The face tells its own story: of laughter, worry, hope and fear. It is a landscape, a map of our experiences. Each face expresses its personal fate and is, at the same time, the face of human kind.
The photos presented on the cover page of the publication were created within the ongoing Global
Photo Project, a study of faces of people of all ages around the world. The photo sessions of the Russian
citizens were arranged in 2002. In the Moscow series there are 73 portraits, depicting people of ages 0 to 72,
which is the life expectancy for women in Russia. Between the ages of 0 and 59, which is the life expectancy for men in Russia, men and women are represented in equal numbers. From the age of 60 the exhibition
shows only women's portraits.
Photographer - © Ivar Sviestins.
www.globalphotoproject.com
DEMOGRAPHIC POLICY
IN RUSSIA:
FROM REFLECTION
TO ACTION
Moscow 2008
This publication has been prepared by a team of Russian experts and consultants. The analysis and policy recommendations in this publication do not necessarily reflect the views of the UN system and the institutions by which the experts and consultants are employed.
Chief author:
Valery Yelizarov, Doctor of Economics, Head of the Center for Population Studies, Moscow State University
Economics Department.
Authors:
Vladimir Arkhangelsky, Doctor of Economics, Lead Scientific Specialist at the Center for Population Studies,
Moscow State University Economics Department.
Alla Ivanova, Doctor of Economics, Professor of Health Statistics at the Central Research Institute for
Organization and Informatization of Healthcare, Russian Ministry of Health and Social Development.
Olga Chudinovskikh, Doctor of Economics, Center for Population Study, Moscow State University Economics
Department, assisted by Yelena Tyuryukanovoi and N. Mkrtchyan.
Svetlana Misikhina, Doctor of Economics, Director of Social Policy at the Institute of Urban Economics.
Box inserts prepared by:
Kirill Danishevsky, Doctor of Medicine, Associate Professor, Social Health Division of the Department of
Healthcare Administration at the Sechenov Moscow Medical Academy and Lead Specialist at the Open
Institute of Health.
Natalia Zvereva, Doctor of Economics, Center for Population Study, Moscow State University Economics
Department.
Natalia Zubarevich, Doctor of Geography, Associate Professor, Moscow State University Department of
Geography.
Andrei Korovkin, Doctor of Economics, Manager of Labor Resource Evaluation, Institute of National Projects
under the Russian Academy of Science.
Aleksandr Nemtsov, Doctor of Medicine, Head of the Information and System Research Division, Moscow
Psychiatric Research Institute, Russian Ministry of Health and Social Development.
Boris Revich, Doctor of Medicine, Lead Scientist at the Institute of National Projects, Russian Academy of
Science.
Viktoria Semenova, Doctor of Economics, Professor and Senior Scientist, Central Research Institute for
Organization and Informatization of Healthcare, Russian Ministry of Health and Social Development.
Svetlana Seregina, Doctor of Economics, Professor in the Theoretical Economic Division, State University
Higher School of Economics, Economics Department.
Yelena Tyuryukanova, Doctor of Economics, Lead Scientist at Institute of Socio-Economic Population Issues,
Russian Academy of Science.
Shombi Sharp, UNDP Regional HIV/AIDS Team Leader.
Reviewers:
Evgeny Andreev, Max Planck Institute for Demographic Research, Rostock, Germany.
Oksana Sinyavskaya, Doctor of Economics, Deputy Director of Independent Institute for Social Policy.
The Publication is intended for use by decision-makers, officials and administrative personnel at the federal and regional level, researches, students and general public.
The United Nations in the Russian Federation express its sincere gratitude to the sponsors of the Publication.
United Nations Population Fund
United Nations Development Programme
United Nations Children’s Fund
United Nations Educational,
Scientific and Cultural Organization
World Food Programme
Office of the United Nations High
Commissioner for Refugees
The authors express their sincere gratitude for leadership and membership of the
UN Russia team: Marco Borsotti - UN Resident Co-ordinator and UNDP Resident
Representative in the RF, Karl Kulessa - UNFPA Representative, as well as Sietske
Steneker, Lidia Bardakova, Dmitri Mariassin, Alexander Mordovin, Arina Flyugova and
Victoria Zotikova.
The authors also wish to thank all experts of the UN system in Russia who submitted
their views and constructive comments to the drafts of the publication.
Dear Readers!
I am glad to present to you the publication "Demographic Policy in Russia: From Reflection to Action"
initiated by the United Nations system in the Russian Federation and prepared by agroup of independent
national experts.
Why the topic of demography has been chosen? It is obvious that a demographic situation directly
affects the economic development of a country, its competitiveness and stability, and in the end, the wellbeing and prosperity of its citizens. And wisely, the leadership of the Russian Federation has brought this
issue to the top of the national agenda, including the adoption of a concept of a long-term demographic policy and a series of decisive measures to overcome the existent demographic crisis.
However, it remains one of the most severe challenges in modem Russia: the ongoing population decline
and shrinking workforce are caused by low fertility, high mortality, ageing, a reduction in the working share
of the population, and so far indistinct migration policy pose risks for the future of the country.
In this context, the UN agencies in the Russian Federation have brought the strategic support of national efforts to overcome a demographic crisis to the forefront of its joint activities. Thecurbing or complete
reversal of negative demographic trends require the development of acomprehensive approach and subsequent long-term policies. By sponsoring this analysis, weattempted to contribute to this complex process.
The authors analyze both positive and negative trends, as well as try to evaluate possible scenarios of
demographic development. The publication is based on a wide range of statistical and empirical data describing - in a concise and clear form - general trends of demographic situation development in Russia as well as
basic properties and causes of the demographic crisis and its negative consequences for the country.
Importantly, it shows how demographic policy is linked to broader social policy and demonstrates the deleterious consequences of leaving demographics unaddressed in social policy.
I hope that the concrete recommendations offered by the publication will prove to be useful todecision-makers at the federal and regional levels of authority in Russia and other high-ranking officials. Let me
also hope that this publication will facilitate a wide public discussion, which will help mobilize joint efforts
for tackling the demographic crisis.
Marco Borsotti
UN Resident Co-ordinator/
UNDP Resident Representative
in the Russian Federation
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
CONTENT
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Excutive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
1. Russia’s Changing Population and Demographic Structure . . . . . . . . . . . . . . . . . . . . . . . . .11
1.1 A declining population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
1.2 The consequences age-group Imbalances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
1.3 Demographic waves and declines in fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
1.4 Growing dependency ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
2. Fertility in Russia: Trends and Policy Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
2.1 Basic characteristics and causes of low fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
2.1.1 Enduring low fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
2.1.2 Low fertility is not unique to Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
2.1.3 Shifts in the age-adjusted fertility model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
2.1.4 Shifts in public attitudes towards reproductive behavior . . . . . . . . . . . . . . . . . . . . . . . . .18
2.1.5 Poor reproductive health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
2.2 Desiging and implementing effective fertility policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
2.2.1 The need for comprehensive fertility policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
2.2.2 Key areas to target for fertility policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
2.2.3 Implementing comprehensive fertility policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
2.3 Expected policy results and prospects for increased fertility . . . . . . . . . . . . . . . . . . . . . . . . . .22
2.3.1 The need for realistic expectations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
2.3.2 International experience on supporting families with children . . . . . . . . . . . . . . . . . . . . . .23
2.3.3 Accounting for shifting age composition in fertility policies . . . . . . . . . . . . . . . . . . . . . . .23
3. Mortality and Life Expextancy in Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
3.1 Why does russia lag in life expectancy indicators? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
5
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
3.2 Why is Russia one of the few countries with decreasing life expectancy? . . . . . . . . . . . . . . . . .26
3.2.1 Common factors with transition countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
3.2.2 Drivers of mortality throughout the Russian transition . . . . . . . . . . . . . . . . . . . . . . . . . . .27
3.2.3 Recent trends: from stability to growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
3.3 Mortality reduction policies in Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
3.3.1 Decreasing poverty as a driver for reduced mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
3.3.2 Encouraging healthy lifestyles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
3.3.3 Reducing preventable mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
4. Migration Trends and Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
4.1 Key migration trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
4.2 The inportance of international labor migration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
4.3 Migrants in Russian society: trends and challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
4.4 Domestic migration: trends, opportunities and limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
4.5 Refugees and forced relocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
4.6 Recommendations for and effective Russian migration policy . . . . . . . . . . . . . . . . . . . . . . . . . .47
5 Demographic Policy as an Element of Social Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
5.1 Demographic components of social policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
5.1.1 Economic growth has not resulted in improved demographics . . . . . . . . . . . . . . . . . . . . . .52
5.1.2 Addressing issues in maternal support policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
5.1.3 Low maternal and child support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
5.1.4 Living conditions as a crucial issue for young people . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
5.1.5 New measures to support families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
5.2 Influence of social policy on demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
5.2.1 Can new measures be effective? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
5.2.2 Opportunities to reduce space shortages in pre-schools . . . . . . . . . . . . . . . . . . . . . . . . .55
6
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
5.2.3 Encouraging responsible parenthood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
5.3 Options to improve socio-demographic policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
5.3.1 Long-term and short-term impact of demographic policies . . . . . . . . . . . . . . . . . . . . . . . .56
5.3.2 Challenges and recommendations for Russia's demographic crisis . . . . . . . . . . . . . . . . . . .57
5.3.3 Implementing demographic policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
6. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
TEXT BOXES
BOX 1 - Age-gender Adjusted Structure of the Russian Population . . . . . . . . . . . . . . . . . . . . . . . . .11
BOX 2 - The Russian Labot Market . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
BOX 3 - Gender Dimensions of Demography Across Regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
BOX 4 - Values and Living Standards as Determinants of Fertiilty . . . . . . . . . . . . . . . . . . . . . . . . . .24
BOX 5 - Mortality from External Causes in Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
BOX 6 - Prevention and Control of Risk Factors: Non-infectious Disease . . . . . . . . . . . . . . . . . . . . .31
BOX 7 - Demography, Economy and AIDS in Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
BOX 8 - Alcohol Policies and Consumption in Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
BOX 9 - Urban Environmental Challenges and their Impact on Mortality . . . . . . . . . . . . . . . . . . . . . .38
BOX 10 - Contribution of Migrants to the Russian Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
BOX 11 - Demographic Challenges in the Concept of Long-term Socio-economic Development
of the Rissian Federation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
BOX 12 - Social Support of Low Income Families in Tomsk Oblast . . . . . . . . . . . . . . . . . . . . . . . . .56
7
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Introduction
For forty years, the level of fertility in Russia
has been too low to ensure a stable population.
Mortality in working-age men is as high now as
it was a century ago. Raising life expectancy above
70 years, achieved in Russia during the late 1960s
and in the anti-alcohol campaigns of 1986-1987, is a
worthy goal. The need to improve quality of life has
become more evident as 15 developed countries
worldwide have already attained life expectancies
above 80 years and an additional dozen are expected to soon reach this level.
Russia's demographic trends have much in
common with other European countries, including
low fertility, shifting family structures, a high percentage of births out of wedlock, and an ageing
population. At the same time, other dynamics bear
a greater resemblance to transition countries,
including declining incomes, growing poverty,
widening social inequalities, high unemployment,
and shrinking access to social services such as
healthcare and education.
The transition from a planned economy to
a market economy, accompanied by a transformation in social policy, has greatly changed the
lifestyles of families and has resulted in great hardships for many households. In turn, these trends
have changed marital, reproductive and coping
behavior across social groups and geographic areas.
Current demographic trends are also related
to the neglect of demographics in medium-term and
long-term strategies, the lack of long-term programs to address Russia's demographic crisis, the
8
absence of a federal agency to ensure the country's
demographic development and insufficient financing
for social policy.
In other words, the current challenge is the
result of neglecting a worsening demographic situation since the late 1980s.
In the past, government strategies assumed
the demographic challenge could be solved by
increasing migration to Russia.
However, President Putin's annual address to
the Federal Assembly in April 2006 admitted that
“migration will not solve our demographic problems
if we do not establish the proper conditions and
stimuli for growth in fertility here, in our own
nation. We lack effective programs for supporting
mothers, children, and families.”
President Putin also stated that Russia
requires long-term programs for at least 10 years
that provide proactive policies to reduce mortality,
increase fertility and create an effective migration
policy. The resulting program based on the Concept
of Demographic Policy of Russia until 2025, was
enacted by Presidential Decree in October 2007.
The government is expected to realize its work plan
to implement the Concept in 2008-2010.
The authors of this report aim to contribute
to the development of these policies by providing
a concrete description and explanation for the current demographic situation. As well, the authors
propose conclusions and recommendations to
assist the development of demographic strategies
and programs designed to halt the decline of population, improve fertility and life expectancy, and to
improve migration.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Executive Summary
Main trends
Demographic development in Russia that to
a large extent has much in common with the European
one is characterized by the following trends:
1. It is already for forty years that fertility
in Russia cannot provide for the simple replacement
of its population; mortality in men of working age
is as high as it was a century ago.
2. Beginning from 1992, mortality in Russia
has consistently exceeded fertility: the loss of population has amounted to approximately 12 mln individuals and was partially compensated for by
5.5 mln due to migration gains.
3. Should current reproductive trends (low
fertility and high mortality) remain, they could lead
to a nationwide population of 125-135 mln by early
2025 and as low as 100 mln by 2050.
4. The age and gender structure of the population has been severely distorted, which has and
will have negative effects on reproduction.
5. The ageing of the population is continuing,
as a result of which the size of the working-age
population will fall by up to 1 mln annually already
by 2020-25, thus raising the dependent load to 670750 and 900-1000 by 2050, which will negatively
influence economic growth rates. This will inevitably
lead to increasing the retirement age in the near
future.
According to the preliminary data for 2007,
the number of births increased and mortality went
down. But this doesn't change a principal evaluation
of the situation: a favorable trend may continue for
another 5-6 years, and then the loss will start to
grow.
At the moment, there are no grounds to
believe that the crisis will be overcome and the size
of the population will be stabilized or that the goal
of the state to raise the size of population to
145 mln persons will be reached.
Fertility in Russia
In last years, the total fertility rate has been
around 1.3 (births per one woman), which is 1.65
times lower than needed for replacement of the
population (2.15). The age fertility model is coming
closer to the one in the majority of developed countries: more and more births take place after 25 and
even 30 years of age. The share of children born
from unmarried mothers is growing. In last years it
has been around 30%.
The primary causes for low fertility and the
low number of children are financial difficulties, the
perception that living conditions will impede on the
raising of children and widespread incidence of
families not wanting to have multiple children, even
under favorable conditions. The negative situation
is worsened by the problems with reproductive
health: low culture of birth management, widespread abortions and infertility. A set of measures
that provides socio-economic support to families
with children, encourages the birth of second and
third children in families, and improves reproductive
health could increase the total fertility rate to
approximately 1.7-1.8, or slightly more, by 2025. At
this, the expectations must be realistic: it is not
likely that in the foreseeable future the fertility rate
in Russia will raise to the level of generation
replacement. To ensure sustainable fertility growth,
it will take long-term budgetary investments and
stage-wise increase in spending on family and
maternity benefits. The implementation of policies
will require the monitoring of fertility and reproductive health.
Mortality and life expectancy in Russia
Russia is one of the few countries in the
world where life expectancy has decreased in
comparison to 1960s levels. Russia is behind
developed countries in terms of life expectancy
by 15-19 years for men and 7-12 years for women.
The Russian phenomenon of hypermortality comes
to be observed primarily in working-age populations: compared to the majority of countries that
have similar level of economic development, mortality in Russia is 3-5 times higher for men and
twice as high for women. In the nearly two
decades of the reform period, a segment of population living on the verge of poverty expanded
and multiplied, exhibiting habits and factors contributing to risk: alcoholism, smoking, improper
nutrition, avoidance of healthcare, and psychological stress.
A clear priority in the area of healthier life
style in Russia is the development of a program to
reduce alcohol consumption. Another important
measure is to develop programs to reduce the distribution and consequences of preventable diseases
and mortality factors by providing economic and
geographic access to healthcare services, most of
9
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
all in medical and social prevention and primary
treatment. In 2005, by primary prevention means
only, about 150 thousand deaths could have been
avoided (about 105 thousand men and 45 thousand
women) in the age of up to 65 years.
Migration and migration policy
Till mid-1990s forced mass migration of
Russian-speaking population was coming in Russia
from the ex-USSR countries. By the mid-1990s,
flows of forced migrants began to fall and labor
migration took the lead in volume and in economic
consequence. According to official data only, 1.014
million labor migrants worked in Russia in 2006,
accounting for 1.5% of workers in the Russian
economy. Migrants are generally concentrated in
lower sectors of the labor market, occupying difficult and unwanted jobs in construction, transportation, industry, agriculture, and service industries.
