ of causes of death, in particular the growing share of ill-defined conditions in the mortality statistics for adolescent boys and working-age men. This points to inadequate quality in medical diagnosis and death registration among the population group that is particularly important economically and demographically, they conclude.
To develop an effective policy for reducing premature mortality, the researchers recommend taking age- and gender-specific risks into account, strengthening primary prevention of cardiovascular disease, improving sports programmes for adolescents and upgrading the system used to register causes of death
Heart and vascular diseases, malignant neoplasms, chronic respiratory diseases and diabetes account for more than 80% of all deaths in Russia, said Batyr Berdyklychev, head of the World Health Organization’s Moscow office. Factors including excessive alcohol consumption, smoking, an unhealthy diet and high salt intake all ‘significantly affect disease and mortality’, he said.
The Russian authorities have also set themselves the goal of increasing life expectancy. President Vladimir Putin instructed the government in 2024 to raise life expectancy in Russia to 78 years by 2030 and 81 years by 2036. This spring, Deputy Prime Minister Tatiana Golikova said the work was being carried out under the Strategy for Action in the Interests of Older Citizens, approved in 2025. The measures planned through 2030 are aimed at improving older people’s quality of life, including healthcare, disease prevention, access to medical care, the introduction of new diagnostic and treatment methods, and extending healthy, active longevity.
ORIGINAL: NG/Poor Diagnosis Is One of the Causes of Excess Mortality among Russian Men
