Geographical diversity of cause-of-death patterns and trends in Russia

This paper performs a systematic analysis of all currently available Russian data on mortality by region, census year (1970, 1979, 1989, and 1994) and cause of death. It investigates what links may be found between these geographical variations in cause-specific mortality, the negative general trends observed since 1965, and the wide fluctuations of the last two decades. For that, four two-year periods of observation were selected where it was possible to calculate fairly reliable mortality indicators by geographic units using census data for 1970, 1979, 1989, and micro-census data for 1994, and used a clustering model. Behind the complexity of the studied universe, three main conclusions appeared. Firstly, in European Russia, there is a stark contrast between south-west and north-east, both in terms of total mortality and of cause-of-death patterns. Secondly, analysis of overall cause-of-death patterns for all periods combined clearly confirms that contrast at the whole country level by the prolongation of the southern part of European Russia through the continuation of the black soil ("chernoziom") belt along the Kazakhstan border, while the rest of Siberia presents a radically different picture to European Russia. Thirdly, while it is difficult to infer any permanent geographical pattern of mortality from that very fluctuating piece of history, 1988-89 appears to be a base period for at least the entire period from 1969-1994.