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Educational level and adult mortality in Russia: An analysis of routine data 1979 to 1994

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  • Shkolnikov, Vladimir M.
  • Leon, David A.
  • Adamets, Sergey
  • Eugeniy Andreev
  • Deev, Alexander

Abstract

The investigation of socio-economic differences in mortality in Russia was effectively prohibited in the Soviet period. The extent and nature of any such differences is of considerable interest given the very different principles upon which Russian society has been organised for most of this century compared to the West where socio-economic differences in health have been extensively documented. Using cross-sectional data on mortality in Russia around the 1979 and 1989 Censuses, we have analysed mortality gradients according to length of education. Our results show that educational differences in mortality are at least as big as seen in Western countries, and are most similar to the recently reported differences observed for other former communist countries such as the Czech Republic, Estonia and Hungary. As observed in many other countries the strength of association of mortality with education declines with age, varies by cause of death and is generally stronger among men than women. Differentials are particularly large for accidents and violence, where for men and women the mortality rate among those with primary or basic secondary education is over twice that of people with higher education. Even larger effects are seen for causes directly related to alcohol (including alcoholic cirrhosis and accidental poisoning by alcohol), and for infectious and parasitic diseases and respiratory diseases. These educational differences may in part be related to educational differences in alcohol consumption. Of particular significance is the fact that there are indications that socio-economic differences in mortality have widened considerably in the 1990s, a period during which there was a huge increase in the national burden of alcohol-related deaths. This widening of socio-economic differences at this time suggest that these increases in consumption were especially acute among those with less education. At a more general level the fact that large educational differences in mortality were seen in Russia in 1979 and 1989, prior to the collapse of the Soviet Union, is very striking and informative. In this period there was a far weaker association between income and education than is seen in the West, suggesting that the education effects are unlikely to be driven by underlying differences in financial resources. The protective effect of education, in the Russian context at least, has been driven by more subtle and mechanisms. The apparent widening of socio-economic mortality differences since the collapse of the Soviet Union suggests that the transformation underway in Russian society requires a strengthening of the public health function.

Suggested Citation

  • Shkolnikov, Vladimir M. & Leon, David A. & Adamets, Sergey & Eugeniy Andreev & Deev, Alexander, 1998. "Educational level and adult mortality in Russia: An analysis of routine data 1979 to 1994," Social Science & Medicine, Elsevier, vol. 47(3), pages 357-369, August.
  • Handle: RePEc:eee:socmed:v:47:y:1998:i:3:p:357-369
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    Cited by:

