MORTALITY AMONG WORKING-AGE POPULATION IN RUSSIA AS INDICATOR OF SOCIAL TENSION ASSOCIATED WITH THE PANDEMIC
Authors:   Federal Research Institute of Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Semyonova Viktoria ,   Institute of Demographic Research - a separate division of the Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences, Moscow, Russia, Evdokushkina Galina ,   Federal Research Institute of Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Muzykantova Natalia ,   Federal Research Institute of Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Zaporozhchenko Vyacheslav ,   Federal Research Institute of Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: January 2024

Significance. Analyzing the period of the COVID-19 pandemic, it seems reasonable to characterize it as a time of social tension: first, due to a complete unexpectedness (it could not have been predicted and, accordingly, prepared for), second, due to universality (the pandemic has affected all countries and all strata of society), third, due to economic consequences. Social tension as such could not but lead to additional deaths among working population, in addition to those directly caused by COVID-19. WHO has suggested to consider deaths from external causes (from suicide, alcohol and drug) as indicators of social tension. That is why manifestations of social tension in working ages are currently of a special interest as a likely predictor of medical and social shifts in the formation of possible crises in future. The purpose of the study is to assess manifestations of social tension among working population in Russia on the basis of deaths from external causes. Material and methods. The assessment of deaths due to social stress associated with the COVID-19 pandemic is based on Rosstat data on deaths from suicide, alcohol, drug use and their consequences among working population (15-59 years) in Russia, Moscow and St. Petersburg since 2011. The indicators were analyzed using Microsoft Excel 16. Results. The cumulative mortality rate due to all 3 indicators of social tension – suicide, alcohol and drug and their consequences – increased by 8.2% in men and 8.4% in women in the first year of the pandemic; in 2020-2021, deaths in men did not change, adding up to 112 per 100,000, while in women it decreased by 2.2%. Such dynamics resulted in an 8.2% increase in the male indicator and a 6% increase in the female indicator in 2019-2021. Changes in the internal structure of the aggregate indicators of social tension are as follows: comparing the indicators of 2019, the pre-crisis year, and 2021, one can see a decrease in the contribution of both suicide and alcohol-related mortality (from 37.7% to 32.3% and from 54.2% to 51.1% in males and from 26.5% to 25% and from 69.5% to 65.9% in females, respectively) against the background of a multiple increase in the total mortality associated with drug use (from 8.1% to 16.6% and from 4% to 9.1%, respectively). Conclusion. The social tension associated with the COVID-19 pandemic in Russia was of a short-term nature, and failed to increase suicide-related mortality in Russia. Mortality caused by alcohol, a traditional risk factor in Russia, showed negative dynamics only in the first year of the pandemic, followed by the return to sustainable positive trends developed in the 2000s. The only pronounced medical and social consequence of the social tension caused by the pandemic is the increased drug-related mortality. Drug addiction and its consequences turned out to be the only cause of death associated with the increase in mortality during both the first and in the second year of the pandemic. Drug-related mortality has a pronounced regional specific, identified by the comparison of entities of the Russian Federation close in socio-economic, demographic, and cultural contexts: Moscow and St. Petersburg. Recommendation. There is a current need to set up a system for comprehensive registration of deaths due to suicide, as well as deaths caused by the main risk factors – alcohol and drug use, based on both mortality from external causes and mortality from the entire spectrum of somatic disorders.