Regional peculiarities of mortality variance by education in Russia

Elena V. Zemlyanova, Federal Research Institute for Health Organization and Informatics, Moscow
Alla E. Ivanova, Federal Research Institute for Health Organization and Informatics, Moscow

Background. Mortality variance by education in Russia significantly exceeds the same in European countries. It is age, gender and nosology-specific, higher in women; adolescents regardless of age; and in all ages from external causes. Objective. To study peculiarities of mortality by education in the Russian regions with reliable statistics; to test whether life expectancy depends upon scale and type of educational mortality variance. Methods and data. Population census 2010, death certificates data including sex, date of birth and death; place of death, ICD-10 code and education. Male and female standardized mortality rates (European standard) by completed years of education in 25-44 and 45-64 age groups. The study included 40 (out of 83) Russian regions with share of unknown education under 10%. Variance in life expectancy in those regions was 9.5 years in men and 5.7 in women. Results. Educational mortality variance is heterogeneous across regions with different levels of life expectancy. The bigger variance, the higher mortality, the lower life expectancy. Increased mortality mainly affects lower educated people; this is relevant for both sexes and 25-44 and 45-64 age groups. Lower educated and people with secondary education account for regional variance up to 2.5 years in men and up to 1.7 years in women However, mortality in groups with higher education hardly varied. Along with mortality increase in the region deaths from external causes increase across all educational groups; at minimal levels of life expectancy external causes predominate in the mortality structure of lower educated (mainly men) aged 25-44 and 45-64. Neoplasms in the mortality structure of higher educated diminish, being replaced by alcohol-related diseases of the circulatory system. Conclusions. Results of the regional analysis make it possible to outline trends in mortality variance by education according to different changes in life expectancy in Russia.