Current priorities in Russian migration policy are associated with combating illegal migration, the volume of which is evaluated differently
by researchers and authorities. New turns in
Russian migration policy include the adoption of a
program promoting the voluntary relocation of
compatriots. Demographic situation and the labor
market in certain regions are compounded by
internal migration, the consequences of which are
controversial.
Today Russia is interested in accepting highly varied groups of migrants: those applying for
permanent residence and Russian citizenship; temporary employees, including short-term season
laborers, and longer-term labor migrants; students;
and relatives visiting family members in the families
reunification program.
Migration legislation and policy have to provide adequate possibilities to implement of each of
these migration models. Solving the problem of
hostile tendencies and social isolation of immigrants from Russian society is an important prerequisite to success.
Demography and social policy
The economic growth observed in 20002006 led to significant growth in the wellbeing of
the population and lower poverty levels in Russia.
However, positive changes in the standard of living have not resulted in demographic improvement.
10
Despite the fact that demographic problems
have been included in the programs of development
in the Russian Federation, it seems it is still too
early to say that Russia has developed and is implementing a detailed set of socio-demographic policies including all necessary components for achieving set goals in demographic development. For
instance:
• As of mid-2007, there was a deficit of
about 1 mln spots in preschool facilities for children.
• Maternity and children allowances in Russia
and their share in GDP and contribution to the family income are much lower than in European countries.
• About 2/3 of the population in Russia are
not satisfied with their housing. One in four families live in poor or very poor housing, whereas no
more than 25-30% families can participate in mortgage lending programs.
• Measures to provide economic assistance
to families with children are currently not supported
with the measures to raise responsibility among parents.
In general, the kind of aid now offered to
families with children, however, is obviously
insufficient to achieve the full program, which
calls for increases in second and higher order
births, just as it fails to boost fertility, change
the system of values, and promote the prestige of
multi-children families. Corrections to such a rampant demographic situation are very expensive
and taxing.
The concept of demographic policy in
Russia is adopted: what next?
On 9 October 2007, the President issued
a Decree to adopt the Concept of Demographic
Policy to 2025 and ordered within 3 months
to adopt the plan of the Program's implementation
in 2008-2010.
The document gives a detailed description
of the principles of the demographic policy,
identifies the tasks and the stages of implementation.
However, quantitative indicator that describe
set ambitious goals and tasks make one doubt if
they are correct, agreed and realistic.
It is obvious that further work is needed to
specify set tasks and goals, to give concrete definition
to such tasks for different levels of implementation of
demographic policy (federal, regional, local), calculate
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
required funds and look for the mechanisms of
financing of demographic policy. Many issues of providing information, legal, scientific support and
human resources for demographic policy remain outstanding.
It is equally necessary to continue the
research of determining factors and consequences
of the current demographic situation and factors
that can in principle impact its improvement by
studying the experience of other countries that try
to address similar problems. Many issues because
of their complexity and scale are still open for discussion that must involve all the stakeholders state authorities, public organizations, socially
responsible business and experts in demographic
and social policy.
11
Russia’s Changing Population
and Demographic Structure
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
1. Russia's Changing Population
and Demographic Structure
1.1. A declining population
Russia's population peaked at 148.5 million in
early 1993 and has since declined to 142 million in
2007 according to the Federal State Statistics
Service.
Since 1992, mortality has consistently
exceeded fertility. For 16 years (1992-2007) deaths
have exceeded births by approximately 12 million,
although this decline was partially off-set by 5.5
million in net migration. In 1992-2007, Russia's population declined by 6.5 million or 400,000 people
per year, with the rate of decline increasing to over
650,000 people per year in 2000-2006.
To put the significance of this decline in
perspective, Russia's population declined by 0.5
percent annually in 2000-2006, a decline roughly
equivalent to the size of Novgorodskaya or
Kostromskaya oblasts, Karelia or large cities such
as Krasnodar or Barnaul.
Unchecked, such demographic trends (low
fertility and high mortality) could lead to a decline
to 122-125 million by early 2025. By 2050, the population could fall as low as 100 million.
Although preliminary data for first three
quarters of 2007 suggest rising fertility (8.3 percent) and declining mortality (4 percent), which is a
significant slowing of the population decline (by 70
percent), the basic demographic dynamics remain
unchanged.
While these favorable trends may last another five or six years, all recent forecasts conducted
by various institutions predict that Russia's population decline will only intensify.
There is no reason to assume that Russia can
recover from the crisis and stabilize its population.
The authors of this publication do not share the
optimism of government officials who claim that
Russia will succeed in halting the population decline
by 2015 and increase the population to 145 million
by 2025. Among other reasons is the distortion of
the population structure in terms of gender and age
that would affect reproduction in the future.
BOX 1 . AGE-GENDER ADJUSTED STRUCTURE OF THE RUSSIAN POPULATION
The below age-sex structure illustrates Russia's
demographic history. Events such as the famine of the
early 1930s, the banning of abortions in 1936, the massive casualties of the Second World War, the demographic policies of 1981-1982, the anti-alcohol campaigns of 1985-1987, and the financial crisis of 1998 significantly influenced fertility and mortality, and consequently the size and structure of Russia's population.
The war generation born in 1943-1944 is one of
the smallest of the 20th century, which reached 62-63
years in early 2007. The next small generation, currently 37-39 years old, are the children of the war
generation. The length of a generation, or the gap
between the births of parents and their children, is
approximately 25 years, which explains why 1943 and
1968 were years of low fertility. Consequently, lower
fertility was structurally unavoidable in 1993.
The gender structure of Russia's population
is highly imbalanced. There are currently 1,160
women for every 1,000 men, such that women outnumber men by more than 10 million. Before the
Second World War, the gender gap was much less
significant. The huge loss of life among men during
the war created a severe gender imbalance. After
the war, the disparity gradually repaired itself and
the gender gap visibly narrowed in national censuses in 1970-79-89.
After 1995, the gender gap began increasing,
primarily because of high mortality among men. Boys
are more likely to be born than girls globally (approximately 106 boys to 100 girls), which compensates for
characteristically higher male mortality.
There are generally equal numbers of men and
women born in the same year at 30 years of age.
Consequently, there is no significant shortage of
potential husbands at the age when families are characteristically formed. Older age groups, including
working-age, early retirees, and pensioners, show a
greater gender gap, which increases with the age of
the group. There are thus 260 working-age women
for every 100 working-age men and 380 women over
80 for every 100 men over 80.
Valery Yelizarov
13
1.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
1967-1969 births
“echo wave”
1986-1987 births
Anti-alcohol campaign
1 500 000
Extrapolating from these dynamics, if we add 25
years to 1986-87, a localized peak of births is projected in 2011-2012. After 2012, however, the number of
births will again decline following the trend in 1987-1994.
1.4. Grownig dependency ratios
Russia's population is ageing, principally
due to low fertility that reduces the number and
proportion of children. According to census data,
the share of children aged 0-15 totaled 29.9 percent in 1959, 24.5 percent in 1989, 18.1 percent in
2002, and 16.0 percent in early 2007.
Although growing at a slower pace than in
the 1960-1990s, the proportion of elderly people
also continues to rise. Census data shows that
the share of people over 60 was 9.0 percent in
1959, 15.3 percent in 1989, 18.5 percent in 2002,
and 17.1 percent in early 2007. This latest
decrease is due to the small generation of
wartime births and is temporary, such that ageing
trends will soon resume. Given the age structure
Diagram 2 - Number of Births in the RF, 1946-2010
Years
2010
2008
2006
2004
1998
2002
1996
2000
1994
1992
1990
1988
1986
1984
1982
1978
1976
1980
1974
1972
1970
1968
1966
1964
1962
1960
1958
3100
3000
2900
2800
2700
2600
2500
2400
2300
2200
2100
2000
1900
1800
1700
1600
1500
1400
1300
1200
1100
1000
1956
The principal reason for persistent imbalances
in the age-adjusted structure of Russia's population is
a curve-like demographic wave in the number of births
(see Diagram 2). A great decline in births, totaling 1
million in 1960-68, was the result of high male casualties during the Second World War. This decline
repeats itself in 1987-95, a full generation later.
The last section of the graph shows recent
data and estimates until 2010. In this period, the
population growth in 1968-1983 is repeated,
although at a lower level.
1 000 000
1954
1.3. Demographic waves and declines
in fertility
500 000
1952
In the four years following the 2002 census, the size of age groups increased significantly for 60-64 years (+3.6 million) and 1014 years (+3.1 million), while 55-59 years
decreased (-3.6 million). Such significant shifts
shape the size of the working-age population and thus
the ratio between working-age people and dependents.
Such fluctuations in age groups negatively
affect the economy by creating high variance in the
size of the labor force, These also affect the size
of the retirement age group, pensions and state
spending on health services, the size of the infant
and child populations, students and state spending
on education, and the size of conscripted groups.
0
1950
500 000
1.2. The Consequences age-group
imbalances
14
1933-1934 births
Famine 1932-1933
1937-1938 births
Abortions banned in
1936
1948
1993-1994 births
second “echo wave”
Women
1946
1983 births
In 1981-1982 state
programs and support
for families with children
100+
Men
95
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
1 500 000 1 000 000
Thousand people
1943-44 - The war
generation
Diagram 1 - Age-Adjusted Structure of Russia's Population
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
of Russia's population, the share of working-age
population has peaked and the dependency ratio
is at its lowest. The size of the working-age population in Russia is projected to fall by up to 1 million per year in the coming years, increasing the
dependency ratio from 670-750 in 2020-2025 to
900-1000 by 2050, which will negatively influence
economic growth rates (see Box 2).
To properly understand Russia's demographic challenges, the regional and gender dimensions
of the demographic situation must also be considered (see Box 3).
Table 1 - Age-adjusted Structure and Dependency Ratios
Age group of the population
(1000s)
Below Working Age
Working Age*
Above Working Age
Dependency Ratio**
1959
(census)
35094
68609
13827
713
1989
(census)
35995
83746
27196
755
2002
(census)
26327
88942
29778
631
2006
2007
(as of 1 Jan) (as of 1 Jan)
23317
22718
90328
90152
29109
29351
580
578
* Men aged 16-59 and Women 16-54
** The number of dependants (those above and below the working age) and per 1000 working-age population.
BOX 2. THE RUSSIAN LABOR MARKET
Demographics will increasingly influence
medium- and long-term trends in the Russian
labor market. The following trends are already
visible in the Russian labor market:
economic growth has increased demand for
labor
a decreasing working-age population
labor market defects in the division of labor
low wages constrain labor productivity growth
social inequalities are exacerbated by wage
inequalities
deteriorating quality of the labor force (declining
educational quality, health and increasing age)
Projections estimate a labor shortage in
2012-2014, which will worsen over time. Depending
on development forecasts, the labor shortage may
total 20 percent of demanded labor. Labor shortages are expected to be most pronounced in the
Central, Ural, Northwest, and Volga federal districts, and in the industry, construction, transportation, and communications sectors. The Russian
economy currently faces a shortage of skilled labor.
Prospects for replacing the ageing work force in
high technology industries, such as the defense sector, are problematic. As a significant share of pensioners is currently employed, an increase in the
retirement age (for example, 60 years for women)
may not significantly alleviate the labor shortage.
A successful approach to resolving the looming labor shortage would include a comprehensive
package of economic and social policies to
increase economic activity, raise labor productivity,
and improve the structure of the labor market, particularly addressing the distribution of the labor
force across sectors, as well as structuring internal
and external migration. Unemployment in Russia is
in a large part due to structural imbalances
between the supply and demand in labor for different regions, sectors, professional categories
and gender-age categories. Sector-specific unemployment grew from 39 to 43 percent of total
unemployment in 2000-2006. Likewise, regional
unemployment increased by 7 percentage points in
2000-2006. This follows a general trend of growing
regional unemployment, which has doubled from 22
percent in 1992 to 43 percent in 2006.
The real scope of unemployment could be
greater. In addition to sectoral and regional
unemployment, there is also localized unemployment within professional, educational, and age
categories. In general, the labor market is not
very effective in matching supply with demand.
Effectively addressing the challenge of unemployment requires tackling the following obstacles:
low and unpredictable labor mobility between
sectors, regions and professional categories
the absence of a professional or vocational education system to meets the needs of the labor market
undeveloped infrastructure and lack of institutionalization of the labor market
15
1.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
The overall efficiency of demand and supply at the labor market remains at a relatively low
level.
The following measures would improve the
effectiveness of the socio-economic situation
and the Russian labor market:
Improved labor productivity, particularly by
modernizing manufacturing and at the same
time maintaining the potential of the extractive industries
A partnership between government and the
private sector to develop a professional and
vocational education system that meets the
needs of the labor market
Reform of higher professional education to
make it more flexible in meeting the needs of
the labor market
Providing stable employment and a secure
social safety net for older generations
Reducing differences in wages between sectors and regions
Considering and utilitizing labor migration
as a significant factor for the labor market
Andrei Korovkin
BOX 3. GENDER DIMENSIONS
OF DEMOGRAPHY ACROSS REGIONS
16
Diagram 3 - Life expectancy in the 5 percent of
regions with the highest and lowest weighted and
non-weighted indicators of the size of the population
75
5% lowest weighted
indicators
70
Life expectancy
The severity of gender gaps in life expectancy
varies significantly across regions. Economic marginalization and worsening living conditions have created
areas with stable, high male mortality. For the most
part, these are regions with small populations of indigenous peoples in the north and in Tyva Republic, where
life expectancy is the lowest for both men (as low as
46 years in the Koryak Autonomous Okrug) and women.
Male life expectancy is 4-5 years below the
national average in the Baikal regions of Siberia and the
non-Black Earth Belt regions of the Central and
Northwest Federal Districts. Life expectancy for men in
rural areas is particularly low in these regions (50-52
years), close to that in the Tyva Republic. Highest male
life expectancy indicators are found in the North
Caucasus Region, with its clean environmental conditions and moderate alcohol consumption, as well as in
the regions with the strongest economies, including
Moscow and the Tyumen autonomous district.
Regional differences in life expectancy intensified with economic growth (see Diagram 3). Better
developed regions contribute more financial resources
to healthcare, there are changes in public perceptions
about health. In Moscow, average life expectancy has
reached 71 years (compared to the national average of
65 years), while it is nearly 69 in oil- and gas-producing
districts of Tyumen Oblast, despite the unfavorable
northern climate. In most regions, however, economic
stimuli have little influence on public attitudes to health.
Regional differences are therefore driven by a combination of factors, including lifestyle and climate.
Despite regional divergences in life expectancy,
both average infant mortality and the differences in
infant mortality across regions have decreased as a
5% lowest non-weighted
indicators
65
Average in the RF
60
5% highest weighted
indicators
55
5% highest non-weighted
indicators
50
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
result of changed reproductive behavior and increased
government spending on maternal and pediatric healthcare. Public resources for decreasing infant mortality,
however, are nearly exhausted. In addition to improving
health care, it is also necessary to change family
lifestyles. Children born out of wedlock face decreased
life expectancy, a common phenomenon in economically
marginalized, industrial municipalities in the Urals and in
eastern regions which lack developed cities. The problem is particularly acute in marginalized rural areas in
the Northwestern and Ural Federal Districts, where up
to 35-40 percent of births are out of wedlock. Children
that have been abandoned or who live in poverty faces
greater risks for risky behavior. Increasing rates of birth
out of wedlock is qualitatively different than in developed
countries, where it is driven by the transformation of the
family and greater economic independence for women.
As in many developed countries, there is also a
trends towards postponed births as careers have become
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Table 2 - Distribution of Russian regions by natural population growth in 2001-2005
Natural growth
per 1000 inhabitants
10,0 — 19,0
5,0 —
9,9
0 —
4,9
-0,1 —
-4,9
-5,0 —
-9,9
-10,0 — -15,3
Number of regions
increasingly important to women with higher education.
Postponed births are more common in large cities and fertility indicators among women of 20-24 and 25-29 years
are nearly identical in Moscow and Saint Petersburg. In
other large municipalities and relatively prosperous
regions, economic growth and increasing numbers of
highly paid jobs for women are only starting to form,
encouraging increased levels of postponed births. The
healthcare system will have to adapt to this trend, which
increases health risks for mothers and their children.
Depopulation across regions is partly driven by
regional differences in age structure. An early demographic transition and several years of migrant outflows
have significantly increased depopulation in the Central
and Northwestern federal districts (except for regions
bordering Moscow). In those regions, the share of residents older than the working-age population is 23-26 percent and is as high as one-third in rural areas. This trend
also has a gender dimension, where 36-44 percent of rural
women are pensioners, decreasing the economic vitality
of these regions. In southern regions, higher fertility in
rural areas has decreased these age imbalances but these
urban-rural differences are gradually decreasing.