    1. Glei, Dana A. & Goldman, Noreen & Shkolnikov, Vladimir M. & Jdanov, Dmitri & Shalnova, Svetlana & Shkolnikova, Maria & Weinstein, Maxine, 2013. "To what extent do biomarkers account for the large social disparities in health in Moscow?," Social Science & Medicine, Elsevier, vol. 77(C), pages 164-172.
    2. Agnieszka Fihel & Marketa Pechholdová, 2017. "Between ‘Pioneers’ of the Cardiovascular Revolution and Its ‘Late Followers’: Mortality Changes in the Czech Republic and Poland Since 1968," European Journal of Population, Springer;European Association for Population Studies, vol. 33(5), pages 651-678, December.
    3. Ogloblin, C & Brock, G, 2011. "The Rise in Female Smoking in Russia: What to Do?," Regional and Sectoral Economic Studies, Euro-American Association of Economic Development, vol. 11(2).
    4. Todd, Megan A. & Shkolnikov, Vladimir M. & Goldman, Noreen, 2016. "Why are well-educated Muscovites more likely to survive? Understanding the biological pathways," Social Science & Medicine, Elsevier, vol. 157(C), pages 138-147.
    5. Zimmer, Zachary & Prachuabmoh, Vipan, 2012. "Comparing the socioeconomic status – Health gradient among adults 50 and older across rural and urban areas of Thailand in 1994 and 2007," Social Science & Medicine, Elsevier, vol. 74(12), pages 1921-1928.
    6. Tatiana Blinova, 2014. "Rural Mortality from External Causes in Russian Regions," ERSA conference papers ersa14p732, European Regional Science Association.
    7. Elizabeth Brainerd & David M. Cutler, 2005. "Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union," Journal of Economic Perspectives, American Economic Association, vol. 19(1), pages 107-130, Winter.
    8. Shkolnikov, Vladimir M. & Cornia, Giovanni A. & Leon, David A. & Mesle, France, 1998. "Causes of the Russian mortality crisis: Evidence and interpretations," World Development, Elsevier, vol. 26(11), pages 1995-2011, November.
    9. Irina Denisova, 2009. "Mortality in Russia: Microanalysis," Working Papers w0128, Center for Economic and Financial Research (CEFIR).
    10. Becker, Charles M. & Urzhumova, Dina S., 2005. "Mortality recovery and stabilization in Kazakhstan, 1995-2001," Economics & Human Biology, Elsevier, vol. 3(1), pages 97-122, March.
    11. Sergey Timonin & Inna Danilova & Evgeny Andreev & Vladimir M. Shkolnikov, 2017. "Recent Mortality Trend Reversal in Russia: Are Regions Following the Same Tempo?," European Journal of Population, Springer;European Association for Population Studies, vol. 33(5), pages 733-763, December.
    12. Akanksha Choudhary & Ashish Singh, 2018. "Effect of intergenerational educational mobility on health of Indian women," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-16, September.
    13. Wei Zheng & Patrick Paul Walsh, 2018. "Air pollution and health - A provincial level analysis of China," Working Papers 201819, Geary Institute, University College Dublin.
    14. Blakely, Tony & Tobias, Martin & Robson, Bridget & Ajwani, Shilpi & Bonné, Martin & Woodward, Alistair, 2005. "Widening ethnic mortality disparities in New Zealand 1981-99," Social Science & Medicine, Elsevier, vol. 61(10), pages 2233-2251, November.
    15. ZHONG, Hai, 2015. "An over time analysis on the mechanisms behind the education–health gradients in China," China Economic Review, Elsevier, vol. 34(C), pages 135-149.
    16. Giovanni Andrea Cornia, 2022. "Transition, Recession and Mortality Crisis in the Former Soviet Bloc: an update to the year 2014," Working Papers - Economics wp2022_04.rdf, Universita' degli Studi di Firenze, Dipartimento di Scienze per l'Economia e l'Impresa.
    17. Irina Denisova, 2009. "Mortality in Russia: Microanalysis," Working Papers w0128, New Economic School (NES).
    18. Samir KC & Harold Lentzner, 2010. "The effect of education on adult mortality and disability: a global perspective," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 201-235.
    19. Eunyoung Shim & Youngtae Cho, 2013. "Widening social disparities in alcohol-attributable deaths among Korean men aged 40–59 years during the transitional period of the economic crisis (1995–2005)," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 521-527, August.
    20. Nicholson, Amanda & Bobak, Martin & Murphy, Michael & Rose, Richard & Marmot, Michael, 2005. "Socio-economic influences on self-rated health in Russian men and women--a life course approach," Social Science & Medicine, Elsevier, vol. 61(11), pages 2345-2354, December.
    21. Iliana Kohler & Pekka Martikainen & Kirsten P. Smith & Irma T. Elo, 2008. "Educational differences in all-cause mortality by marital status," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 19(60), pages 2011-2042.
    22. Irina Denisova, 2010. "Adult mortality in Russia," The Economics of Transition, The European Bank for Reconstruction and Development, vol. 18(2), pages 333-363, April.
    23. Cockerham, William C. & Hinote, Brian P. & Abbott, Pamela, 2006. "Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine," Social Science & Medicine, Elsevier, vol. 63(9), pages 2381-2394, November.
    24. Rojas, Yerko & Carlson, Per, 2006. "The stratification of social capital and its consequences for self-rated health in Taganrog, Russia," Social Science & Medicine, Elsevier, vol. 62(11), pages 2732-2741, June.
    25. Franz Schwarz, 2007. "Widening educational disparities in all-cause mortality: An analysis of Austrian data with international comparisons," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 5(1), pages 93-105.

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