The St. Petersburg International Economic Forum hosted an expert discussion entitled ‘Russia’s Demographics’. The session had two thematic parts – ‘Preservation of the Able-Bodied Population as a Socio-Economic Challenge’ and ‘Increasing the Birth Rate in Russia: Solutions and Prospects’. The session was moderated by Oleg Apolikhin, Director of N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the Institution National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation.

The discussion brought together the following participants: Igor Shchegolev, Presidential Plenipotentiary Envoy to the Central Federal District; Alexander Galushka, Vice President of the Civic Chamber of the Russian Federation; Lilia Ovcharova, Vice Rector of the National Research University Higher School of Economics; Olga Kobyakova, Director, Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation; Sergey Rybalchenko, General Director, Institute for Scientific Public Expertise; Natalia Pochinok, Rector, Russian State Social University; as well as heads of Russian regions.

As of 1 January 2021, Russia’s de jure population amounted to 146.24 million people, which 510 thousand less than a year before (146.75 million people as of 1 January 2020). A more significant decline of 564.5 thousand people was recorded in 2005.

Experts, who participated in the first part of the discussion in the Governors’ Club, noted the need for a disease prevention system. They also emphasized the importance of corporate health programmes, as well as outreach campaigns that would promote healthy lifestyles among Russians. Experts recommended the following instruments: tax deductions for individuals and corporations that support healthy lifestyles, as well as fines for facilitating or promoting bad habits or unhealthy eating.   

“By 2030, we need to take life expectancy in Russia up to 78 years. This task takes a whole range of measures, which include preventive healthcare. Pretty much any disease is easier to prevent than to treat. This is why our job is to focus on prevention and early treatment,” emphasized Oleg Apolikhin, Director of N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the Institution National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation.

Participants also noted that men account for almost 80% of deaths among working-age adults, while key causes of mortality among men aged 40–65 are socially important diseases, such as cardiovascular diseases and cancers.   

According to the Federal State Statistics Service, in 2019 the gap in life expectancy among men and women was 9.93 years, despite a certain upward trend.  

The data by the Global Burden of Diseases Study and the Federal State Statistics Service shows that Russia and the world share main causes of death, with cardiovascular diseases and cancers remaining at the top of the list. Cardiovascular diseases are the main cause of mortality among both men and women in Russia: 307.7 women and 577.6 men per 100 thousand people.    A significantly larger number of men die of this cause. This gap is bigger for working-age adults. Cardiovascular diseases kill five times more men than women: 44.9 women and 216.9 men per 100 thousand people.

The average case scenario by the Federal State Statistics Service forecasts that by 2036 male population in Russia will drop by 995 thousand people (5.5 million people under worst-case scenario). The key driver of these numbers is excess mortality among working-age men. At the same time, three out of four men die at work, while only 48% of all men reach retirement age.    Among men, cardiovascular diseases are the main cause of death, while their complications account for 51% of deaths and incapacitations. External causes rank third.    

The data proves that in 2017 mortality rates for men was higher than for women (respiratory system diseases – 2.4 times; infectious and parasitic diseases – 2.4 times; tumours – 33%; digestive system diseases – 38%; external causes – 3.7 times).  

The second part of ‘Russia’s Demographics’ was dedicated to increasing birth rate in Russia, which includes reproductive health and the role socioeconomic support measures for parents and children can play in boosting Russia’s demographic development.

“No matter life expectancy or mortality, a steady population growth is only possible with a birth rate of two children per woman. It means at least half the families need to have three or more children. Our birth rate situation is not hopeless thanks to families with multiple children, while an increase in their number is the cornerstone of the outstripping economic growth,” Igor Shchegolev, Presidential Plenipotentiary Envoy to the Central Federal District.

Experts noted that Russia does not have a state policy for supporting families with multiple children. Support measures for families with three children or more are the responsibility of regional governments and depend on their budgets. When moving to a different region, such a family may lose its status and government support. As a result, many face an absurd situation, when guaranteed benefits end after child one or two.

According to Russian Accounts Chamber, the aggregate birth rate in 2020 dropped to 1.489 compared to 1.78 in 2015, despite the doubling of the Demography national project budget – up to RUB 690 billion. In 2015–2020, Russia recorded a decrease in birth rate – from 13.3 to 9.8 per 1,000 people. At the same time, over the last ten years mean maternal age has gained another year and is now nearing 30. The average age of first-time mothers is almost 26 years. According to a 2020 RANEPA survey, the share of childfree reproductive-age Russians (18–44 years) has dramatically grown – from 5% in 2015 and 10% in 2017 to 22% in 2020.    

The Federal State Statistics Service has published a demographics forecast until 2036. It reveals that the number of children in Russia is likely to decline year by year. While best-case scenario predicts a drop in the number of children aged 0–15 from 18.7% to 15.2% of the total population, worst-case scenario forecasts this number will reach 13.1%.

The session participants defined key drivers of demographic success. They are family values (having multiple children as a social norm and purpose of life) multiplied by financial wellbeing. The experts also suggested setting a unified standard for the Demography national project, which would include the fixed status of a family with multiple children and basic support measures regardless of the region. Participants also emphasized the need for communications policy that would promote family values and having multiple children.  

Professor Apolikhin also noted that currently, in accordance with the decisions of the Council for Social Welfare Care under the Government of the Russian Federation, a group of experts, chaired by Deputy Prime Minister Tatiana Golikova, is actively working on the Federal Reproductive Health Programme, which aims to increase the birth rate by timely diagnostics and treatment of reproductive disorders, and a large public awareness programme on the importance of family values and right to reproductive health.