Spatial Inequalities in Mortality in Russia before and during the Covid-19 Pandemic: A District-Level Analysis

Egor Sergeev, National Research University Higher School of Economics, Moscow
Aleksey Shchur, National Research University Higher School of Economics
Sergey Timonin, Australian National University

Numerous studies have documented significant fluctuations in life expectancy trends in Russia and other Eastern European countries from the late 20th century to the present, often attributed to hazardous alcohol consumption, risky behaviors, socio-economic upheavals, and privatization. While some research has examined mortality patterns at the regional level, less is known about geographical inequalities at more granular levels and their changes over time within Russia. To address this gap, we assess spatial inequalities in cause-specific mortality across Russian districts for three periods: 2001–2003, 2009–2011, and 2020–2021. We analyzed death records categorized by sex, age, district, and cause of death, calculating sex- and cause-specific age-standardized death rates (SDRs) for 2,264 districts. Regression-based metrics, including the slope index of inequality (SII) and the relative index of inequality (RII), were employed to capture both absolute and relative inequalities in mortality. Districts were ranked and divided into population percentiles to reveal nuanced mortality patterns. Expected findings suggest greater inequality in male mortality compared to females, with amplified disparities during the COVID-19 pandemic. Long-term trends indicate reductions in mortality inequality before the pandemic, but men faced higher disparities. The study aims to explore how these trends and pandemic impacts shaped health inequalities across Russia's regions.

Keywords: Mortality and Longevity, Spatial Demography, Small area estimation

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