Over 70 percent of Russians live in regions with
high rates of natural population decline and 16 percent live
in regions with extremely high losses of 1-1.5 percent per
year (see Table 1). The population momentum of these
demographic trends is such that natural population decline
will most quickly affect European Russia. Increased fertility is not a realistic solution to halt natural population
decline in most Russian regions, which are losing more
than 0.5 percent of their population per year. Regional differences in fertility have slowly narrowed from their
peak in the 1960s, when only the Central and
Northwestern federal districts completed the demographic transition to one- and two-child families (1.4
births per woman) and regions such as Tyva and
Dagestan had fertility rates of 4.2-4.9 births per woman.
Fertility rates in the latter republics fell during the mid2000s, leaving only Chechnya with high fertility rates of
2.9 children per woman. However, this level of fertility
is not sustainable over time.
3
3
10
23
33
17
Share of national
populaton (percent)
2,9
1,4
2,0
23,4
54,0
16,4
The potential to use migration resources for
public policy is limited, as migrant flows to Russia have
decreased by four to five times since the 1990s. The
factors of migration have changed to economic ones,
considerably changing the face of migration. Even
though the outflow of migrants from the northeastern
regions of the country continues, it is less intensive. In
the southern and western parts of the country, the
inflow of migrants is much smaller (see Diagram 4).
Since 2000, the Soviet-era trend of urban-bound
migration reappeared characterized by concentration of
migrants in agglomerations and in federal cities. The outflow of migrants from southern republics is destined to the
developed regions that have typically attracted migrants.
The reappearance of these trends from the second half of
the 20th century suggests an enduring trend that should not
be overlooked in developing migration policy. While demographic differences across regions are slowly narrowing, migration trends are polarizing the country creating local migration inflow areas, as well as intensifying
migration outflow areas. This would potentially have
negative social consequences, particularly with the
depopulation of regions in east and the north, as well
as many rural regions in European Russia.
Natalia Zubarevich
Diagram 4 - Annual migration in 1993-2000
and 2000-2005, by region
2001-2005
1993-2000
Annual average
of net migration
Annual average of net migration per
10000 people
-800 -300 -100 -25 -1 0 25 100
17
Fertility in Russia:
Trends and Policy Options
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
2. Fertility in Russia: Trends and
Policy Options
However, these measures only increased the
fertility rate by 0.1-0.2, primarily among women
born in 1953-1957.1
2.1. Basic characteristics and causes
of Low Fertility
2.1.2. Low fertility is not unique
to Russia
2.1.1. Enduring low fertility
The factors driving falling fertility in Russia
are shared by most developed countries. Many
countries have had similar or lower fertility rates
(1.2-1.3) in their history: Armenia, Belarus, Bulgaria,
Bosnia and Herzegovina, Hungary, Germany,
Greece, Italy, Spain, Latvia, Lithuania, Moldova,
Poland, Romania, Singapore, Slovakia, Slovenia,
Ukraine, Croatia, the Czech Republic, South Korea,
and Japan. Most of these countries have undergone
considerable socio-economic and cultural transformations in the past 20 years.
The global problem of low fertility rates suggests a joint response from the international community.
Fertility in Russia decreased throughout the
course of the 20th century and by the mid-1960s it
was already insufficient to ensure the replacement
of Russia's population (at 2.14 average children
born per woman in 1964-1965). With the adoption
of government policies to support families with
children in 1986-1987, fertility again increased to
this level. From the late 1980s to 1993, fertility
plummeted.
Eventually the decline slowed and fertility
began to increase again in 2000-2004. This
growth, however, has not managed significantly
increase the fertility level, such that in 2006 the
total fertility rate (1.30) was 1.65 times lower than
it was needed to halt the decline of Russia's population.
Fertility in older female age groups has
decreased over time. Even for women born in 19331937, the average number of childbirths was 2.01,
lower than the replacement rate. Falling fertility has
been constant throughout all generations, except
women born in 1948-1952 and 1953-1957, the result
of state policies in the 1980s to support families
with children.
2.1.3. Shifts in the age-adjusted
fertility model
Russia's age-adjusted model of fertility is
approaching the model currently seen in most developed countries. Until 1993, fertility fell most significantly in older generations, primarily at the
expense of second and further births. After 1994,
age-adjusted fertility shifted, such that rates for
women over 25 have now returned to levels
Diagram 5 - Age-adjusted fertility rate in Russia in 1994 and 2006
140
Number of births per 1000 women
120
100
80
60
40
20
0
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Age
1994
2006
1
Sergey Zakharov estimates this growth at the lower limit, i.e. no more than 0.1, because estimates closer to 0.2 rely on trends
showing that decreases in fertility in actual generations would have remained without the introduction of such measures.
19
2.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
observed in 1990s, while fertility rates for younger
women have dropped considerably (see Diagram 5).
Differences in fertility rates between women
aged 20-24 and 25-29 are narrowing. In 1993, rates
for women aged 20-24 were higher than those of
25-29 years by nearly 90 percent. In 2006, the former group's fertility is less than 9 percent than the
later group's fertility. Fertility rates for urban
women of 25-29 were higher than rates for women
aged 20-24 for the first time in 2006. Fertility for
women 30-34 are now 54.5 percent of the fertility
rate of women 10 years younger, whereas in 19931994 was only 25 percent of the latter category.
Postponed births help preparing for parenthood by giving time to gain life experience and
establishing financially. However, delaying childbirth
too long can also complicate the decision to have
children (especially two or three children), as children may be perceived to bring undesired changes
to lifestyle and living standards. As well, reproductive health becomes more complicated with age,
which may upset hopes for postponed childbirth. In
Russia, the situation is even more complicated, as
abortion is a frequent method of birth control.
In Russia, unregistered marriages are also
increasing - one of the main reasons for shifts in the
age-adjusted fertility model. Shifts in the age-adjusted fertility model are closely linked to changing marital behavior among young people, who are getting
married at an older age or rejecting marriage altogether. Rates of unmarried young people increased
significantly in 1989-2002 for both men (from 20.9 to
35.3 percent) and women (from 12.1 to 22.1 percent).
Late marriages generally result in having a first child
later. In 2002, nearly 10 percent of marriages were
unregistered, particularly for men (16.2 percent) and
women (17.6 percent) at an active reproductive age
(20-29). A 2006 survey of 1,500 people of 18-34 years
old in 18 regions showed that only 8.3 percent aged 1834 had been married for over three years and had no
children, while five times more (42.3 percent) in the
same group were in unregistered marriages.
Accordingly, the number of children born out
of wedlock is also increasing and recently reached
30 percent, only half of whom were registered on
a joint request of both parents.
2.1.4. Shifts in public attitudes
towards reproductive behavior
Low fertility (1-2 children per family) is often
linked to poor living conditions for households.
20
A significant portion of respondents in household
surveys cited financial or housing difficulties as well
as uncertainty about the future as factors limiting
their desired number of children. However, these
answers do not always reflect respondents' true
preferences but are sometimes cited as a socially
acceptable explanation for not having children. As
well, the perceived impact of living conditions on
reproductive behavior implies a value judgment on
the relative value of children to material prosperity.
In addition to living conditions, another important
limiting factor is the perception that children can be
an obstacle to achieving other life goals, such as
material wellbeing, career success or personal fulfillment in other activities. There is generally an
inverse relationship between the material quality of
life and the number of children, where a higher
material quality of life is associated with lower fertility and fewer children. The assumption comes
from ignoring the desired number of children and,
indeed, the desire to have children when selecting
parameters to compare quality of life and fertility.
Respondents with higher subjective evaluations of
their own quality of life are associated with having
more children, despite having only an average
desired number of children. Research in 2006 suggested that respondents' who both wanted three or
more children under satisfactory conditions and
perceived their quality of life to be high tended to
have high fertility levels: 2.52 for men and 2.29 for
women. These fertility rates are high enough to
ensure the replacement of Russia's population.
Other surveys, such as a 2004 Moscow survey and
a 2005 Samara Oblast survey, suggest that such
ambitious reproductive plans are actually achieved,
despite low national fertility levels.
2.1.5. Poor reproductive health
Reproductive health challenges are closely
linked to family planning, especially the widespread
use of abortions which may lead to reproductive
problems and sterility. Consequently, it is crucial to
develop policies to reduce abortions and protect
reproductive health. Abortions, however, should not
be banned. Experience in Russia and abroad shows
that banning abortions leads to short-term increases in fertility for 1-2 years, but afterwards fertility
quickly returns to previous levels. In Poland, a 1993
ban on abortions did not result in increased fertility.
Fertility continued to decrease and reached 1.24 in
2002, lower than Russian fertility despite more per-
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Diagram 6 - Popular opinion of state policies for increasing fertility
80
%
60
40
20
0
Moscow, 2004
Samara
oblast, 2005
KhantyMansy
Autonomous
okrug, 2005
Lipetsk
Tver oblast,
oblast, 2005-20062006
If there are too few children in families the government has to try to interest families in having more children and establish
favorable conditions for such families
The government has to help children to have as many children as they want and not try to make families to have more children than that.
missive legislation and high rates of abortion in
Russia. Banning abortions may also lead to increased
maternal mortality, infanticide, congenital defects
(after failed attempts to remove the fetus), rejection
of newborn infants, and illegal abortions, which
greatly affect reproductive health. After the 1966
abortion ban in Romania, the incidence of mortality
caused by abortion increased more than seven
times. Abortions can be more effectively decreased
with policies to help women avoid unwanted pregnancies.
Sterility is the worst state of reproductive
health, for which no reliable data is available in
Russia. Several studies estimate that 15-20 percent of
married couples are sterile. However, the 2002 census indicates that only 6-7 percent of women have
not had children by the end of their reproductive
years.
Lower estimates of sterility rates do not
reduce the need to address the problem and protect
reproductive health, which is important as an element
of a comprehensive fertility policy.
Decreasing fertility in Russia accelerated in the
late 1980s and fell sharply to a level far below that
needed to ensure the replacement of Russia's population. The principal causes of this decrease are:
• fewer couples desiring children and hesitation to have more than one child, even under satisfactory conditions
• the perception of living standards is an
obstacle to having children, both due to perceived
difficulty of achieving desired living standards and
growing perceptions that children competing with
other life goals
2.2. Designing and implementing
effective fertility policies
2.2.1. The need for comprehensive fertility policies
Fertility policies aimed at increased fertility
rates must be comprehensive to resolve the range
of problems causing low levels of fertility. The key
goals for such a policy include:
• ensuring the social status of families with
multiple children and encouraging families to have
2-3 children
• establishing conditions to support families
to have multiple children
• ensuring reproductive health through family
planning, such that women are able to have the
number of children they desire
However, simply improving quality of life is
unlikely to increase fertility sufficiently for those
families who desire 1-2 children. Allowing families
with several children to enjoy advantaged living
conditions is a key factor in raising their social status and thus increasing families desiring 2-3 children. Recent research in several regions (Moscow,
Lipetsk, Samara, Tver oblasts, Khanty-Mansy
autonomous district) suggest a need to encourage
families to desire more children, rather than simply
improving living standards, in order to achieve
increased fertility (see Diagram 6). It is thus important in order to ensure a positive public attitude to
fertility policies.
Most respondents indicated that government
has a responsibility to encourage families to have
21
2.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
more children if there are too few children in families, rather than helping families to have their
desired number of children. The latter choice
appealed to respondents who preferred less government intrusion into family life and also received
less government support.
2.2.2. Key areas to target
for fertility policies
Recent researches on the factors driving fertility suggest that an effective fertility policy
should:
• assist young families to acquire housing
• improve social support and benefits system
to families with children
• enable parents to combine work outside
of the home with responsible parenthood
• increase access to preschool services
• strengthen families values, particularly the
social prestige associated with raising multiple children
• reduce abortion rates by building awareness about family planning
• protect and improve reproductive health
Studies suggest that housing conditions are
the most important socio-economic factor influencing reproductive behavior. Programs that provide
young families with improved housing, being implemented in Russia, should be given special attention
as a key tool in an effective demographic policy.
Policies should allow families to write off part of
their housing debt with the birth of a child and to
fully write off the debt with the birth of a third
child. As well, housing programs should subsidize
down payments for young families based on the
number of children in a family. Introducing number
of children as a criterion to determine down payments would ensure that housing programs remain
open to all families while improving the equity of
such policies, as average income spread across
a families with more children tends to be lower.
Some women are reluctant to have one or
multiple children because they fear losing skills and
contact with colleagues during maternity leave.
Accordingly, it is important to enable women to
both participate in the workforce and be responsible parents. Low cost professional and vocational
2
education for attractive professions would encourage women to work after having children. Some
employers take measures to ensure that female
employees will not to have children for a certain
period after hiring, which is a violation of their legal
rights. Protecting the rights of parents in the workplace from such practices would reduce the professional costs of having children.
Fertility policies must also influence social
values and improve the social prestige accorded
to parenthood and raising multiple children. The
demographer of Canada A. Romaniuk argues
that “Currently women have the possibility of
pursuing social success outside of motherhood;
therefore, society needs to tackle the challenge
of transforming motherhood into an attractive
profession for women. The function of mothers
has to be both well respected and well compensated.” 2
Accessible and social support to families
should be increased to reduce abortions and maintain reproductive health through family planning.
Children and adolescents need to have greater
knowledge and awareness about health and particularly reproductive health. In addition, young families
would benefit from partial or full subsidization to
treat sterility with new reproductive technologies.
2.2.3. Implementing comprehensive
fertility policies
• Transfers to improve the living conditions
for families should increase with the number of
children in a family. For example, the size and
duration of transfers for children (currently 1.5
years) should vary based on the number of children in the family. Greater financial support should
target families with two or three children, and
ensure at least minimum transfers for families with
one child.
First born children currently comprise 58-60
percent of all children. Young mothers under 30
years bear 70-75 percent of firstborn children. If
social support is distributed without regard for the
number of children in a family, the majority of support will target one-child families. Currently, families who do not wish to have children are rare and
it is unlikely that reduced support will discourage
them to have a first child. Only a significant
Romaniuk, Anatole (1999) “The Demographic Future of Developed Societies.” Presented at the Russian conference
Demographic Processes and Family Policy: Regional Problems Moscow, p. 131
22
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
increase in families with two children and especially with three children would slow the current decline
of Russia's population.
• Social support to families should not seek
to replace employment as the primary means of
improving the quality of life. Without growth in
wages, however, achieving a standard of living
and self-sufficiency necessary to increased fertility and living conditions for children seems unlikely. As well, it is important to reduce uncertainty
about the future, especially among young people.
Social support to families should be designed to
narrow the inequalities between different types of
families, particularly between multiple child families and single child families. Increasing support
to families with multiple children both reduce
inequalities between families types and increases
fertility.
• Fertility depends on marital behavior and
the strength of families as a social institution.
Fertility policies must therefore encourage the creation of families, the registration of marriages, and
encourage enduring marriages, prepare children and
adolescents for family life, provide counseling for
families and establish family recreational programs.
Preparing children and adolescents for family life
should focus on strengthening family values,
encouraging the registration of marriages with multiple children, and developing family life skills.
Various approaches, from computer games that
simulate family models to the testing of future husbands and wives during marriage registration could
help prepare future spouses for marriage and
improve the durability of marriages. It is important
to establish an effective network of counselors,
train psychologists to deal with family issues and
attract young spouses to seek counseling, as well
as to provide assistance to support families. It is
also important to develop infrastructure and facilities for family recreational activities.
Table 3 - Challenges related to low fertility and recommendations
Challenges
Recommendations
Principal causes
Decreasing preference for children or multiple children,
despite favorable conditions, and the -perception that children compete with other life goals
Varied measures to support standards of living based on the
numberofchildren,particularlyprovidingincreasesupportfor
families with 2-3 children
Strengthening family values and improving the prestige of
raising multiple children
Assistance to young families to obtain housing
Perception that current quality of life is inadequate to
have children, both due to perceived level of living standards and the growing perception that children compete
with other life goals
Substantial increase in wages
Improved support to families based on number of children
Encouraging parents to work outside of the home while
parenting
Increasing access to quality preschool facilities
Causes worsening the situation
Unfavorable marriage trends, particularly increasing unregistered marriages and instability of marriages
Preparation of children and adolescents for family life by
instilling family values, increasing registered of marriages
with multiple children, and developing family living skills
Access to counseling for spouses in critical stages of family life to resolve and reduce family conflict
Increasing opportunities for family recreation
Reduction of abortions through improved family planning
Poor reproductive healthfl
Maintaining and improving reproductive health and treating sterility to allow families to have their desired number
of children
23
2.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
• Fertility policies should have a welldefined legal and administrative framework and a
strong financial basis. Durable increases in fertility require long-term state support and a gradual
increase in spending on maternal and family support. Without a long-term perspective, demographic policies are likely to be less effective,
wasting valuable state resources. As well, poor
implementation may lead to disillusionment about
the feasibility of increasing fertility and reduce
public support for demographic policies, thus
leading to the conclusion that nothing at all
should be done, since the money is wasted anyway without achieving the result.
