Mortality Trends in the Working Ages: Soviet Regions in Comparative Perspective, 1959-1988

This paper examines mortality in the working ages (20-59) in the Soviet Union between 1958 and 1988 and compares mortality levels and trends in the USSR with those of 33 other developed countries. The paper first describes the main trends in mortality in the working ages between 1958 and 1988 in the USSR as a whole. Mortality of Soviet women in the working ages changed very little during this interval. In contrast, mortality of Soviet men in the working ages increased substantially between 1964 and 1980, and then began to fall, especially sharply after 1985. The marked difference in the trends for males and females suggests that no simple set of factors accounts for them. Also, the timing of the inflection points in mortality rates for Soviet working-age men, in 1964 and 1980, does not correspond to any obvious change in the availability or quality of heatlh care. Data quality problems are probably partly responsible for the observed trends in mortality. Urban-rural mortality crossovers, as well as a sharp sex difference between republics in the age at which the urban-rural mortality crossover occurs, are important indications of problems with data quality.

The extreme diversity of the Soviet population means that examination of mortality data for the Soviet Union as a whole is of limited use. Accordingly, the paper examines differeces in mortality in the working ages (40-59) in Soviet union republics with survival rates in these ages in 33 developed countries show that mortality levels in the USSR are high and have become relatively worse over time. In 1969-70, for men in 10 other developed countries the number of person-years lived between ages 40 and 60 was greater than the number lived by men in any of the 15 Soviet union republics, while for 23 countries the figure fell within the range found among the Soviet union republics. By 1980, men in 19 other developed countries aged 40-59 had higher survival than men in any of the Soviet republics. By 1985, this was true of men in 17 other developed countries.

The situation is similar for women. In 1969-70, in 5 other developed countries women lived more person-years between ages 40 and 60 than women in any Soviet union republic. By 1980, this number increased to 13; and by 1985, it was 22. Thus, although mortality of Soviet women increased only slightly in recent decades, the lack of a decline in mortality of Soviet women has left them behind women in most of the rest of the developed world. Soviet women's closest "competitors" in mortality are women in the countries of Eastern Europe.

The analysis then focuses on comparisons of mortality within major Soviet regions (groups of union republics). Although on the whole the relative rankings of working-age mortality rates among women in different republics makes sense -- mortality levels are inversely related to the level of economic development -- the relative rankings for working-age men more often run in the opposite direction. To what extent these differing patterns between men and women are a result of poor data quality, in particular, underreporting of mortality in the less developed regions, especially for men; or to other factors such as unfavorable health conditions in the more developed regions, especially for men, remains to be determined.