Current trends in population mortality in economically developed and developing countries. Maternal mortality in many countries of the world still remains high Causes of mortality in developed countries
Mortality
Health and longevity are the most important and undeniable values social development. Over the past decades, the average life expectancy at birth has increased significantly due to increased attention to health problems and a reduction in child and infant mortality. Accordingly, the proportion of countries whose governments consider the current mortality rate to be acceptable has increased, from 37% in the mid-1970s and 1980s to 43% in 2007. This trend is more pronounced in the group of developing countries, among which the proportion of those satisfied with the mortality level increased from 24% to 36%.
However, significant differences in objective and subjective estimates of mortality trends remain between developing and developed countries. Average life expectancy at birth was 76 years in developed countries, 64 years in developing countries and only 53 years in the least developed countries in 2000-2005.
One of the reasons for the stagnation and even increase in mortality in some African countries is the epidemic of HIV infection and AIDS. It is therefore not surprising that the assessment of the acceptability of the current mortality rate depends significantly on the level of development of the country. In 2007, just over a third of developed countries considered the current mortality rate unacceptable (although this was noticeably higher than in the mid-1970s-1980s), and among developing countries - almost two-thirds. Among the 50 least developed countries, not a single one considered the current mortality rate as acceptable.
Of the 105 countries (representing 50% of the world's population) that, in accordance with the World Program of Action, set themselves the goal of achieving an average life expectancy of at least 70 years by 2000-2005, 90 failed to achieve it. Moreover, in 48 of these countries (14% of the world's population), located mainly on the African continent south of the Sahara, life expectancy dropped well below the target criterion - to a level below 60 years. Such a low level of life expectancy is explained by many factors, including military and political conflicts, economic crises, socio-economic changes, the prevalence of unhealthy lifestyles and bad habits, the return of such formidable infectious diseases, such as malaria, tuberculosis, cholera, as well as the epidemic spread of HIV infection and AIDS. In many low-income countries, the cost of a minimum package of health care is significantly higher than the level of government spending on health care. Thus, in 2004, the average per capita expenditure on health care in developing countries was about 91 US dollars per year, and in the least developed countries it was only 15 US dollars. The situation is complicated by the fact that in a number of countries it is impossible to use additional resources and there is a shortage of medical workers due to low wages, difficult working conditions and the emigration of qualified personnel.
As mentioned above, the problems of child and maternal mortality took, according to estimates of national governments, the second and third places, respectively, among the population problems of particular concern to the countries of the world. True, over the past decade, concern about these problems has weakened somewhat - the share of governments that consider the current mortality rate in their countries for children under 5 years of age to be acceptable decreased from 77% in 1996 to 73% in 2007. But this happened mainly due to developed countries, and among developing countries, on the contrary, it increased. The rapid decline in child mortality observed before 1990 in developing countries gave way to almost stagnation in the 1990s. In 2006, the number of children dying under age 5 fell for the first time to 10 million per year. But half of them still die from preventable causes such as acute respiratory infections, diarrhea, measles and malaria.
High maternal mortality is also a major concern. In 2007, 70% of national governments (135 out of 193 countries) considered the current level of maternal mortality unacceptable, among developed countries - 33% (16 out of 49 countries), among developing countries - 83% (119 out of 144), including among the least developed - 98% (48 out of 50). It is estimated that about half a million women die each year during pregnancy or childbirth, most in sub-Saharan Africa and Asia.
The HIV and AIDS epidemic is one of the most serious challenges facing the international community in recent years. Since 1981, when the disease was first diagnosed, more than 25 million people have died from it. In 2007, more than 33 million people were living with HIV. The spread of this infection in a number of countries has practically erased many achievements of socio-economic development, leading to an increase in the level of morbidity and mortality and undermining the foundations of existence of households, enterprises, and individual industries ( agriculture, education, health) and national economies. If in 1996 71% of national governments (89 out of 125 countries) expressed serious concern about the spread of HIV infection, then in 2007 this figure was already 90% (175 out of 194). At the same time, the governments of the least developed countries in the world are most concerned - 98%.