An effective demographic policy must also
have a sound administrative framework, with an
executive body (such as an independent ministry,
agency, service or committee) accountable for
realizing demographic and family policies. Similar
institutions should be established at the regional
level to ensure effective implementation on the
ground.
As well, there is a shortage of qualified
demographers at the local level, particularly in
regional and municipal administrations. It is crucial that demographers be trained to implement
demographic policies and that specialists from
other disciplines engaged in demographic issues
also receive appropriate training. Developing and
implementing effective demographic policies is
unlikely without strong research and scientific
expertise both at the federal and regional levels.
• Effectively implementing policies will
require improved monitoring of fertility and
reproductive health, which is needed to track
the impact of policies across several different
categories of families. This will help policy-makers identify effective fertility policies and subsequently
refine
demographic
policies.
Monitoring should employ both statistical and
sociological indicators of reproductive health,
which are crucial to effective estimate the
socio-economic and attitudinal impact of demographic policies.
• Both short-term and long-term measures
to increase fertility should be employed. Fertility
policies currently implemented and planned generally aim to improve certain conditions to allow families to desire more children rather than to influence
the desire itself. Such direct policies were
employed in the Soviet Union in the 1980s to
encourage women to have children earlier. The most
24
significant result of this policy normally takes place
in the view of so called timing or calendar shift
when children are more likely to be born at an earlier stage due to these measures. Alternatively, fertility policies could aim to change public attitudes
towards children as this has a greater impact,
although there is a considerable lag in observing
this impact.
Effective fertility policies should include
both measures. On one side, they create enabling
conditions for families with multiple children by
supporting standards of living for families with
several children and increasing perceptions of stability and certainty about the future. Such financial
support can yield positive short-term results for
fertility.
On the other hand, demographic policies aim
to shift social values, particularly the status of families with multiple children and the prestige associated with parenthood. These measures increase fertility but are observable only after 15-20 years.
Thus, social support policies should be complemented by changing public attitudes through awareness raising for which journalists and advertisers
deserve special attention as key partners for demographic policies.
Implementing fertility policies will require significant expenditures, but these costs must be
weighed against the economic and social costs of
falling fertility in Russia.
Since the economic impact of fertility policies, the future expansion of the labor force, will
take place significantly after public investment in
such policies, a long-term perspective on the
demographic must be encouraged. Immediate
economic effects of increased fertility should
also be emphasized, such as increased demand
for goods for children and services for families
with children.
2.3. Expected policy results and
prospects for increased fertility
2.3.1. The need for realistic
expectations: it is unlikely that the
fertility level in Russia will achieve
the level of replacement in the nearest future
In the next 20-25 years, fertility will increase
due to improving living standards, which encourages families to want more children. While shifts in
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
the timing of births should be expected, they will
not affect the overall number of children born.
Changing family preferences about the desired
number of children will require significant investment of time and effort.
Such limitations would mean that the
increase of fertility rate will take place practically
without changes in family preferences about the
desired number of children.
Research on fertility and reproductive
behavior estimates that the average difference
between the desired number (under favorable conditions) of children and the expected number of
children (under current conditions) is 0.4-0.5 children per family.
While the estimated desired number of children and consequently the above gap may be overstated, substantially improving living standards
for families could increase the average number
of children born by 0.3-0.4. Measures to
improve reproductive health and increase access to
new reproductive treatments would also increase
fertility.
A comprehensive set of measures that provides socio-economic support to families with
more children and improves reproductive health
could increase the total fertility rate to an estimated 1.7-1.8 by 2025.
2.3.2. International experience on supporting families with children
Several European countries, including France,
Denmark, and Finland, have significant experience
in family support policies to increase fertility. In the
mid 1990s, these countries had the highest spending on family support policies in the European
Union, at nearly 4 percent of GDP. It is important
that the spending was not decreased even after
increase of fertility. After an initial increase, falling
fertility has been halted. The total fertility rate in
France grew from 1.66 in 1994 to nearly 1.9 in 2001
and 2.0 in 2006.
The size and duration of this increase cannot
be simply due to shifting timing of births, as the
increase in fertility would then be followed by a
drop of the same magnitude.
In Sweden, for example, the total fertility
rate rose from 1.61 in 1983 to 2.14 in 1990 before
decreasing to 1.61 in 1996, suggesting simply a shift
in the timing of births. Accordingly, increased fertility in countries with effective fertility policies is
associated with more couples seeking to have children.
According to A.G. Vishnevsky, it is possible
to increase fertility in Russia to a level currently
observed in France, but it would be a considerable
challenge3.
At the same time, the European experience
demonstrates the limitations of fertility policies
based simply on socio-economic measures. These
measures are designed to create favorable conditions for increasing the number of children per
family rather than the overall number of children.
Increasing fertility to replacement levels should
involve a comprehensive approach that includes
socio-economic support, improved reproductive
health and changing family preferences about their
desired number of children.
2.3.3. Accounting for shifting age
composition in fertility policies in
Russia
The next 3-4 years are predicted to be
favorable for age composition and with successful
public policy, the number of births may increase.
After that time, the share of women in an active
reproductive age (20-29) will substantially
decrease. In early 2007 the number of women aged
10-19 was lower than the number of women aged
20-29 by 24.1 percent and 0-9 years by 44.1 percent.
The smaller size of these cohorts significantly decreases the potential impact of fertility
policies on demographic trends. During this period, policies must be implemented to avoid a
demographic crisis and the ensuing consequences
for Russia's future.
At the current level of fertility, the total number of births in 2015 would drop to 1.3 million and
to less than 1 million in 2023, leading to an even
greater natural decline in population. Increasing the
fertility rate to 1.8 by 2025 would increase births in
that year by 1.4 million.
At that level of fertility, the natural decline of
the population would be reduced by more than 0.4
million per year.
3
See A.G. Vishnevsky. Fertility trends in the Russian Federation vs. other industrially developed countries. .// Materials for
the international seminar: “Low Fertility in the Russian Federation: Challenges and Strategic Approaches', Moscow, 2006, page 26
25
2.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
BOX 4 . VALUES AND LIVING STANDARDS AS
DETERMINANTS OF FERTIILTY
The decision to have one or multiple children,
as well as the perception of whether living standards are adequate to have children, depend on the
values of an individual. One income or set of living
conditions could be perceived by one person as
insufficient to be married or have children, and be
judged as acceptable by another. Beliefs about the
suitability of conditions for childbearing depend not
only on objective conditions but also on individual
values, particularly those concerning family life in
relation to other priorities.
Studies carried out in 2004-2006 in Novgorod,
Lipetsk, and Tver oblasts show that material living conditions were ranked higher than others across socio-demographic categories, including age, income, place of residence, and education. In each group, having a family with
three children was ranked lowest in preference while having one child ranked in the top 50 percent and having two
children scored in the bottom third of choices. Individual
values imply prioritization of different needs. When material resources are limited, money is generally spent on
pressing needs, which rank higher than the desire to have
children. The idea that individual values, including values
of family life and children, can be changed is one of the
central concepts of the “second demographic transition”
proposed by Dirk van de Kaa and Ron Lesthaeghe. With
shifting values comes a transition to a new fertility level
and family model. The higher the value of having multiple
children, the less people will consider other priorities as
obstacles to having one or multiple children. This suggests that values and individual priorities have a strong
influence on the desire to have children, in addition to perceptions about current living conditions that may affect
the decision to have children. If the value placed on having multiple children is constant, rising income and living
standards will enable families to have more children, up
to their desired number of children. If the value placed on
having multiple children decreases while living standards
increase, both the desired number of children and fertility will decrease. This effect is called the “paradox of
reverse relations” between living standards and fertility.
Increasing the value placed on having multiple children increases the desired number of children. Studies indicate that if the value of having
two children increased and became at least as significant as material priorities, the expected number
of children would grow by 0.5-0.7. Analysis of the
general Russian Youth Survey in 2006 indicates that
if the desire to have two children remains below
26
materials , but would be equal to the desire of having one child, the expected number of children per
young family would grow by 0.2, which is already
significant for Russia's demographic situation.
Therefore, fertility policies must include the
following two elements:
measures to increase families' desire to have
more children and to encourage them not to postpone having those children, which would reduce the
gap between desired and planned number of children
measures to increase the social value placed on having children, to increase the desired number of children
Some measures will address both elements
and other will have to target each element individually. Priority common measures include increasing
access to loans and housing subsidies based on
number of children. The “maternal capital” could
also be regarded as a general measure.
Increasing the desired number of children and
encouraging earlier births can be supported by
increasing access to quality preschool facilities and
increasing child transfers based on the number of children. Equally important are wage increases and
improving social support for families with children,
including monthly child support transfers. Increasing
the social value placed on children should focus on
enhancing the value of second and a third children. The
General Russian Youth Survey suggests that the concept of “maternal capital” would influence more than
half of respondents' desire to have more children, and
half of those would spend it on housing. For young
people, the most attractive fertility measures would be
improvements in living conditions (30 percent) not limited to maternal capital, increased wages (31 percent
of women and 38 of men), and increase social support
(13 percent of women and 15 percent of men.) Given
the importance of values and particularly the value
placed on having multiple children, as well as attitute
about the materials conditions under which it is feasible to have children, these measures would have to
complement each other,.The effectiveness of both
components of the policy depends on them being
implemented together as a comprehensive program.
Socio-economic support to help families have their
desired number of children will not increase fertility if
implemented separately from measures to increase the
desired number of children and value of a family.
Natalia Zvereva
Mortality
and Life Expectancy in Russia
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
3. Mortality and Life Expectancy in
Russia
3.1. Why does Russia lag in life
expectancy indicators?
Russia lags behind the top ten developed
countries in life expectancy by 15-19 years for men
and 7-12 years for women. If Russia is compared to
other countries with similar GDP per capita, the life
expectancy gap remains 3-11 years for men and 1-5
years for women (see Diagram 7).
If Russia is compared to developed counties,
mortality is consistently higher across all age
groups. If Russia is compared with countries with
similar economic development indicators, however,
it exhibits particular trends. Russia performs well in
terms of child mortality, comparable to other CIS
countries such as Lithuania, Belarus, and Estonia
and outperforms Brazil, Mexico and Turkey. With
regard to older people, mortality in Russia is comparable with its peer group. However, mortality in
Russia is exceptionally high among working aged
people, where it is 3-5 times higher for men and
more than twice as high for women.
Russia's lagging life expectancy is caused by
two types of health challenges that refer to different stages of epidemiologic transition. The Russia
health system faces two sets of acute problems.
First, the diseases characteristic for early industrial societies, which affect mostly children and young
people of active working age. Second, an ageing
population, characteristic for a mature industrial
and postindustrial society. The depth and duration
of the first group of problems are driven primarily
by the social consequences of the economic transition, including the poverty level, inequality in living
standards, and unequal access to education, healthcare and other social services. The severity of ageing-related health challenges is driven primarily by
demographic trends and can be mitigated by appropriate demographic policy.
3.2. Wht is Russia one of the few
countries with decreased life
expectancy in comparison to level of
1960s?
Russian mortality trends are clearly divided
into two stages. The first is driven by socio-economic development from the 1960s until the mid
1980s. The second is driven by the rapid social
change and instability of transition, from 1985 to
the present. These stages are completely different
in terms of both their causes and their trends.
3.2.1.Common factors with transition
countries
The Soviet phase of mortality was shaped
by a number of factors. First, social policy placed
a strong emphasis on equity, where citizens were
provided similar levels of social services in the
Diagram 7 - Living standards and
life expectancy in the world in 2005*
MALE POPULATION
FEMALE POPULATION
90
90
80
80
70
70
60
60
50
50
40
40
30
30
0
10000
20000
GDP (ppp)
*The cross indicates Russia.
28
R2 = 0,6162
ALE
ALE
R2 = 0,6159
30000
40000
0
10000
20000
GDP (ppp)
30000
40000
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
area of health, education, etc. At the same time
is ensured maximum personal inclusion into social
structure. Second, traditionally low value of a
human life both by the state and its people mainly due to the achieved equality or “equality in
poverty” in lack of motivation to modify individual lifestyle towards taking care of one's personal health. Third, public healthcare was accessible
but did not take lifestyle and behavioral drivers of
mortality as a priority.
As a result, mortality decreased among
children and from causes due to infections, respiratory and digestive illnesses, which were targeted by healthcare. However, mortality due to
other causes that were not targeted by social
spending continually increased, including accidents, intoxication, and cardiovascular disorders. Given the strong increases in the latter
causes, the overall trend in mortality was negative. Throughout the Soviet period, life
expectancy in Russia decreased while life
expectancy in developed countries increased.
However, the drivers of mortality in Russia were
the same as in developed countries, thus remaining at the modern stage of the epidemiological
transition.
The negligence of the value of personal life
was one of the key factors of deterioration of
the demographic situation in mid-1960s-mid1980s. The common trend of increasing mortality
among socialist countries suggests that socialist
health and social policy was a key factor in this
decline (see Diagram 8).
3.2.2. Drivers of mortality throughout
the Russian transition
Through transition from 1985, mortality
trends began to distinguish themselves not only
from the Soviet period but also from Central and
East European trends. Life expectancy decreased
more in 1985-20034 , by 4.1 years in men and 1.6
years in women, than in 1965-1984, where the
decline was by 2.6 and 0.4 years respectively.
In addition to increased magnitude, the characteristics of mortality changed considerably. First,
life expectancy sharply decreased in adolescents
and young working age people, nearly 50 percent
more than during the Soviet period for young men
aged 20-39. In women, the decrease was even more
dramatic, particularly for women over 15. The causes of mortality driving the decrease in life
expectancy also shifted, towards socially induced
and preventable diseases5.
Both the severity and causes of decreasing
life expectancy were fundamentally different in
the Soviet and transition periods. During the
transition period, reforms resulted in a growing
and diverse proportion of society that was marginalized that from one side was also diversified
and on another hand did not participate robustly in
public life6. In addition to the traditionally marginal
Diagram 8 - Life expectancy trends in Eastern
Europe and Russia in 1970-2004, in years
75
73
71
69
67
65
63
61
59
57
55
82
MALE POPULATION
FEMALE POPULATION
80
78
76
74
72
70
1970 1974
1978 1982 1986 1990
Bulgaria
Poland
Czech Rep.
Russia
1994 1998 2002
Hungary
Slovakia
1970 1974
1978 1982 1986 1990
Bulgaria
Poland
Czech Rep.
Russia
1994 1998 2002
Hungary
Slovakia
4
In 2004-2005 the indicators relatively stabilized.
Pathologies driving decreased life expectancy increased due to higher rates of digestive system disorders (mainly alcoholcaused fibroid indurations), respiratory disorders (pneumonia), infections (tuberculosis), violence and poisonings, which overtook other,
more typical external causes of mortality, such as traffic incidents and suicides in men and circulatory system disorders in women.
5
29
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
groups such as homeless people or prisoners, marginalized unemployed workers and illegal labor
migrants became more common. Throughout the
two decades of transition, people living in poverty
multiplied and began exhibiting behavior that contributed to higher mortality risks. Growing marginalization drove growing mortality, primary through
alcoholism, smoking, improper nutrition, avoidance
of healthcare, and psychological stress that affected many Russians during the reform experience.
The extent of marginalization distinguishes the
Russian transition from the transitions in Central
and East Europe, where economies rebounded relatively quickly after transition and the positive
impact was more quickly felt. In those countries,
shorter economic downturns led to greater gains in
life expectancy for both men and women, as transition has a less negative impact on social structures.
3.2.3. Recent trends: from stability to
growth
In 2006, two years of stability resulted in a
significant increase in life expectancy for men (1.3
years) and women (0.8). However, the gains across
age groups were not the same as the decreases
across age groups in 1990s (see Diagram 9). The
major increase for men and women were mainly
Diagram 9 - Evolution in mortality,
by age group, percent to 1998
enjoyed by those over 40 (see Diagram 10), perhaps because current policies to reduce mortality
do not target younger generations.
.
3.3. Mortaliy reduction policies in
Russia
Current public health challenges are largely
the result of a long-term negative trend in mortality. The social crisis experience of the 1990s exacerbated increasing mortality and changed the determinants of mortality. Policies to reduce mortality,
then, should target the problems that drove high
mortality in the 1990s.
