Narrowing Gap in Self-Rated Health between Men and Women in Russia: Measurement Problem or Fact?

Aleksey Shchur, National Research University Higher School of Economics
Vladimir M. M. Shkolnikov, Max Planck Institute for Demographic Research (MPIDR)
Egor Sergeev, National Research University Higher School of Economics, Moscow
Sergey Timonin, Australian National University

The male-female health survival paradox is a well-established conceptual framework. The paradox was particularly acute in Russia in the 1990s and early 2000s, when extremely high levels of excess male mortality were combined with a very high burden of poor health among women. In the late 2000s and 2010s, there was a substantial decline in mortality for both sexes, but the implications for sex differences in health are less well understood. We obtained data on self-rated health (SRH) by age, sex and educational attainment for 1994-2022 from the RLMS representative sample. We used logistic regression to determine associations between these variables and poor SRH, and examined trends in poor SRH by sex and educational attainment (age-adjusted). We calculated healthy life expectancy (HLE) and decomposed sex differences in HLE into mortality and morbidity contributions. Since the mid-2000s, the prevalence of poor SRH has decreased for both sexes and all educational groups. After 2019 the effect of sex on poor SRH had become insignificant. Despite high excess mortality, the prevalence of poor SRH decreased in Russia during the pandemic. The gender gap in HLE remained unchanged because of the mutually exclusive contributions of morbidity and mortality.

Keywords: Health and Morbidity, Gender Dynamics, Mortality and Longevity

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