Already from the mid-1980s, some governments began to take certain measures to counter the onslaught of the epidemic, but they were most often fragmented and aimed mainly at solving health problems. But in recent years, entire strategies have been developed to combat HIV infection and AIDS, which include the following areas: preventive measures aimed at preventing the spread of the disease; treatment and care for the sick; protection from discrimination and exclusion of sick people; development of coordinated interdepartmental strategies; creation of bodies coordinating activities to combat AIDS and HIV infection; development of partnerships between civil society, groups of people living with HIV-infected people, local communities, non-governmental organizations and the private sector of the economy.
To improve public awareness of the problem, governments seek to attract attention to them by supporting special information and educational programs in the media mass media and communications. The participation of non-governmental organizations, people living with HIV, religious leaders and international donor organizations in these programs greatly increases the effectiveness of such programs.
Antiretroviral therapy can significantly increase the life expectancy of HIV-infected people and alleviate their suffering, but it still remains very inaccessible. Although nearly 85% of countries (165) reported support for access to antiretroviral therapy in 2007, in many of them actual treatment coverage remains extremely low. Despite concerted international and national efforts to reduce the cost of medications, only 2 of the 7.1 million people needing such treatment in developing countries were receiving it at the end of 2006.
Programs to support the practice of using condoms (safe sex) are quite widespread (in 86% of countries in the world), but the demand for them still remains unsatisfied and the quality is low. According to UN experts, the supply of condoms is 50% lower than necessary.
In 2007, the governments of 182 of 195 countries (93%) indicated that their countries provide preventive blood tests for HIV. Among developing countries there were 135, or 92%, and among developed countries - 47, or 96%. However, it is important to emphasize that countries vary in the extent to which such programs reach their populations.
All governments more countries are enacting legislation to protect people affected by HIV infection. In 2007, 63% of national governments reported taking measures to ensure non-discrimination against people living with HIV. Among developed countries their share reaches 76%, among developing countries - only 58%, including among the least developed countries - 38%. In Africa, where the epidemic is particularly widespread, 47% of countries said they had implemented such measures.
Mortality is the main indicator of the health status of the population. The causes of mortality change over time: if in the distant past people died mainly from infectious diseases - plague, malaria, smallpox, etc., now main reason Deaths have become circulatory diseases, especially in developed countries, where the number of deaths from these diseases is about 50% (in other countries - 27%). In second place is mortality from malignant tumors; For this reason, in developed countries, 21% of the dead die, in the rest - 11%. A new dangerous disease is AIDS X (acquired immunodeficiency syndrome), which has spread in many countries of the world, including Russia. Other causes of mortality include mental illness, drug addiction, alcoholism, and diseases caused by malnutrition.
Poor nutrition is the lot of residents of many underdeveloped countries, one of the main causes of illness in children and adults, and often their death. Thus, 40 million children suffer from a lack of vitamin A, and more than 500 million people suffer from anemia from a lack of iron. In Africa, due to maternal malnutrition during pregnancy, 15% of births have low birth weight, in Asia - 20%. A baby's weight at birth is one of important factors, determining his chances of survival and normal development. In African countries, 70% of children have slow growth, half of them have pronounced atrophy, carrying the threat of rapid death. Africa's infant mortality rate is approaching 200%, i.e. There are 200 deaths per 1000 newborns.
In developed countries, the infant mortality rate was 15%, and in three of them - Finland, Sweden and Japan - 6.5-7%. Low infant mortality rates are the result of a high standard of living, highly effective treatments and medical care. Thus, in most African countries there is one doctor per 10 thousand inhabitants, and in Europe there are more than 20. But not only the number of doctors, but also the quality of their work affects infant mortality rates. For example, former USSR In terms of the number of doctors, it ranked first in the world (42.1 per 10 thousand people), but the level of service was lower than in many other countries, and infant mortality rates were not the best in the world.
Accidents are one of the most common causes of death, and their number is constantly growing. Here the first place is occupied by road accidents. Many people are victims of incidents involving chemical and radioactive substances. Big
Pesticides are harmful to health. Every year, about 1 million people are poisoned with severe symptoms and more than 220 thousand people die from it. With increasing rates of resource exploitation and intensification of production, new sources and causes of danger to human health arise.