3.3.1. Decreasing poverty as a driver
for reduced mortality
Increased mortality in at-risk groups, such as
working age people, is concentrated among marginalized groups. Mortality among young people is
concentrated among the unemployed (55-70 percent) and unskilled laborers (20-30 percent).7
Likewise, the share mortality among socially
adapted people8 between 20-39 years of age is
extremely low (5-10 percent).
Causes of death between nominally marginalized and adapted groups are very different.
Diagram 10 - Contribution of age groups
to life expectancy growth in 2005-2006
150
0.25
145
140
male population
females
0.2
135
130
0.15
125
120
115
0.1
110
105
0.05
100
1998
1999
2000
2001 2002
2003 2004
2005
2006
6
85+
75-79
65-69
55-59
45-49
35-39
60-69-m
60-69-f
25-29
45-59-m
45-59-f
15-19
25-44-m
25-44-f
5-9
0
0
The term 'marginal' denotes certain vulnerable groups/subpopulations deprived of robust involvement in social, political and
economic life of the society (Goals of Achieving Universal Health. ERB WHO, Copenhagen, 2001).
7
Data is based on a survey of death certificates in three Russian regions (Kirov, Smolensk and selected districts in Moscow)
at various levels of economic development.
8
The socially adapted group comprises people with higher and unfinished higher education whose professional status corresponds to relevant qualification and education requirements, and some people with secondary and post-secondary education whose professional status corresponds with social demands.
30
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Marginalized people aged 20-39 years have a
higher share of deaths from injuries, intoxications and tumors, causes characteristic of older
people, as well as physical causes such as cardio-vascular, respiratory and infectious pathologies (see Diagram 11).
Mortality due to external factors also
exhibits significant differences. As in most
developed countries, the cause of death among
socially adapted groups tends to be traffic-related accidents and suicides, as opposed to intoxications and injuries that affect marginalized
groups (see Diagram 12). Growth mortality
through injuries and intoxications is a clear consequence of socio-economic changes in Russia.
Diagram 11 - Working-age people (20-39)
9
Analysis of empirical data supports the
hypothesis that marginalization drove increasing mortality during transition.
Mortality among younger generations
after 2000 is concentrated among the unemployed.
The marginalized groups that now drive
increasing mortality did not exist in the Soviet
era and therefore traditional approaches to
understanding mortality through factors such as
alcoholism, improper nutrition, and smoking are
not effective.
Currently, an increasing number of people
find that these risky habits are bound to their
social and economic standing.
Diagram 12 - External causes of death in
socially adapted and marginalized groups in
Kirov Oblast in 2004, percent
Respiratory diseases
100%
murder
Digestive diseases
90%
accidental
alcohol
poisoning
80%
InfectionsË
70%
60%
Other somatic diseases
suicide
50%
40%
Unknown causes
injury (without
explanation)
30%
Cardiovascular diseases
20%
traffic accidents
10%
Cancer
0%
socially adapted
0
marginalized
marginalized
Accidents and poisonings
5
10
15
20
25
30
socially adapted
BOX 5 . MORTALITY FROM EXTERNAL CAUSES IN RUSSA
Russian mortality from external causes is higher than in other developed countries, particularly the
high level of mortality from accidents and intoxications in the working-age population and particularly
youth. This gap continues to grow as overall mortality in Russia increases. In 1985-2006, mortality from
external causes rose significantly in 20-39 year olds
(by 32.5-63.5 percent) and in 40-59 year olds (by
29.8-15.4 percent) for men and women accordingly.
Changing priorities
Working age people tended to suffer from an
increase in deaths from murders, accidental intoxica9
10
tions and injuries10. Increased deaths from traffic-related accidents were minimal in all groups, except 20-30
year old women, which doubled, suggesting that young
women continue to be at risk from traffic-related accidents (see Diagram 13). Deaths from suicides in working-age population were reduced across age groups.
In the past two decades, deaths from external causes increased in Russia. In 1985, the leading
causes of death were suicides and transport-related incidents, similar to the rest of the civilized
world. By 2006 the share of traffic incidents and
suicides noticeably decreased with the growth of
Average data for all three regions
According to the WHO's International Classification of Diseases.
31
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Diagram 13 - Mortality from external causes among working-age people in 1985-2006
other types of accidents
other types of intoxication
other forms of intoxication
other forms of intoxication
alcoholic intoxication
alcoholic intoxication
‡ÎÍÓ„ÓÎÂÏ
accidental injuries
accidental injuries
murder
murder
suicide
suicide
traffic-related accidents
traffic-related accidents
accidentsandintoxications
accidents and intoxications
men
-50% 0%
50%
100% 150% 200% 250%
20-39
woman
-50% 0%
40-59
50%
100% 150% 200% 250%
20-39
40-59
Table 4 - Mortality in Russian working-age people from primary external causes in 1985 and 2006,
standardized rate per 100,000 people
Causes of death
Men
Women
20-39 years
40-59 years
40-59 years
1985
2006
1985
2006
1985
2006
1985
2006
Accidents and intoxications
273,3
362,1
379,7
492,7
43,3
70,8
90,3
104,2
Traffic accidents
50,1
57,9
42,9
45,9
7,0
14,3
10,5
12,6
Suicide
62,7
65,0
96,3
69,1
9,3
8,7
19,2
9,5
Murder
24,1
41,8
21,3
47,9
8,1
11,2
9,4
11,6
Accidental injuries
15,6
54,5
23,9
78,3
3,0
10,1
6,0
15,0
Alcohol poisoning
27,7
30,7
67,1
79,4
4,0
6,6
18,9
20,5
Other accidental intoxications
14,8
41,9
29,8
28,9
3,2
6,9
6,4
6,4
All other types of accidents
30,3
21,4
40,9
60,8
3,9
4,8
10,1
14,2
causes associated with social problems, particularly alcoholic intoxication and accidental injuries (see
Table 4). Therefore, there was a change in priorities, especially in the group of 40-59 year olds.
Mortality from external causes may be even
more severe than indicated by official statistics
Official statistics do not register all deaths
from violence. Violent deaths are sometimes cited
as 'accidental injuries' and 'all other and unspecified
accidents.' According to the WHO's International
Classification of Diseases, 'accidental injuries' may
incorporate murders and suicides. 'All other and
unspecified accidents', according to the abridged
classification used in Russia, contains a whole
range of causes, including 'exposures to unspecified factors,' and the clinical presentation of such
causes does not always eliminate the possibility of
death through violence.
It is also possible that cases of mortality
through external causes are underreported. A sur-
32
20-39 years
vey of several Russian regions suggests that death
through external causes is sometimes disguised in
diagnoses as 'Symptoms, signs and actual deviations from the norm identified in clinical and laboratory research and otherwise unclassified.'
Mortality due to unidentified causes reached 30-40
thousand in the 1990s and early 2000s and it significantly increased mortality through external causes (by 15-20 percent).
Challenges for analysis and interpretation
The reliability of official statistics does not
allow an accurate analysis of the actual scope of
mortality through external causes and consequently
prevents the identification of priorities to target to
reduce mortality. Many vague or uncertain causes
may conceal causes of death such as suicides or
accidents.
Rising mortality from external causes in the
1990s was driven by wide-scale marginalization (half
of all deceased through 'uncertain' causes were
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
unemployed), as well as inattention to the importance of mortality statistics. The federal law on acts
of civil status (1997) no longer mandated the registration of social status of the deceased by education or profession, while Order No. 161 (24.04.2003)
from the Ministry of Public Health and Social
Development authorized the issuing of final death
certificates stating that no cause of death was
determined.
Accurate analysis about the severity of various
causes of death across social groups is undermined
by the lack of reliable data and prevents recommendations to address mortality from external causes in working-age people. The re-establishment of global mortality statistics standards would allow for adequate, targeted and efficient measures to reduce mortality.
Victoria Semionova
BOX 6. PREVENTION AND CONTROL OF
RISK FACTORS: NON-INFECTIOUS DISEASE
Manage over the primary risk factors associated with non-infectious diseases. According to
various estimates, alcohol kills approximately half a
million people every year11, smoking kills 330,00012,
and almost 40,00013
die in traffic accidents.
Improper nutrition and physical inactivity claim a
significant number of lives in Russia14. Behavioral
factors account for more than half of the life
expectancy gap between Russia and other developed countries15. Before implementing policy to target these factors, it is crucial to consider the available experience in reducing non-infectious disease.
Challenges
Programs targeting children and adolescences that build awareness about risk factors
and shape certain behavior models to avoid risks
are among the most effective tools for prevention worldwide. However, the efficacy of such
programs has to be realistically assessed based
on both positive and negative experiences. For
example, programs for children and adolescences
11
that directly communicating the health effects of
smoking and alcohol frequently produce an
inverse effect. 16-21 Programs that take a different approach report better results. For example,
developing negative images of tobacco and alcohol industries or drug dealers with troubled youth
known to practice risk behaviors has been effective17. For girls, campaigns promoting the idea
linked health with being beautiful and attractive
reported higher effectiveness. While teaching
youth to resist tobacco, alcohol and environmental pressures is important, it is less effective
among youth who use tobacco and alcohol to
challenge society than among youth who are simply susceptible to peer pressure18.
Preventive initiatives to change behavior
targeted at people over 30 have also had less
success. Resisting tobacco use may be difficult
because of addiction, for example. While some
developed countries managed to help 40 percent
of smokers quit, the best anti-smoking cam-
Khalturina and Korotaev (2006) The Russian Cross: Factors, Mechanisms, and Methods to Avoiding Demographic Crisis in
Russia.
12
Zaridze et al (2002) “Smoking as a primary cause of mortality in Russia” Bulletin of the Russian Academy of Medical Science,
n. 9: p. 40-45.
13
Statistical Yearbook of Russia. Federal State Statistics Service, 2006.
14
Dying Too Young. Addressing Premature Mortality and Ill Health Due to Non-Communicable Diseases and Injuries in the
Russian Federation. World Bank, 2006.
15
Andreev et al. “The evolving pattern of avoidable mortality in Russia.” International Journal of Epidemiology 2003, n.32: p.
437-46.
See Krasovskiy. Competition of smoking-free classes - shall it be held? CONTACT. No23. 2006
16
Nutbeam D, Macaskill P, Smith C, Simpson JM, Catford J. Evaluation of two school smoking education programmes under normal classroom conditions. BMJ 1993;306:102-7
Brown JH. Youth, drugs and resilience education. J Drug Educ. 2001;31:83-122
Schonfeld DJ. Teaching young children about HIV and AIDS. Child Adolesc Psychiatr Clin N Am. 2000;9:375-87.
17
http://www.protectthetruth.org/truthcampaign.htm
18
Ljubotina D, Galic J, Jukic V. Prevalence and risk factors of substance use among urban adolescents: questionnaire study.
Croat Med J. 2004;45:88-98.
33
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
paigns that encourage the use of special medication and other methods have at best resulted
in only 8 percent of smokers quitting 19.
Nevertheless, doctor advice to reduce tobacco
consumption is more effective, especially when
the patient develops a disease. Since such interventions are very low cost, they are quite cost
effective20. Working with alcohol abuse is less
efficient, with success in only a few percent of
the small share of those who suffer alcohol
abuse and seek professional help21. Direct confrontation with obesity without reference to professional assistance is counterproductive in the
majority of cases and can cause further obesity
disorders22.
Positive opportunities
Efficient means to address non-infectious
diseases should include legal tools, the most
efficient of which target the availability and
accessibility of risk factors. Reducing access to
risk factors is most effectively achieved through
pricing. Cigarettes and alcohol should have high
prices and should not be available at any corner,
at any time to all ages. Currently, prices of vegetables and fruits in Russia are increasing, while
alcohol and cigarettes become cheaper relative
to personal income. Twenty cigarettes cost as
much as a one-way trip on public transport or a
chocolate bar. Children also face little difficulty
in buying beer or cigarettes.
Other measures include dynamic public
information campaigns. However, information
campaigns are currently underused in Russia.
Information campaigns are not presented in a
dynamic way and typically feature direct advice
from medical professionals, without any colorful
video images on health. Even recent progressive
changes in traffic regulation received little coverage in the media, particularly campaigns
explaining that safety belts and speed limits mitigate the risk of death and disability from traffic
accident.
3.2.2. Encouraging healthy lifestyles
secondary education, achieving higher level of education people consume less alcohol and have lower
risks of alcoholism, especially among women. Higher
education has little effect on the categories of people consuming alcohol, with the exception of homemade spirits, which are consumed by one-quarter of
respondents with uncompleted secondary education.
Effective anti-alcohol policies must take into
account public opinion and the social acceptability of
proposed initiatives. A 2005 survey on higher pricing
of alcohol, usually of the most effective measures to
reduce alcohol consumption, was perceived as one of
the least effective methods by both the public and
health experts. Federal legislation has already been
passed to limit the sale and public consumption of
alcohol but it is poorly enforced. If vendors or legal
guardians were liable for significant penalties, access
to alcohol for youth could be greatly reduced.
A clear priority for encouraging healthy
lifestyles are programs to reduce alcohol abuse.
Alcohol-related deaths in Russia are 6 times higher for men and 5 times higher for women than in
Europe.
In contrast, alcohol-related deaths in Russia
were only twice as high as in Europe during the
extensive period of alcohol abuse in the early
1980s which prompted anti-alcohol campaigns.
Problems related to alcohol abuse are twofold.
First, a significant proportion of alcohol-related
deaths occur in marginalized groups. Second, alcohol consumption is very high among even socially
adapted groups.
Alcohol consumption differs greatly between
those with secondary and those with special or post19
One step to increase the scope and efficacy of prevention initiatives in Russia is professional training of specialists capable of influencing attitudes towards health, as is the case in
Europe and the US.
K. Danishevsky
Ranney L, Melvin C, Lux L, McClain E, Morgan L, Lohr K. Tobacco use: prevention, cessation, and control. Evid Rep Technol
Assess. 2006;1-120.
20
Rigotti NA, Munafo MR, Stead LF Interventions for smoking cessation in hospitalised patients. Cochrane reviews database,
2006
21
Oslin DW, Slaymaker VJ, Blow FC, Owen PL, Colleran C. Treatment outcomes for alcohol dependence among middle-aged
and older adults. Addict Behav. 2005;30:1431-6
22
Weight cycling. National Task Force on the Prevention and Treatment of Obesity. JAMA. 1994;272:1196-202.
34
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
BOX 7 . DEMOGRAPHY, ECONOMY AND AIDS
IN RUSSIA
Russia has experienced a dramatic spread of HIV
in just over a decade. In 1997-2007, there was a 370-fold
increase from less than 1,090 to 405,427 officially registered cases23. While the number of new infections registered annually peaked in 2001, this figure is again rising with nearly 40,000 new cases registered in 2006, a
13 percent increase over the prior year.i Even this statistic, by definition, represents only a minimum known
boundary of those persons who have been in direct
contact with the HIV reporting system,ii while a significant majority of the population remains untested.iii
General expert consensus among those who have produced estimates places the actual total number of people living with HIV at a multiple several times higher
than those who have been registered. The Federal AIDS
Center estimates that up to 1.3 million Russians are living with HIV while UNAIDS/WHO estimates 940,000
people. In either case, this would mean that the actual
prevalence rate exceeds 1 percent of the adult population.iv The overwhelming majority of cases are found
among adults aged 15-49, the age segments most
responsible for generating economic activity. Further,
nearly 60 percent of registered cases are clustered in
the ten regions that comprise Russia's most active economic centers.v While the epidemic was initially highly
concentrated among men, as the role of heterosexual
transmission increases, so will the burden on women
and consequently on Russia's reproductive potential. By
2005, the number of pregnant women registered with
HIV reached 1-1.8 percent in five regions.vi By 2006,
women of child bearing age accounted for 44 percent
of new infections,vii while the cumulative total of children born to women living with HIV has risen from 100
in 1998 to over 19,000 today.viii
Results of the HIV screening assay
among women in the RF
8000000
140
7000000
120
100
6000000
80
5000000
60
4000000
40
3000000
20
2000000
0
1000000
-20
-40
0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Number of screened pregnant women
Number of HIV positive per 100 screened pregnant women
Linear (Number of HIV positive per 100 screened pregnant women)
In addition to straining health care resources,
AIDS impacts a national economy largely through
effects on its demography, a salient feature given
Russia's current population decline that is projected to
continue over the long term.ix The situation among
working age people is even more stark. Without factoring the impact of AIDS, the number of males aged
15-24 could decline by nearly half over the next 20
years.x With over 80 percent of people living with HIV
(PLHIV) in Russia under the age of 30,xi HIV targets
those age cohorts that would otherwise have played a
key role in economic activity and demographic reproduction.
