TRANSFORMATION OF THE STRUCTURE OF YOUTH MORTALITY DURING THE PANDEMIC IN RURAL SETTLEMENTS, MOSCOW AND OTHER CITIES OF RUSSIA
Authors:   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Sabgaida Tamara 
Published: June 2024

Significance. A change in the structure of youth mortality may indicate the emergence of new problems in health protection among young people. The increase in mortality among young people during the pandemic is largely due to its indirect influence, which can be determined by living conditions that are fundamentally different in rural settlements, the capital and other cities of the Russian Federation. It can be assumed that among young people, the highest indirect loss during the pandemic will be among rural youth, while the least one - among Muscovites. The ppurpose of the study was to analyse transformation of the structure of youth mortality in rural settlements, Moscow and other Russian cities. Material and methods. The study used Rosstat data on mortality among Russians aged 20-34. The standardized death rates for boys and girls living in the capital, other cities of the country and rural areas were compared, and the ratios between the 2022 indicators and 2019 indicators were calculated. Deaths due to alcohol and drug use were analysed. Years of potential life lost until 70 years were calculated per 1000 corresponding population. Results. From 2019 to 2022, mortality among young Muscovites increased by 7.4% compared to 23.0% in other cities and 27.3% in rural areas. Among girls, mortality increased by 4.5% in Moscow and decreased by 7.3% in other cities and by 11.0% in rural areas. Despite the fact that the contribution of COVID-19 to youth mortality was less than 5% in 2022, the structure of mortality was significantly different from the one in 2019. Among Muscovites, changes in mortality are largely due to indirect impact of the pandemic; while among rural youth, a greater increase in mortality is due to concomitant infection with the SARS-CoV-2 virus, resulting in complications, and among residents of other cities, direct and indirect impacts were approximately the same. With the smallest total years of potential life lost due to all causes in Moscow, in 2022, YPLL associated with the use of psychoactive substances equalled to 25.3 and 3.9 person-years per 1000 population of corresponding gender and age in Moscow, among boys and girls, respectively, 14.5 and 2.5 person-years in other cities and 10.5 and 2.1 person-years in rural areas. Limitations. The quality of the analysed data is limited by quality of death cause coding in different regions. Conclusion. Young people in the capital experienced the greatest changes in the structure of death causes after the pandemic and the highest indirect loss due to the pandemic, associated with behavioural risk factors. More favourable living conditions and a higher level of life in the capital create “hothouse” conditions for young people, slowing down the development of their ability to withstand difficulties. The influence of “hothouse” conditions is not compensated by the capital’s opportunities for creativity realization and entrepreneurial activity. There are some grounds to hope for a reduction in youth mortality from alcohol-related causes, but so far there is no reason to expect a reduction in mortality from drug-related causes.