The world population in 2014 was 7.2 billion people. The Earth's population increases annually by almost 100 million. The main feature of its development is the preservation of the population of developed and developing countries. Most of the world's population is concentrated in developing countries. So, if in 1950 these countries accounted for 2/3 of the world population, in 1998 - 4/5, then, according to the UN population forecast for 2050, 7/8 of the world population. Although the population in developed countries is growing much more slowly than in developing countries, and its relative size is declining, many more resources are consumed per capita, so developed countries have an impact on natural environment stronger than developing ones.
By the middle of the 21st century. the population of most regions of the world will increase. The largest increase is expected on the African continent. Currently, world population growth is concentrated in a limited number of countries. Thus, about 1/3 of the increase occurs in India and China.
UN experts predict population decline in countries with developed economies and low level birth rate, primarily in Japan and European countries. It is expected that by 2050 the number of inhabitants, for example, of Bulgaria will decrease by 34%, Romania - by 29, Ukraine - by 28, Russia - by 22, Latvia - by 23, Poland - by 17, South Korea - by 13, Germany - by 9%.
The birth rate in developed countries is at a level below that necessary for the simple renewal of generations. Currently, the average total fertility rate in developed countries is 1.6 children (2013). However, by 2050, according to UN forecasts, it may increase to 1.9. Among developed countries, the highest birth rates in recent years have been observed in Great Britain and France - 2.0.
In developing countries, the total fertility rate is at a level significantly higher than the replacement level. Thus, in 2013, its value for the African continent as a whole was 4.8 children, including in Central Africa - 6.1, in Western Asia - 2.9, in Central America - 2.4, etc. However, in these countries, the birth rate is also declining.
The mortality rate is currently gradually decreasing in almost all regions of the world.
Activities to reduce mortality become most successful as humanity develops, sustainable economic growth, and the creation of a material basis for the development of medicine, healthcare, etc. This was most clearly evident primarily in Europe. Until the beginning of the 20th century. here it was possible to significantly reduce mortality from hunger, infectious diseases, and significant epidemics. By the end of the 20th century. The decline in mortality has slowed and its level has now stabilized.
In developing countries, the process of reducing mortality continues. Not only its level is changing, but also the structure of causes of death - it is tending to the type of mortality in developed countries. Despite the successes achieved in the second half of the last century, mortality in Africa, Asia and Latin America still has reserves for further reduction, especially in infants. TO beginning of XXI V. (2013) the highest infant mortality rate remains in Africa - 68%, with the world average being 40%.
Due to the decrease in overall mortality of the population, life expectancy is increasing. So, if in the early 1950s. life expectancy for the entire world population was 46 years, then by the beginning of this century it increased to 70. In industrialized countries, this figure increased in these years from 66 to 78 years. In developing countries it was 41 and 69 years, respectively. The existing gap in life expectancy between developed and developing countries will remain in the foreseeable future. By 2050 (according to UN estimates), life expectancy in more developed countries may reach 82 years, and in less developed countries - 75 years (for both sexes). This means that developing countries will only reach the current level of mortality in developed countries in another century.
An increase in life expectancy, due to a decrease in mortality (especially in older ages), and a decrease in fertility lead to an increase in the proportion of older ages in the total population, and to an aging population.
The age structure, being a reflection of the population reproduction regime in the past, at the same time plays an extremely important role in shaping the future demographic development society (trends in population reproduction, its size and structure, etc.). In this regard, an increase in the proportion of the population of older ages, i.e. Demographic aging is currently developing into a global problem and is under the attention of the UN.
For the first time, the problem of the aging of the world population was considered at a UN meeting back in 1948. In subsequent decades, the pace of the aging process turned out to be higher than previously assumed. Therefore, in 1992, the UN adopted the International Plan of Action on Aging and established the International Day of Older Populations on October 1 of each year.
The problem of population aging has become especially noticeable for economically developed countries. According to UN estimates, in these countries as a whole, the population aged 65 years and over makes up 17% of the total population. Japan is named the oldest among developed countries, where every fifth resident is over 65 years old. It is followed by: Italy and Germany - 21% elderly, Bulgaria, Latvia, Finland - 19, France - 17, Great Britain - 16, Canada - 15, USA - 14%, etc. Improvements age structure population in these countries is not expected in the near future.