AIDS represents a 'long wave' demographic
shock poised to exacerbate existing trends. President
Putin first linked the dual threats of population decline
and AIDS in his 2002 address to the Federal
Assembly, and since 2005 has described the AIDS epidemic in Russia as “an acute problem which requires
the attention of all sectors of society.”xii
23
Pokrovsky, V.V., Head of the Federal AIDS Center, press conference speech for World AIDS Day, 29.11.07 Central House of
Journalists, Moscow.
i
Russian Federal AIDS Center, 2007, accessed at http://www.afew.org/english/statistics/HIVdata-RF.htm on 23.01.08
ii
UNAIDS Epi Update 2007 p.26
iii
Ruhl, Pokrovsky and Vinogradov, 2002
iv
UNAIDS Epi Update 2007
v
MAP - Monitoring the AIDS Pandemic, 2007, HIV in the CIS and the Russian Federation: 10 year's review”, p. 1
vi
Federal AIDS Center, 2007, “HIV Infection, Information Bulletin No. 29, p. 30
vii
Russian Federal AIDS Center referenced in UNAIDS Epi Update 2007, p. 26
viii
Federal AIDS Center website data as of 31.10.07 http://hivrussia.ru/stat/2007.shtml accessed 22.01.08
ix
UN Population Division
x
Eberstadt, 2004, pp. 26-27
xi
Russian Federal AIDS Center, 2007, “HIV Infection, Information Bulletin No. 29, p. 24i
xii
UNAIDS “National Consultation on Scaling Up to Universal Access to Prevention, Care, Treatment and Support in the Russian
Federation,” Moscow, 15-16 December 2005
35
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
xiii
Impact on social policy:
“Bottoming of vulnerable groups”
HIVIAIDS Impact (% Change)
A number of mathematical models have been
calibrated to the Russian Federation in order to better
understand the long-term linkages between demographic and economic implications of AIDS, including
initiatives from the World Bank, the International
Labour Organisation (ILO) and United Nations
Development Programme (UNDP), the former two with
direct collaboration from the Federal AIDS Center.
These models estimated the impact of demographics
on economic trends, including:
reduction and shift in age composition of the labor
force, where the dependency ratio of the economy
will increase, and fewer workers will have to support a growing number of very young and retired
persons
reduction in labor force productivity due to absenteeism and other effects on labor productivity
increased public health and social protection sector
financing via direct and indirect costs of care, treatment, and disability financing.
Given that World Bank and UNDP models were
developed at a time when even expectations for an
even higher HIV spread prevailed, it is important to
consider these models as purely indicative, while discarding medium and high projections. A cursory glance
at the 'optimistic' scenarios for both, and the ILO 'Risk
Group Saturation' scenario, which of the most acute
of the five ILO scenarios best corresponds to current
UNAIDS estimates, finds that all three demonstrate
potentially significant consequences for the demographic underpinnings of Russia's economy.
At the sectoral level, understanding the impact
that AIDS may have on the economy's dependency
ratios requires a more nuanced analysis. As ratio
between dependents and workers increases, national
savings decrease and social protection systems
become strained. All three studies suggest that the primary impact will be by increasing morbidity and mortality among the economy's most productive and reproductive age groups. At the same time, HIV can exacerbate existing challenges to national health provision and
social protection by driving up health and social protection costs associated with treatment and care.
The ILO model, designed as a policy tool specifically for evaluating the impact of AIDS on social pol-
14
12
10
8
6
4
2
0
-2
-4
-6
2002
2003
S-T disability benefits cjsts
2005
2010
2015
System dependency ratio
2020
2025
2030
Affordable replacement ratio
icy, best demonstrates changes in three key indicators:
short-term disability benefit costs; the pension
dependency ratio; and the affordable replacement
ratio.xiii From this graph, it is possible to discern potentially significant and sustained AIDS-induced strains on
Russia's social policy mechanisms. Short-term disability benefit costs rise from an immediate 7 percent
increase to nearly 13 percent additional burden for
over five years from 2005 through 2010 and remaining
over 10 percent higher for decades. The pension system becomes equally stressed, with the dependency
ratio and affordable replacement ratio moving inversely, reflecting a relative weakening of pension system
viability. Even within the next decade, Russia may
employ only four workers for every three dependents.xiv
This overview demonstrates that the case for
decisive action remains as clear and urgent as ever.
Indeed, the Russian government has responded with a
commendable increase in high-level commitment on
AIDS and more than 20-fold growth in annual federal
funding since 2006, targeted in large part towards
scaling up access for people living with HIV to life-saving ART drugs. If sustained over the long term, these
efforts should significantly mitigate the implications
considered in the models discussed above. However,
further efforts to prevent new infections, reduce ART
costs, and promote evidence-informed and rightsbased public health approaches for outreach to people
living with HIV will remain critical to reach and sustain
the Universal Access targets necessary to do so.
Shombi Sharp
United Nations Development Program
These are defined (ILO, 2004, p.24) as follows: the 'short-term disability benefit cost' refers to Russian government compensation to workers with 'temporary disability' associated with HIV/AIDS (assumed to be a 20 percent reduction in the ability to work
with HIV; 'pension dependency ratio' is the ratio of the number of employed persons to the number of people receiving pension benefits (age and disability categories); the 'affordable replacement ratio' is the ratio of the pension contribution rate to the pension dependency rate, characterizing the viability of a 'pay-as-you-go' pension system.
xiv
(World Bank, 2003, p. 70)
xv
UNAIDS Universal Access consultations
36
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Anti-alcohol measures which found public support included alcohol abuse education in schools, limiting the number of points of sale for alcohol, prohibiting public consumption of alcohol and anti-alcohol
advertising campaigns, although the expected results
of these measures would need to be better specified.
In conclusion, anti-alcohol policy must target specific groups and their needs, interests
and motivations rather broad target all of society. Implementing ill-designed policies will be at
best ineffective and at worst exacerbate the situation.
Diagram 14 - Distribution of alcohol consumers by level of education, percent
(survey of three regions).29
men
women
higher
higher
compulsory or
special
basic or uncompleted secondary (compulsory)
education
compulsory or
special
basic or uncompleted secondary (compulsory)
education
0%
25%
50%
75%
100%
alcoholics
high to mid consumption
moderate comsumption
0%
25%
50%
75%
100%
alcoholics
high to mid consumption
moderate comsumption
BOX 8 . ALCOHOL POLICIES
AND CONSUMPTION IN RUSSIA
Current alcohol abuse problems were
prompted in part by the poor anti-alcohol policies
of the past. A stringent anti-alcohol campaign initiated by Gorbachev in 1985 without warning
failed to sustainably reduce alcohol consumption
or alcoholism and thus improve economic growth.
On the contrary, it triggered black-market production of alcohol and by 1991 consumption had
returned to initial levels. In 1992, Boris Yeltsin
cancelled the federal monopoly on the production
and sale of alcoholic beverages, which had exacerbated the black market for alcohol, greatly
reducing the price of alcohol and making it difficult to limit the accessibility of alcohol.
The increase of alcohol consumption from 10
to 15 liters and an almost simultaneous increase in
mortality suggests the central role played by alcohol to mortality, in average up to 426,000 per year
in 1980-2001. Alcohol-related deaths total 29.6 percent of total mortality for men and 17.0 percent for
women. Cardio-vascular diseases and external
causes tend to be most associated with alcohol
consumption. The highest number of alcohol-related deaths is from external causes (64.1 percent in
men and 49.6 percent in women), including alcoholic intoxications (100 percent), manslaughters
(73.5 percent in men and 67.3 percent in women),
and suicides in men (55.0 percent).
Government tolerance of black market production during the anti-alcohol campaign and
subsequent market reforms led to a powerful
alcohol lobby that effectively resisted weak and
ill-conceived government attempts to regulate
the alcohol market. The main political goal in
reducing the alcohol consumption and alcoholrelated mortality is often to restrict the illegal
production of alcohol. The obstacle to doing is
pervasive corruption in alcohol production, from
cellar production to village moonshine to factory
production, which is well established not only in
alcohol production but also in other sectors.
A number of other measures would contribute to reducing alcohol consumption:
1. Administrative measures could limit the
sale of alcohol to certain hours (from 10 am to 10
pm, for example), to certain age groups (over 18)
and in certain locations,24 encourage treatment
of alcohol abuse by police or social workers,
37
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
treat alcoholism in hospitals, allow administrative
bodies to punish drunkenness, and allow employers to sanction alcoholism.
2. Legislative measures could increase
punishment for the illegal production and sale of
alcohol, administrative sanctions on local law
enforcement bodies and stations that permit such
illegal production and trade, increase fines and
sentences for drunk driving and dispense alcoholcontaining medicines only by prescription.
3. Social policy could restore treatment
facilities for alcoholics, expand the network of
centers for anonymous and free treatment of
alcoholism, open facilities to rehabilitate alcoholics referred by treatment stations, expand the
network of ambulances and emergency rooms,
train primary-care doctors and nurses to recognize the symptoms of alcohol-related diseases and
forward returning patients with continuing alcoholic abuse to drug-abuse rehabilitation centers.
4. Educational measures could establish
divisions in district administrations to collect data
on alcohol abusers, develop and implement antialcohol education programs in schools, vocational
schools, and universities, inform the public using
the mass media and television, as well as ban all
television commercials for alcoholic beverages
5. Research measures to conduct research
on alcohol abuse in the country and in particular
regions, focusing on the alcohol market and alcohol-related social problems, to establish an alcohol-related database including statistical data
from ministries and departments associated with
alcohol issues, to develop evaluations on the
effectiveness of anti-alcohol events carried out
on federal, regional and municipal levels, to provide easily accessible evaluations of events on
the alcohol market, including the level of alcohol
consumption and other alcohol-related situations
at federal, regional, and municipal levels and to a
state center to coordinate alcohol policy.
3.2.3. Reducing preventable mortality
include intoxications and injuries preventable by law
enforcement, including traffic safety and preventing
violent crime. The second most common cause of preventable mortality includes diseases which can be
reduced primarily through improving access to healthcare (third group of causes). Reducing mortality from
causes requiring medical assistance26 demands a combination of measures from different areas of the public
health system, including transportation to hospital, as
well as adequate and timely medical assistance. The
last category of preventable mortality includes illnesses which require early detection for treatment
(second group of causes). The key characteristic of
this group is high mortality among women, particularly malignant ovarian tumors and cancer in female
reproductive systems (see Diagram 16).
Estimates27 suggest that in 2005 simply being
referred to primary prevention could have prevented
150,000 deaths (105,000 men and 45,000 women) up
to 65 years of age (one third of deaths due to first
group of causes). The greatest preventable mortality
is from causes related to alcoholism.28 Reducing mortality for diseases requiring medical treatment is achiev-
A key element to reduce the spread and consequences of preventable diseases is to ensure access to
medical services across different economic groups and
regions, particularly for preventative treatment and primary care. With effective healthcare, preventable
mortality can be reduced more quickly than non-preventable mortality. Mortality in Russia grew by 61.2
percent for men and by 45.1 percent for women in the
past 15 years, with preventable mortality growing at
approximately the same rate. These trends contrast
sharply with Europe where mortality is decreasing and
where mortality from preventable causes declines
faster (2.4 percent annually) than non-preventable
mortality (1.5 percent annually).25 As in Europe, preventable mortality in Russia is primarily determined by
the prevalence of first group of causes, which are in
turn dependent on primary prevention, particularly
alcohol and nicotine addiction, which causes preventable diseases such as vascular brain damage, tumors of
the upper digestive systems and respiratory tract, and
chronic liver disorders. These primary causes also
24
Alexander Nemtsov
For example, no more than one commercial center per 5,000 inhabitants at least 1 km away from an educational facility in
cities and no closer than 5 km between population centers in rural areas per 1,000 inhabitants.
25
Preventable mortality and reduction measures / Under editorship of Yu.V. Mikhailova, A.E. Ivanova - M., CNII OIZ, 2006
26
This group includes high blood pressure, ulcers, pregnancy complications, appendicitis, hernias, chololith.
38
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Diagram 16 - Mortality from preventable causes (per thousand people between 5 and 64)
men
women
250
800
200
600
150
400
100
200
50
0
0
1990
Group 1
1990
2005
Group 2
Group 3
Group 1
able by improving access to quality treatment. This
improvement could have reduced the total number of
cases of disease by more than 25 percent, preventing
almost 30,000 deaths (including 22,500 men and 8,000
women). Better and earlier detection of the last group
of disease could prevent more than 4,000 deaths, primarily among women. In 2005, improved access to public health could have prevented health could be more
than 185,000 deaths, among children, working-age and
older age groups. ëontemporary challenges are primarily
driven by long-term mortality trends. The social crisis of
the 1990s intensified and changed the determinants of
mortality, which could have prevented under normal cir-
2005
Group 2
Group 3
cumstances, such as rejuvenation of losses in life
expectancy; development of negative trends in women.
Many challenges successfully addressed during the Soviet
period reappeared, including poor hygiene and nutrition,
lack of basic medical access and poor education.
Demographic policies among most important
areas should be aimed at reduction the life expectancy gap between Russia and other developed countries, reduction of high mortality from preventable
causes, particularly in working-age groups. As well,
such policies must ensure that inequalities in mortality between socio-economic categories are
addressed to enhance equity in life expectancy.
Table 5 - Key policy challenges and recommendations for mortality reduction
Challenges
Infant mortality
Remains stable. Growing mortality
caused by poor childcare in marginalized families
Recommendations
• Social policy to support families under high risk of marginalization
• Stricter measures for parents who do not meet childcare requirements
• Extend authority of medical staff and social workers to intervene in at risk families
Child and adolescent mortality
High mortality from external causes
resulting from risky behavior
• Stricter responsibility for educational facilities for non-attendance in school
• Oblige law enforcement authorities to control children and adolescents during
school hours outside school premises without parents
• Develop information campaigns on first-aid to prevent injuries from traffic accidents, burns, intoxication, fall and drowning
• Regularly monitor through the education system to build youth aware ness
about risks of unhealthy behavior
Negative mortality trends in active working age groups
Very high mortality rates among young
working age groups with high risk of
marginalization. Marginalization driven
by poor education, unskilled unemployment and limited access to medical and
social assistance
• Establish accessible occupational consulting services to develop practical
knowledge and skills in resolving life problems
• Organize mobile first aid stations for socially marginalized groups
• Develop a set of criteria to adequately compensating for workplace injuries
• Develop an employment insurance system
27
For indicative analysis purposes, the achievable level of preventable mortality is calculated as the minimal average Russian mortality indicator for each of the listed causes. The basis is the data on federal districts.
28
Together with injuries, intoxications, alcohol-caused granular indurations, other liver disorders, malignant tumors in the digestive system and larynx.
39
3.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Challenges
Recommendations
Mortality in those over 40 years
High level of mortality caused
by unhealthy lifestyles.
Focusing on public health initiatives will not be efficient
• Develop and place information material in public places to increase the identification of
primary symptoms and ensure correct preventive measures for non-infectious diseases
• Develop policies to improves socio-economic conditions for households leading healthy
lifestyles, in addition to occupational employment
• Encouraging access to healthy nutrition for working age people by supporting price and
tax controls for vendors providing low calorie, low cholesterol and low salt products
Mortality in elderly population
• Improve access to affordable or free medical assistance in terms of geographic location
Historically determined mortal• Encourage the elderly to pursue social work to provide assistance to other elderly peoity. Great variance in access
ple in need
to medical and social assis• Establish a hotline for elderly seeking assistance in difficult life situations, with call centance
ters staffed by elderly employees
Challenges to develop and implement policies
• Develop a methodology for selecting priority areas for reducing mortality
Priority selection criteria for • Estimate the short- and long-term outcomes of demographic and socio-economic effects
mortality reduction in regional from the selection of various priorities
and municipal level programs • Improve professional expertise of federal and regional decision-makers to choosing mortality-reducing policy priorities
Existing system does not provide decision makers with sufficient reliable information on
mortality causes and risk
groups
• Prepare a bill for the Federal Council to introduce changes to the Law on Acts of civil
status to reintroduce social status as a criterion reported on death certificates
• Develop and introduce a set of measures to improve diagnosis of causes of death,
including training seminars to assist personnel in identifying causes of disease and death
• Establish informational channels to promote coordination between forensic teams and
state mortality statistics services, to improve data on alcohol and drug usage
BOX 9 . URBAN ENVIRONMENTAL CHALLENGES AND THEIR IMPACT ON MORTALITY
Environmental pollution in cities, particularly
the quality of air and drinking water, is an important external factor driving additional mortality in
the cities. Russia's population is concentrated in
large and mid-sized cities, although increasing habitation in individual houses with lawns has partially
reversed this trend. There are also a significant
number of industrial cities built around a single
large company, usually in the defense, metallurgical,
or chemical sectors, as well as several cities in the
Russian arctic regions. Air quality control in Russian
municipalities is outdated and only Moscow enjoys
modern controls compliant with EU requirements. In
Moscow, the quality of air is slightly poorer than in
Paris, London and Stockholm but remains better than
in other European cities such as Athens or Milan.
