Regional indices and total mortality in the Russian Federation: general trends of associations in 2005–2022 and the impact of COVID-19

Regional differences in living conditions can affect human health, which must be taken into account when solving a wide range of practical health problems. In Russia, the impact of a set of regional conditions on public health indicators has not been assessed within the framework of unifi ed methodological approaches over a long period of time.

Aim. To analyze associations of total mortality with regional indices in the period 2005–2022, with an assessment of the impact of the COVID-19 pandemic.

Materials and methods. Four regional indices characterizing the territories of Russia in 2005–2022 from socio-economic, demographic and industrial-ecological positions were used as living conditions of the population. Total mortality rates for the same period were obtained from the official website of the Federal State Statistics Service. To assess the associations, linear regression was used, adjusted for the medical and organizational characteristics of the regions.

Results. In the vast majority of the analyzed years, total mortality is statistically significantly associated with demographic and socio-economic, but not with industrial and ecological living conditions in the regions. The strongest inverse associations are demonstrated by the Demographic Index, an increase in which by 1 unit statistically signifi cantly reduces the total mortality rate by 2–3 units. During the COVID-19 pandemic, in 2020–2021, there was an increase in the associations of the Demographic and Economic indices, with a subsequent return to pre-COVID values  in 2022. The identified trends are characteristic of both quantitative and qualitative presentation of regional indices, as well as with a shift (lag) of the indicators under consideration.

Conclusion. The study allowed us to state long-term stable associations of demographic, economic and social regional characteristics with total mortality. A significant change in the strength of associations of regional indices with total mortality in 2019–2021 characterizes the COVID-19 pandemic as a powerful public health factor.

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