Population aging is gradually becoming a serious problem for some countries in Asia and Latin America. Taking into account global trends demographic processes, it can be assumed that demographic aging will eventually affect the entire world population.
One of the characteristics of the demographic situation is the state and forms of marriage and family relations. The basis for demographic differences between economically developed and developing countries lies in the different roles of the family in the culture and economy of these countries.
In developing countries, the family still largely retains its productive and social functions. In this regard, complex families are common in them, capable of maintaining the norms of large families and acting as a mediator in the relationship between society and the individual.
In economically developed countries, simple families consisting of parents and children predominate. Many functions of the family were transferred to other social institutions, and intrafamily ties lost their former importance as an intermediary, making the family fragile.
The unfavorable development of global demographic processes has made it necessary to solve the complex problem of maintaining a balance between population size, stable economic growth and sustainable development. One of the directions is the development of a new approach to a complex phenomenon - international migration. UN documents indicate the need to develop and implement a migration policy at the level of individual countries, the task of which remains to establish strict control over migration movements in order to prevent the fight against illegal migration that is undesirable for the interests of the country. Among economically developed countries large regions The United States and the EEC countries are the main recipients of migrants. In Western Europe, the majority of foreign specialists are concentrated in Germany, France, and Great Britain. In these countries, migration has become a leading factor in population growth.
Currently, there are almost no states left in the world whose governments are not concerned about population problems. Therefore, most countries pursue specific government policies in the field of population.
For economically developed countries, the key demographic problem can be considered, first of all, low birth rate, which does not ensure even simple reproduction of the population and causes its reduction (depopulation). However, almost all of them officially pursue a policy of non-interference in the reproductive behavior of the population. At the same time, some of these states (Belgium, Germany, Greece, Italy, Luxembourg, Japan, etc.) consider the population growth rate and birth rate of their countries to be unsatisfactory.
Industrialized countries pursue public policies that most likely can be classified as family policies. What all these countries have in common is the recognition that family is the most important social institution, whose main tasks include the birth and upbringing of children, preparing them for adult life. At the same time, while implementing measures of state assistance to families with children in practice, many countries do not officially proclaim family policy.
Most developed countries are strengthening measures to help families or introducing them if they were not there. Organization for Economic Co-operation and Development (OECD) countries' investment in this area increased from an average of 1.65% of GDP in 1980 to 2.4% in 2003. The overall increase in investment varies from country to country, as does its direction . Countries differ primarily in the assistance they provide in the form of leave and childcare for children under three whose parents work.
Currently, family benefits absorb about 2.6% of France's GDP, in Sweden, Denmark and Finland this share is 4% of GDP. The budget of the National Family Benefits Fund in France exceeds the country's defense budget. The policies of France and other European countries clearly demonstrate that today the most successful government programs are those that promote the formation of flexible norms in the field of combining careers and careers. family life. Ideally, this is a policy that eliminates the risk of a sharp decline in living standards at the birth of the first child and thereby creates the basis for stimulating the birth of subsequent children.
Most developed countries are strengthening family assistance measures or introducing them where they were not available. State family policy measures in developed countries mainly come down to: maternity leave; family benefits for children; tax benefits; benefits for travel on city and railway transport; prohibitions on dismissal of pregnant women, preservation of their place of work during maternity leave, rights of pregnant women to transfer to easier work; benefits for disabled children; benefits for newlyweds and schoolchildren (in some countries), etc. In addition, all these countries have family planning services. However, the conditions and forms of implementation of all of the above government measures in individual countries differ significantly.
In countries belonging to the group of economically developed countries, the goal is to prevent population growth and stabilize its size. At the same time, the actual measures to help families with children have a clear pronatalist (fertility-encouraging) orientation. Such a contradiction is observed, for example, in Holland, where the amount of benefits increases with each child born, up to the eighth. Similar differentiation of child benefits currently exists in Australia.
An opposite attitude to the issues of regulating the birth rate has historically developed in France and Germany. These states, as a result of wars in the 19th-20th centuries. suffered huge population losses. The restoration of the destroyed economy, demographic potential, and the need to maintain geopolitical balance in Europe led to the implementation of an active demographic policy in these countries. In recent years, the demographic orientation of state policy has been replaced by a social one.