Air pollution causes over 40,000 deaths
annually from cardiovascular and respiratory diseases, mostly due to finely dispersed dust that con-
29
40
tributes to 3 percent of urban mortality29. In comparison, finely dispersed dust accounts for 6 percent of urban mortality in France, Austria, and
Switzerland, double the rate in Russia, despite
more precise monitoring of airborne substances
(PM10 and PM2.5) in European cities.30 Given the
predicted increased use of coal in Russia's fuel consumption, it is estimated that emissions will
increased for solid pollutants (2.281 k mt), sodium
dioxide (1.318 k mt) and nitrogen dioxide (391 k mt)
by 2010. These emissions increases will in turn
reduce life expectancy by an estimated 1.96 years31.
Therefore, Russia's future shift to coal poses a significant challenge to public health.
The rapid increase in cars in municipalities
also significantly increases air pollution. Many
Russian cities now suffer from automobile traffic
issues as old city centers are unable to accommodate the growth in vehicle use. As well, most vehi-
“Bulletin on air pollution in Moscow for 2004.” Moscow Economic Monitoring, Moscow: 2005, p. 48.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
cles are outdated and do comply with modern emission controls standards.
An ecological survey of 12 cities identified
regions where severe ecological damage affected
the health of residents. These regions included
Cherepovetz, Kamensk-Uralsky, Shelekhov,
and Bratsk where aluminium smelters are located; Karabash, Nizhnii Tagil, and Magnitogorsk
which house large metallurgical smelters; nickel
pollution in Orsk in Orenburgskaya Oblast;
dioxide-polluted Chapaevsk; Angarsk, and
Novokuibshevsk, which house oil refineries; and
Novocherkassk in Rostovskaya Oblast, the home
of Europe's largest electrode factory. This list
would also include Dzerzhinsk, Norilsk, and
Dalnegorsk, three of the most polluted places on
earth, if these cities were included in the study of
the Blacksmith Institute. Expert estimate that 4050 other cities experience serious ecological problems.32
Epidemiological research in several Russian
cities provides more precise estimates of the
impact of air pollution on mortality. Studies in
Nizhnii Tagil in the Urals (home to large metallurgical and engineering plants) based on time series33
identify the impact of pollutants on mortality rates.
The contribution of suspended substances to overall urban mortality amounts to 3.1-3.6 percent.34
In Volgograd, mortality from respiratory diseases in 1983-1996 was significantly higher in all age
groups in the municipal districts with higher air pollution than in cleaner ones. Air pollution was the highest
mortality factors in children under 12 months of age living near large metallurgical and chemical plants.35
In Berezniki, Permskaya Oblast, where a
chemical plant is located, the average life expectancy for men is 50.8 compared to the national average
of 58.9 years. In several cities in Siberia and Far
East, domestic use of coal poses a significant risk
to public health. Burning coal causes up to 1.6 mil-
lion deaths per year globally but monitoring its
prevalence in Russia is difficult as household emissions are not tracked.36 A 2002 census indicated that
up to 21 percent of urban and 60 percent of rural
inhabitants used domestic traditional wood- and
coal-fired stoves, a serious risk factor for mortality.37
In the view of the vast geographic expanse of
the country climate change significantly influences
health of the population in Russia In Moscow, for
example, temperatures have risen by 0.25 degrees in
the past 10 years, far higher than the global average.
Preliminary estimates suggest climate change could
cause 4,000-28,000 deaths per year in Russian cities.
Can any reduction in mortality from environmental factors be achieved in the near future? Reduced
mortality is possible with the following measures:
Introduce Euro-2 standards for fuel and automobile exhaust and increase to progressively stricter
norms (further introduction of Euro-3 and 4). As
well, gasoline quality regulations should be
strengthened, particularly with regard to lead content. In spite of laws prohibiting the use of leaded
gas, its use continues. As well, it is vital that the
traffic system be modernized to take ecological
issues and civil engineering into account
Limit and eventually eliminate the prevalence of
coal in fuel consumption. In the short term, introduce improved and ecologically safe methods for
coal heating
Encourage the use of renewable energy sources
Modernize systems for monitoring urban air
quality
Establish federal and regional lists of polluted
regions and pass a Law Concerning the Status of
Ecologically-Depressed Zones and Regulated
Industries and Activities
Develop and implement a national plan to minimize
the negative effects of global warming on public health
Boris Revich
31
Bobylev, S et al. “Predicted interaction between changes in the fuel balance of power plants and the health of the Russian
population.” Forecasting Issues. N. 4, 2004, p. 99-113.
32
Revich, B. “Hot spots of environmental chemical pollution and health of the Russian population.” Russian Federal Public
Chamber, Center for Russian Ecological Policy, Moscow, 2007.
33
Time series refers to the analysis of daily death cases and concentration of air pollutants on the day of death.
34
Kantznelson, B. et al. Evaluating risk as an instrument of socio-hygienic monitoring. Yekaterinburg: 2001, 244.
35
Kvartovkina, L. and Pershin, S. “Age-adjusted distribution of mortality from ecologically-related diseases as an indirect indicator of urban ecological health.” Modern problems in using risk to maintain environmental health in Russia. Moscow: 1997, p. 27-28.
36
M. Ezzati et al. Comparative Quantification of Health Risks: global and regional burden of disease attributable to selected
major risk factors. vol.1 and 2, 2004.
37
Vishnevskogo, A. “Population of Russia 2003-2004: Eleventh and Twelfth Annual Demographic Report.” Science, 2006, p. 356.
41
Migration Trends and Policy
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
4. Migration Trends and Policy
Migration is one of the most important
factors shaping socio-economic development in
Russia today. International migration offsets the
decline in Russia's population and workforce.
Internal migration enables millions of Russians
to find jobs and assure their economic livelihoods. Mass migration from former Soviet countries in the early 1990s gave many people an
opportunity to find asylum, work, and a new life
in Russia. Migration has significantly changed
the face of modern Russia. At the same time,
there are real and contested challenges that
require well-conceived solutions from the
Russian government. The diversity and complexity of migration, driven by different factors and
circumstances, demand a carefully designed
migration policy. Such a policy should take into
account Russia's history of migration, the potential impact of current migration policies and the
humanitarian dimension of migration.
4.1. Key international migration
trends in Russia
After the collapse of the Soviet Union,
Russia became a global center for migration. In the
early 1990s, Eurasia experienced widespread migration and fundamental shifts in both the trends and
character of migration. Millions of ethnic Russians
stranded in the former Soviet republics, nonRussians, and stateless persons migrated to Russia
or other former Soviet republics. Official statistics
indicate that 8.6 million individuals moved to
Russia to reside permanently in 1991-2006, resulting in net migration of approximately 4 million people. The arrival of more than 11 million migrants
became a crucial support to a shrinking workforce
and a declining population.
The 2002 census indicates that approximately 9 percent of permanent residents in Russia (12.4
million) were born outside the country. According
to the UN methodology, this places Russia second
in terms of the number of international migrants
received, after the United States. Many of these
migrants arrived in Russia from other Soviet
republics before the collapse of the Soviet Union
and are not typical international migrants. Many of
them, however, arrived in the last decade.
Nevertheless, both long-standing and recently
arrived migrants have had a significant impact on
Russia's demography and socio-economic life. The
broad array of migration effects still has to be
understood. Addressing adaptation, employment
and social protection issues for migrants remains
an important and challenging task for government.
There were also substantial changes in
Russian patterns of emigration, as almost 5 million
people left Russia for permanent residence abroad.
The fall of the Iron Curtain, introduction of freedom
of movement in late 1980s and monetary reforms
led to the emigration of tens of thousands Russians
to Western countries for work and study. Since
1991, nearly 1.3 million have left Russia for countries
outside of the former Soviet Union and 3.8 million
moved to former Soviet republics.
Key migrant groups
Nearly 90 percent of migration in Russia is
linked to former Soviet republics. The constant
increase in migration for permanent residence and
the intensive inflow of labor migrants makes the
regulation of migration from these countries the
central priority for Russian migration policies.
However, unreliable data on Russian migration suggest that Russia's losses may be dramatic. Brain
drain and the loss of educated professionals, especially in the 1990s, have a substantial impact given
the economic importance of an educated workforce.
Changing international migration during the
late 1990s was triggered by subtle changes in
migration patterns. Until the mid-1990s, Russianspeakers facing growing international pressure in
former Soviet countries migrated to Russia in
large numbers. Thus, migration policies and institutions were designed to regulate the flow of
these migrants, particularly from Central Asia and
the Caucasus. By the mid-1990s, the flow of forced
migrants decreased and labor migration became
the largest migration trend. Working abroad, primarily in Russia, became a key source of income
for millions of citizens of former Soviet republics.
Statistics and accounting issues
The Federal State Statistics Service data
indicate a sharp decrease in international migration since the mid-1990s. However, a significant
part of this drop is due to changing accounting
practices and poor data collection at borders,
resulting from changing registration procedures
for long-term migrants. Specialists estimate that
the real number of immigrants after 1996 is nearly twice as large as in official statistics.
43
4.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
According to FSSS data, over 85 percent
of all arrivals in 2002-2006 were citizens of
Russia. However, the real inflow of foreigners as
long-term migrants was likely considerably higher,
based on the number people with residence permits from the Federal Migration Service, which is
considerable higher than FSSS data (see Diagram
17). In 2002-2007, there were no special regulations for the transfer of data on foreign migrants
from the Ministry of Internal Affairs to statistical
agencies, making it difficult to interpret FSSS
data. In this respect, a recent agreement between
the FSSS and the Federal Migration Service to
exchange data on foreign migrants is a welcome
development. However, data collection on migration still needs to be improved.
Status of migrants
The 2002 census indicates that 1.46 million
foreign residents and stateless people were living in
Russia. A significant number (1.26 million) who did
not indicate their citizenship were likely nonRussian citizens as well. While the census counts
239,000 temporary residents, the number of temporary migrants was likely much higher.39
Diagram 17 - Flows of long-term international migrants
according to the FSSS and FMS of Russia, Number of
Migrants
180000
160000
140000
120000
Number of temporary residence permit
Permanent residence permits
100000
80000
Number of foreigners and
stateless
60000
persons arriving from abroad
40000
20000
0
2003
2004
2005
2006
The analysis of migration is difficult because
irregular and unreliable data on migrant flows
across different categories by the Federal Migration
Service. Importantly, authorities need to have an
exact count of people receiving resident status in
Russia. Nevertheless, the data released by the
Federal Migration Service upon request indicates
38
that in 2003-2006 most individuals receiving permanent residence permits (22.1 percent) were citizens of Central Asian republics (excluding
Kazakhstan), 19.6 percent were from the Caucasus,
and 18 percent were from Kazakhstan. It is likely
that citizens of Ukraine, Moldova, and Belarus rarer
apply for formal residential status and prefer to
repeatedly travel back and forth to Russia.
Migration from Baltic States is insignificant given
economic incentives for Baltic citizens after their
accession to the European Union.
Since 1992, nearly 4 million acquired Russian
citizenship through the Federal Migration Service.
Most recipients of the Russian citizenship in this
period are former citizens of Kazakhstan (34 percent), Central Asian countries (21 percent), Ukraine
(20 percent), and Caucasian republics (18 percent).
Hundreds of Russian-speaking migrants who arrived
in Russia during mid-1990s as first wave migrants
from other former Soviet countries with Soviet
passports are still attempting to receive Russian
citizenship or permanent residence permits.
Bureaucratic hurdles, particularly due to the judicial
procedures of local internal affairs authorities,
often put these migrants in a difficult position. The
majority have jobs and homes in Russia and have
already been integrated into Russian society, but
are not citizens.40
Registering and counting illegal migrants
The priority of Russian migration policy
remains the reduction of illegal migration. The
extent of illegal migration is estimated differently
by researchers and authorities, with estimates ranging from 5 million to 15 million. The highest estimates are made by the Federal Migration Service,
based on border statistics, which estimate migration
based on the number of trips. However, arrivals are
easier to register than departures, which may bias
the estimate upwards. The Federal Migration Service
estimates that the number of arrivals of foreigners
formally exceeded departures by 21 million in 19992006, half of which occurred in 2002-2006. This difference is often estimated as the number of illegal
migrants remaining in the country, which overestimates illegal migration and leads to an inaccurate
picture of the overall migration situation.
The 2002 census indicates that 1.46 million foreign residents and stateless people were living in Russia. A significant number
(1.26 million) who did not indicate their citizenship were likely non-Russian citizens as well. While the census counts 239,000 temporary
residents, the number of temporary migrants was likely much higher.
40
O. Ponyatkovskaya. Becoming an Outlaw // Migration. Supplement to the Your Right Paper. Legal Newspaper No 9(17), 2007
44
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Creation of systems for counting foreign
migrants has attracted much public attention. In
2002, migration cards were introduced and this initiative led to the creation of databases that can
adequately track the arrival and departure of foreigners. Unfortunately, the full potential of this system remains unfulfilled.
4.2. The importance of inernational
labor migration
Forecasts estimate that Russia's potential
workforce will fall by 8 million by 2015 and by 1819 million by 2025. The workforce is turning into
one of the scarcest factors in the Russian economy. The deepest decline in Russia's working-age
population is estimated to occur in 2010-2014,
when this age group will decline by more than
1.3 million a year. Offsetting this decline to
ensure an adequate workforce by 2025 is impossible even by increasing fertility trend, lowering
mortality or improving health care. Migration could
provide a faster and more efficient solution to the
demographic challenges of the coming decade.
Labor migration in Russia is currently the
most dynamic form of migration and labor migration has grown consistently over the past 5 years
(see Diagram 18). Official statistics estimate that
1.014 million labor migrants from more than
40 countries worked in Russia in 2006, accounting for 1.5 percent of the workforce.
Migrants are unevenly distributed across
employment sectors, with 40 percent working in
construction, 30 percent in trade, 10 percent in
industry, 7 percent in agriculture, 5 percent in
transportation, and 8 percent in other sectors.
The actual distribution differs from official data
because of data gaps on migrants in sectors
where informal and illegal employment is common, particularly agriculture, services industries,
and domestic labor.
Diagram 18 - Labor migrants in Russia, thousands
1500
1014
1000
500
702
211
213
284
360
378
1999
2000
2001
2002
2003
460
0
2004
2005
2006
Migrants are also unequally distributed
across Russia's regions. In 2005, the share of the
foreign workforce varied considerably across
Chukot (16 percent), Yamalo-Nenets (9 percent),
the Jewish Autonomous Region (5.2 percent),
Moscow (4.1 percent), Chita (3.2 percent) and did
not exceed 1 percent for other regions.
The Federal Migration Service estimates
that arrival from former Soviet republics comprise 53 percent of total labor migration,
although expert estimates place this proportion
considerably higher, at over two-thirds of labor
migration. In 2006, the majority of legal labor
migrants were citizens of Ukraine (16.9 percent),
Uzbekistan (10.4 percent), Tajikistan (9.7 percent), China (20.8 percent), and Turkey (10.0 percent).
Official statistics indicate that more than
80 percent of labor migrants were men. However,
selected research suggests that the number of
women may be underestimated and could be as
high as 30-35 percent.
Diagram 19 - Labor migration by education
Secondary
3%
12%
13%
Incomplete secondary
7%
34%
Elementary
and unschooled
Higher
31%
Incomplete higher
Post-secondary
There has been a recent and substantial
shift in labor migration patterns. The share of
migrants from Central Asian countries has
increased and migrants increasingly arrive from
small cities and rural areas (70 percent). The level
of education of migrants is decreasing, such that
half do not possess tertiary education or vocational training (see Diagram 19).41 As well, cultural differences are increasing, as migrant flows
contain fewer ethnic Russians and many current
migrants speak poor Russian.
Labor migration is broadly similar to global pattern of migration. Migrants are concentrated in lower sectors of the labor market as they
are willing to take difficult and unwanted jobs
in construction, transportation, industry, agriculture, and services industries. Unlike many
other developed countries, Russia does not
Source: Federal Migration Services of the Russian Federation
41
Source: IOM poll, 2006
45
4.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
have yet a special program to attract skilled
professionals such as managers, scientists, and
high-tech specialists. There is also no mechanism
to select migrants based on skills that are needed in the economy. Skilled labor shortages, however, will soon become sound and the lack of
such policies deprives Russia of significant
migration benefits.
In addition to addressing temporary labor
shortages, labor migration can increase Russia's
permanent population.