In almost all countries with high level birth rate, family planning policy is being implemented. Currently, China ranks first in the world in terms of population. According to the latest data, almost 1.4 billion people live in this country. More than 25 years ago, the “one family, one child” system was introduced in China. However, even under conditions of severe birth control, its population continues to grow and by 2025 may exceed 1.4 billion people. Only by 2050 will the population begin to decline. In 2002, the first law on demography and planned childbearing came into force in China, enshrining the current government policy in law. According to this law, some categories of citizens were allowed to have a second child. Families with a large number of children are practically deprived of state support, and many are deprived of their own civil rights. Birth control policies, national traditions, and modern medical technologies have led to a disruption of the gender structure of the Chinese population. Currently, many more boys are born in the country than girls. This leads to an overabundance of young men, a shortage of potential brides and causes negative social, political, moral, psychological and other negative consequences. Along with this, there is a rapid aging of the population associated with a rapid decline in the birth rate. The burden on the working-age population increases significantly, and difficulties arise with pension provision.
A similar violation of the gender and age structure with the same set of negative consequences is currently observed in India.
Vietnam has achieved some success in limiting the birth rate. But even here, despite the ongoing family planning policy, the population growth rate remains quite high.
In some countries that were previously classified as developing, as their economic growth progressed, the birth rate decreased to a level close to the level that ensures simple reproduction of the population. To a certain extent, this was facilitated by the family planning policy pursued in them. The most striking example of this is Iran XX Demographic Statistics / ed. M. V. Karmanova. P. 456.ЇЇ. The population increased during the 20th century. six times: from 10 million people. at the beginning of the century up to 60 million people. at the end. The first family planning program was adopted in Iran during the reign of the Shah in 1967. Over the next decade, there were no significant changes in the birth rate. After the Islamic Revolution of 1979, this program was discontinued. In 1989, a second family planning program was adopted, approved by the country's religious leaders. However, five years before the adoption of the second program, from the mid-1980s. In Iran, the total fertility rate began to decline, and by 1988 its value was at 5.5 (versus 6.8 in 1984). After this, the decline in fertility accelerated, and by 1996 the total fertility rate had fallen to 2.8 children.
In 2001, its value dropped to a level close to simple reproduction, and, according to various estimates, ranged from 2.1 to 2.6. Currently, the total fertility rate in this country is 2.1. This decrease occurred among urban and rural women of all ages in all provinces of the country. One of the main reasons for the decline in the birth rate in Iran since the second half of the 1980s. there was an improvement in socio-economic living conditions, especially in remote rural areas, a significant reduction in infant mortality, the development of education, means of transport, communications, and the spread of a way of life modern society, including women's education and employment.
A significant decrease in the total fertility rate to a level close to simple replacement has now occurred in a number of other countries with previously high levels: Tunisia - 2.2; Türkiye - 2.1; Sri Lanka - 2.1; Thailand - 1.6; Taiwan - 1.3; South Korea - 1.3, etc.
Thus, despite continued population growth and the existence different types reproduction of the population, a steady trend of declining birth rates has formed and is developing in the world, which in the foreseeable future will lead to a cessation of growth in the planet's population (if the trends in the development of civilization do not radically change). Demographic behavior is closely related to the system life values, is formed under the influence of a whole set of factors - cultural, socio-economic, political. Each stage of human civilization is characterized by a certain model of demographic behavior.
- Population Reference Bureau. 2014 World Population Data Sheet. URL: prb. org/
- Grigorieva II., Dupra-Kushtapia V.. Sharova M. Social policy in the field of parenthood: comparative analysis (Russia - France) // Journal of Research social policy. 2014. T. 12. No. 1. P. 32.
Maternal mortality is still high in many countries around the world
Despite progress made in reducing maternal mortality, pregnancy and childbirth still pose significant risks to the health and lives of women in many developing countries. The estimated number of deaths from complications of pregnancy, childbirth and the postpartum period was 358 thousand in 2008, of which 355 thousand, or 99%, in developing countries.
The main causes of maternal mortality in developing regions are hemorrhage (35% of cases) and hypertension (18%). Abortions also contribute to maternal mortality (about 9%), primarily unsafe ones.
If we compare the values of the maternal mortality ratio by country with the number of legal grounds for abortion discussed above, it turns out that with a more liberal attitude of the state towards induced termination of pregnancy, maternal mortality is usually lower (Fig. 15). The highest maternal mortality rates are observed in countries with stricter abortion laws. According to 2008 estimates available for 171 countries, maternal mortality ratios ranged from 2 per 100,000 live births in Greece to 1,400 in Afghanistan. The median value was 68 deaths from complications of pregnancy, childbirth and the puerperium per 100 thousand live births (Venezuela).
Most countries with lower maternal mortality rates had the most liberal abortion laws (the number of legal grounds for abortion was 7 in 56% of countries, 5 or more in 71% of countries). The only exceptions were Malta and Chile, where the legislation does not provide any grounds for artificial termination of pregnancy.
The other half of the countries where maternal mortality was above the median had fairly strict abortion laws - 70% of countries provided for no more than three reasons for abortion (usually related to a risk to the life and health of the mother).
Of course, the determining role in this distribution is played by the fact that a more liberal attitude towards abortion is typical for developed countries with a higher level of health protection in general. However, legislative provision of the safest medical abortions in developing countries could also make a contribution to reducing maternal mortality and preserving women's reproductive health.
Figure 15. Countries of the world by maternal mortality ratio and number of legal grounds for abortion, 2008
The risk of mortality from complications of pregnancy, childbirth and the postpartum period depends on the number of pregnancies, and, therefore, on the birth rate. In half of the countries in which the maternal mortality ratio is below the median, the total fertility rate does not exceed 3.5 children per woman, and in the majority - in 80% of countries - it does not exceed the replacement level (2.1) and only in 5 countries ranges from 3.1 to 3.5 (Fig. 16).
In the other half of countries where the maternal mortality rate is above the median, the total fertility rate is noticeably higher. Only in one country - North Korea (DPRK) - is its value below 2 (1.9 children per woman with 250 deaths from complications of pregnancy, childbirth and the postpartum period per 100 thousand live births). In the rest, the total fertility rate exceeds 2.2, in half - 4.0 children per woman.
Figure 16. Countries of the world by maternal mortality ratio (2008) and total fertility rate (2005-2010)
Since reducing maternal mortality (by ¾ by 2015 compared to 1990) is one of the Millennium Goals, the analysis of this indicator is given constant attention in all UN Reports on the implementation of the Millennium Development Goals. Data presented in 2011 show a consistent downward trend in maternal mortality in all major regions of the world (Figure 17). However, the rate of decline does not allow us to hope that the task will be solved.
In developed countries, maternal mortality decreased from 26 deaths from complications of pregnancy, childbirth and the puerperium per 100 live births in 1990 to 17 in 2000 (that is, a decrease of 35%). In 2008 it remained at the same level as in 2000.
The decrease in maternal mortality in developing countries over the entire period was 34%: from 440 per 100 thousand live births in 1990 to 370 in 2000 and 290 in 2008.
The greatest success in reducing maternal mortality was observed in East Asia, where it decreased by 63% (from 110 per 100 thousand live births in 1990 to 41 in 2008), North Africa - by 60% (from 230 to 92), Southeast Asia– by 58% (from 380 to 160). The smallest decrease - by about a quarter - was noted in Oceania, Transcaucasia and Central Asia(with relatively low rates), as well as in sub-Saharan Africa (with extremely high maternal mortality rates).
Figure 17. Maternal mortality in selected regions of the world, per 100 thousand live births, 1990, 2000 and 2008
The high risk of mortality from complications of pregnancy, childbirth and the postpartum period in developing countries is associated with low availability of medical services (observation, consultations and, if necessary, medical care during pregnancy and after childbirth, skilled obstetric care). In developed countries, almost all births are accompanied by qualified medical care; in developing countries, obstetric care is not always available.
The proportion of women receiving skilled attendance at birth increased in developing countries from 55% in 1990 to 65% in 2009 (Figure 18). Improvements in this indicator have been observed in all developing regions, but particularly significant progress has been made in North Africa, where the proportion of births attended by a skilled attendant increased by 80% (from 45% to 81%). The provision of obstetric care in South Asia and sub-Saharan Africa remains extremely low, with half of all births occurring without a skilled attendant.
Figure 18. Proportion of births attended by skilled birth attendants,
%, 1990 and 2009
Sources
:
United Nations, Department of Economic and Social Affairs, Population Division.
World Abortion Policies 2011. - http://www.un.org/esa/population/publications/2011abortion/2011abortionwallchart.html
The Millennium Development Goals Report 2011. United Nations New York, 2011. -
The Millennium Development Goals Report 2011. United Nations New York, 2011. 11-31339-June 2011-31,000. Sales No. E.11.I.10 – P. 28.
The overall mortality rate of the population on a global scale shows a clear downward trend: in 1955 - 18.6, in 1975 - 12.0, in 1995 - 9.1, in 2002 - 9.2 per 1 thousand population. The lowest mortality rates are typical for economically developed countries: from 6.5 in Japan and Canada to 12.0 in Austria. In European countries, over the past 40 years, the population mortality rate has remained at the level of 10.0–11.0 with slight fluctuations. More than 60% of all deaths in developed countries and 30% in developing countries occur over the age of 70 years. The age group over 60 years of age in developed countries accounts for 78% of deaths, and in developing countries – 42% of deaths. On age group 15–59 years old account for 20% in developed countries and 30% in developing countries of all deaths.
The mortality rate of men in Eastern European countries is higher than in developing countries of America and Asia, and 3–4 times higher than in developed countries. At the same time, among men in the European region it remained at the level of the 80s and amounted to 230 per 1 thousand population, and among women it decreased to 98. Many researchers explain this pattern by the protective function of female sex hormones and the lower prevalence of tobacco smoking and alcoholism among women during many countries in Europe and North America.
The main cause of death in economically developed countries is cardiovascular diseases, cancer is in second place, and external factors (bodily injuries and poisoning) are in third place. In countries where the transition to market economy, deaths associated with the latter cause are reaching epidemic proportions as a result of increased violence in society, economic crises, and mental stress.
In 2002, injuries were the cause of death for 5 million people (9.1%) (1 in 10 deaths): 3.4 million men and 1.7 million women. In several countries in the Americas, Eastern Europe and the Eastern Mediterranean region, injuries caused the death of 30% of the population aged 15 to 44 years. Men die 3 times more often in road accidents, and 4 times more often in homicides, suicides and wars than women.
Accidents and other external causes of injury in countries Western Europe account for 6%, and in Eastern Europe – 12% of total mortality. Mortality from these causes has increased sharply in the CIS countries and Russia, partly as a result of violence, due to weakening (compared to the past) control over the use of safety precautions, efforts psychological stress, which in turn leads to increased alcohol consumption. In Russia, more than 200 thousand people die each year due to alcoholism. According to WHO, in Russia in 1985, the consumption of “legal” alcohol per year was 8 liters per person, and “illegal” alcohol consumption was 10 liters. In 2004, consumption of “legal” alcohol was 6.4 liters per year, and “illegal” alcohol consumption was 14 liters per year per person. Only 15% of technical alcohol is used for its intended purpose, and the remaining 85% is drunk by Russians.
The leading causes of death among the population of working age (20 years - 64 years) are (in descending order): HIV/AIDS, coronary heart disease, tuberculosis, road traffic accidents (RTA), cerebrovascular diseases (14; 8.6; 6. 6; 5.3; 5.2% of all cases, respectively).
It should be noted the influence of tobacco smoking on mortality statistics. These are malignant tumors of the oral cavity, larynx, and bronchi. The effect of nicotine complicates the course of a number of diseases: atherosclerosis, hypertension, gastritis, endocrine diseases. In Russia, more than 260 thousand people die annually from causes related to smoking.
Significant progress in reducing infant mortality (IC) has been achieved in economically developed countries, where it does not exceed 6.0 per 1 thousand births. In our country in 1965 it was 26.6; in 1985 – 20.7; in 1998 – 16.5; in 2002 – 18.0 per 1 thousand births, but it remains 2–4 times higher than in developed countries.