According to recent research, 30 percent
of migrants consider pursuing permanent residence and naturalization in Russia and an additional 20 percent wish to reside for over one
year.
BOX 10 . CONTRIBUTION OF MIGRANTS
TO THE RUSSIAN ECONOMY
When evaluating the influence of migrants on
the economy, it is common to examine their share
of the workforce and their effect on the unemployment rates and wages paid to local workers. Such
estimates have to be conducted across skills categories and their sector of employment, given
Russia's tendency to attract unskilled rather than
skilled labor. Russia also needs to realistically estimate the potential impact of migrants on an
expanding shadow economy. The formation of niches for migrant employment is particularly important,
because these niches may evolve into economic
enclaves dependent on labor migration that could
threaten the country's economic security.
While most Western researchers estimate
that migration has little or no impact on employment and wages, data limitations and the methodologies used in such estimates do not make them
conclusive. It is unlikely that any country has the
means to reliably estimate these effects. In Russia,
such an estimate is impossible for a number of reasons as well. However, an unbiased evaluation of
the effects of migration on the Russian economy
could and must be pursued to gain a better understanding of current attitudes against migrants and
political perceptions that migration increases
unpaid taxes and capital outflows.
Official statistics indicate foreign workers
accounted for 1.5 percent of the workforce in 2006,
including 7.5 percent in construction, 2.3 percent in
trade and renovation sectors, 1 percent in agriculture, 0.9 percent in transportation, and 0.8 percent
in industry. Expert estimates place the number of
migrants somewhere between 3.5 to 7 million, with
a mean estimate of 5 million. Estimates also place
the proportion of foreign workers at 5-9 percent,
with the mean estimate at 7.5 percent, which is
close to levels in Germany, Austria, Sweden,
France, and Canada.
46
Accurately evaluating the contribution of
migrants to the economy requires data on factors
such as duration of employment and skills levels.
Unfortunately, official statistics on these factors
are unavailable. Survey data suggests that 20 percent migrants arrive to stay for no longer than 6
months, one-third arrive stay between 6-12 months,
and the remaining 45 percent intend to stay in
Russia for a longer period. The average work week
for labor migrants is 60 hours, 1.5 times higher than
the average hours worked by Russian workers.
Based on this data and estimates of numbers of
migrants, experts estimate that migrants comprise
6.9 percent of total hours worked by the Russian
citizens in the Russian economy (excluding annual
leaves).
International Organization of Migration (IOM)
2006 survey data on education and skills of labor
migrants estimate that about 50 percent of
migrants have the higher or vocational education to
be classified as skilled labor, while 20 percent have
complete or incomplete higher education, and 30
percent have special compulsory education and
could be considered as skilled labor force.
IOM 2006 survey data estimates migrants'
average monthly wage at RUR 11,000, approximately USD 420, which is in line with the average wage
in Russia of that time. While this income seems
considerable, this is paid for working an average of
60 hours more per month than Russians. More than
one-third of migrants work 70 hours per week or
more, working 10 hours per day without weekends.
While the average hourly wage for local residents
was USD 2.60, it was only USD 1.00 for migrants.
This wage gap is related to the differences in the
skill levels and employment category, as well as
wages discrimination (see Diagram 20).
Most migrants take jobs that do not interest
local workers, usually because they are complex,
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
informal or seasonal, which creates migrant employment niches. Research suggests that most migrants
are engaged in these sectors. Only 8 percent of
migrants indicated that they work primarily alongside
local residents (see Diagram 20). However, 25 percent of migrants respondents indicated that there
was competition with local workers for their job, suggesting that there is no simple answer as to whether
migrants constrain employment for local workers.
80 percent of labor migrants work informally
in the shadow sectors of the economy, where there
are no employment contracts and where wages are
paid in cash, under the table. Employers prefer this
arrangement for employers because migrant wages
are lower than local wages and because it allows
them to evade taxes. There is often competition
4.3. Migrants in Russian society:
trends and challenges
Whether Russia will be able to benefit from
migration does not depend only on the degree to
which it offsets population decline or to which
migrant labor can be efficiency employed in the
Russian economy. But also eliminating negative
attitudes towards migrants and the social isolation
of migrants are important factors to effectively
utilize migrant labor. Cultural differences between
migrants and local people are growing and public
opinion is reacting accordingly. Surveys indicate
that one-half of Russians are disturbed by the
scale of migration.42 At least 30-35 percent of ethnic Russians are opposed to further migration,
particularly from the Caucasus and Central Asia,
while 11 percent believe that the presence of any
ethnicity except Russians is should be limited.
Only 10 percent of respondents describe their attitude towards migrants as welcoming and compassionate.
Surveys of migrants suggest increasing
social isolation. Most migrants attempt to keep
their presence in Russia hidden. Apart from migration offices, migrants generally frequent only banks
and mosques, if migrants are Islamic. The majority
of people are comfortable with labor migrants on
construction sites, in marketplaces, and in supermarkets. However, people are reluctant to see them
elsewhere, including schools, banks, and in hospi42
Who is working together with you?
4%
8%
Migrants and local
workers
Mainly local
28%
60%
No answer
Mainly migrants
between migrants for employment in the informal
economy. As a destination country, Russia certainly benefits from migrant labor. However, a significant amount of benefits is not transferred to government but remain with employers in the informal
economy.
Yelena Turyukanova
tals. Social isolation of migrants in deeply rooted in
Russia's culture, history and economy. While there
is a common public perception that migrants make
no contribution to the state, but use the same
goods and services created by tax payers, research
suggests that labor migrants produce more than
they consume. Moreover free social services are
generally unavailable to migrants. Because of illegal
employment, however, the state receives little tax
revenue from migrants, which reinforces negative
attitudes towards them.
Public opinion against migrants is skillfully
used by extremist organizations and political
groups and migration is becoming an increasingly
important political issue. Media frequently portray
migrants negatively, further reinforcing negative
stereotypes. As a result over half of Russians
believe that migration increases criminality and the
danger of terrorism. However, criminal offenses are
significantly lower among foreign citizens than
among Russians. In 2006, foreign citizens and
stateless persons committed 53,000 crimes, only 1.4
percent of all registered crimes.
Overcoming negative attitudes towards foreigners and promoting social tolerance is serious
challenge for Russia in the future. It is directly
linked to integration policies for migrants and
measures to reduce their social isolation. These
goals must be solved in the next decade while the
first generation of post-Soviet immigrants are finding their place in Russian society. Second genera-
Data from International Organization of Migration surveys in 2006 and a Levada Center all-Russia survey of social opinion in 2007.
47
4.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
tion immigrants will made different demands of
Russian society, which they will rightfully call their
own. Recent events in France and other countries
show the dangers of social isolation among second
and third generation immigrants. Russia should do
its best to learn from this experience.
4.4. Domestic migration: trends,
opportunities and limitations
Demographic challenges in Russia are complicated by internal migration and its unclear
effects. Since late 1980s, domestic migration has
decreased, with registered relocations decreasing
from 4.7 million in 1989 to 1.9 million in 2005. More
than half of migrants changed their place of residence within the same region.
Russians were attracted towards Western
Russia as a result of migration flows between
regions. Significant out-migration was common in
northern regions with extreme climates. Many residents of these regions were forced to move after
transition due to unemployment and worsening
social infrastructure in both cities and rural areas.
Social benefits and wage bonuses given by government were no longer a sufficient incentive and
failed to provide a sufficient level of living, leaving little economic motivation to remain in these
regions. The peak of out-migration from eastern
and northern regions occurred in the mid-1990s
and departures have now decreased. In 19912005, net migration was highest in the Far East
of Russia (-780,000 thousand), Siberia (320,000) and Northwestern Russia (-170,000).
At the same time, there was a net migration to
Central Russia of over 1 million, including 440
thousand people received by Moscow in 20012005. Much of this migration was from regions
bordering Central Russia. Proximity to Moscow
is a driver for the out-migration of hundreds of
thousands of temporary labor migrants from
Central Russia, creating a skilled labor shortage
in smaller cities, rural settlements and regional
centers.
Instability in the North Caucasus, unemployment and low household income has resulted in significant permanent and temporary out-migration.
Migrants from titular groups in South Russia face
discrimination and are pressured by extremist
42
groups. In turn, they consider themselves isolated
and occupy specific labor niches like foreign
migrants.
Despite reduced urban migration, many residents of rural areas and small cities migrate to
large cities for employment. Researchers estimate
that nearly 3 million migrate domestically each year
for temporary employment.
Large cities attract migrants, particularly
Saint Petersburg and other large cities in the
Povolzhie, Krasnodar and Stavropolie regions, as
well as Yekaterinburg. These urban areas draw
migrants from neighboring regions that are economically weaker. No cities east of the Urals have
positive net migration and almost all these regions
face declining populations. Over the past 15 years,
out-migration has exceeded natural population
decline in some regions.
Economic growth tends to increase domestic
migration, especially with increasing skilled labor
shortages in developing regions. Revitalizing
domestic migration is constrained by the lack of
affordable housing in large cities, which results in
price increases for purchased or rented homes, an
undeveloped market for housing loans and a lack of
access to housing loans. The current registration
system causes numerous problems as employers,
apartment owners and migrants are not aware of
reforms in labor and housing law, although the policy and regulations in this field were practically set
and solved.
The proposals for government to encourage
migration to northern and eastern Russia to
reduce workforce shortages and the out-migration
of youth have been mentioned in public debate,
but they have little practical chance of success.
The government is limited in the economic incentives it can offer and it is not clear from where
migrants should be relocated, as population
across Russia is already declining.43 In the next
20 years, the workforce demands in Central
Russian cities will be sufficient to engage the
entire workforce.
Domestic migration tends to relocate people
from Russia's borders to the historically developed
central and European areas, as well as big cities. In
the view of the future reductions in the working-age
population this would allow useing more effectively
the workforce and to eliminating problems associ-
Both the eastern and European regions of Russian are still sparsely settled. See Vishnevskii, A. et al. “The Future Development
of Russia: the role of demographic factors.” Institute of Economics for the Transition Period. Scientific research, n. 3ê, 2003, p. 33-36.
48
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
ated with unemployment and poverty, especially in
depressed regions. At the same time, out-migration
from the regions would exacerbate challenges to
regional development, particularly skilled labor
shortages.
4.5. Refugees and forced relocation
The challenge of forced migration arose
shortly before the collapse of the Soviet Union,
when Russia received victims of violent conflicts
in the Caucasus and Central Asia. Official registration of refugees and forced relocated populations was introduced in 1992 and the Laws on
Refugees and Forced Relocations were adopted
in 1993. The peak of registered forced migrants
was 272,000 in 1995, of which 226,000 were those
forced to relocate. Since 1998, forced migration has
totaled 1.2 million. Later, forced relocations and
numbers of registered refugees as the flow of
refugees was exceed by those who had lost their
refugee status.43
Reduced forced migration to Russia is the
result of the end of violent conflict in the post
Soviet territories, as well as changes in forced
migration policies, which have tightened conditions
for refugee status. Stricter conditions reduced
flows of refugees, as many potential migrants could
not longer seek amnesty.
In 1992-2006, the status of forced migrants
and refugees was granted to 1.658 million people in
Russia, 1.396 million of whom came from the CIS
countries or the Baltic states and 260,000 arrived
from regions of Russia. These figures do not include
temporarily migration from Chechnya in 1994-1996
and 1999-2001, as well as a number of other categories of internal migrants. At the worst period of
the conflict, temporary migrants totaled 400,000
people. However, the end of violent conflict resulted in the return of many temporary migrants. In early
2007, forced migrants were constant at approximately 118,000, as the majority of former forced
migrants or refugees had lost their status. The federal government has failed to meet its legal obligation to many forced migrants and did not provide
them with adequate living conditions, employment
opportunities. Given limited financial resources, support was not provided even to the migrants with low
social protection status.
43
44
On the other hand, limited government involvement in settling refugees allowed them to settle in a
location of their choosing. Accordingly, most refugees
settled in central and south European Russia, as well as
in border regions in the Urals and western Siberia. In
the 1990s, Russia pursued an open door policy for
forced migrants from former Soviet republics. The proportion of forced migrants in terms of population has
always been small (below 1 percent), even during the
hardships faced in the former Soviet republics. In 1993,
Russia entered the 1951 Convention on the Status of
Refugees and cooperated with the UN High Commission
for Refugees and other international agencies, demonstrating the government's commitment to accepting and
assisting forced migrants. The situation in the former
Soviet Union remains complex, as some former
republics have faced ethnic conflicts and others have
not. In some former republics, changing political leadership has also triggered forced migration.
4.6. Recommendations for
a comprehensive Russian migration policy
In 1991-2007, Russia had its first experience
in dealing with migration. Given the novelty of this
phenomenon, this experience involved a significant
amount of trial and error. The first laws on
migrants44 appeared in early 1990s but by 2000 it
was clear that current regulation was no longer sufficient to address changing patterns of migration.
Migration policy was changed to address new priorities: labor migration and long-term immigration.
This new approach was established in legislation in 2002 with the Law on Russian Citizenship
and the Law on Legal Status of Foreign Citizens in
the Russian Federation. However, the first years of
implementation demonstrated that this new legislation was too difficult to enforce. In addition, ineffective enforcement increased the evasion of legal
employment by migrants and employers. The majority of migrants were not registered and thus an
estimate of the number of migrants became impossible, with millions of migrants living and working in
Russia illegally. Illegal migration increased criminal
activity, which profited from assisting illegal migration and the evasion of law enforcement.
Corruption in the regulation of migration increased
such that effective policy implementation became
almost impossible.
Pursuant to the Law on Forced Migrants the status is conferred for a period of 5 years.
For example, on refugees and forced migrants, freedom of movement, citizenship, entrance to and departure from the Russian Federation
49
4.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Even if the new laws presented a step forward, they did not anticipate problems related to
illegal immigration, mechanisms to regulate migrant
status, and the cumbersome procedures required to
obtain work permits and registration.
With the introduction of migration laws, the
Federal Migration Service (FMS) was established as
a special agency to implement migration policy.
After several structural reforms, the FMS was
transferred under the Ministry of Internal Affairs in
2002. Accordingly, the focus of migration policies
shifted to combating illegal migration. In 2003,
amendments to Russian Criminal Code substantially
strengthened measures against human trafficking,
the use of slave labor, and the organization of illegal migration.
The key priorities of current migration policy
are to expand legal migration and remove administrative barriers to legalizing migrants. A few years
ago, migration policy was reform in response to the
demographic crisis and severe lack of labor
resources. This new migration policy aims to
expand legal migration and remove administrative
barriers to legalization. In 2006, the Law on
Migration Count of Foreign Citizens was adopted
and there were significant changes made to the
Law on the Legal Status of Foreign Citizens. These
laws, enacted on 15 January 2007, significantly simplified procedures for registration and issuing work
permits.
According to the FMS, the number of work
permits issued and migrants registered in 2007
increased several times. As well, Russia's borders
have been strengthened to reduce the flow of illegal migrants to Russia.
Migration policy has recently introduced a
program to encourage the voluntary repatriation of
Russians. International organizations have initiated
discussions about potential initiatives to attract
migrants, including a network of agencies to provide legal and information support, accessible
housing and an efficient system of finding employment.
Russia is currently interested in receiving
very diverse groups of migrants, including those
applying for permanent residence and Russian citizenship; temporary employees, including short-term
seasonal workers; longer-term labor migrants; students; and relatives visiting family members under
the 'Families Reunited' program. Migration legislation and policies have to effectively address each
of these migration models.
Migration is currently the most dynamic and
positive process affecting Russia demographics.
Table 9 - Key Challenges and Recommendations for Russia's Migration Policy
Challenges
Recommendations
1. Increasing effective utilization of migrant labor
• Foreign labor migrants do not always match the needs of
local labor markets.
• There is no system to select migrants based on the qualifications and skills needed in the economy.
• Knowledge of the Russian language is frequently poor,
even when migrants are issued temporary or permanent
residence permits
• Develop a methodology to evaluate workforce needs
• Introduce a system of priorities and a mechanism to select
migrants by qualifications, skills, language and other criteria
• Develop a program for short-term and long-term labor
migration, which introduce a system of categories for foreign workers and a system of scores for immigrants
• Create a mechanism to protect the national labor market
and give priority to Russian citizens for certain jobs
2. Simpler immigration and naturalization procedures
• Migration does not effectively off-set Russia's declining • Expand channels for residence and naturalization for volpopulation
untary migrants, as well as student migrants and temporary
labor migrants wishing to settle in Russia
• Develop family reunification programs
• Lack of documentation or outstanding residence or citi- • Begin an initiative to address outstanding issues for first
zenship claims for the first wave of migrants arriving in wave migrants
the 1990s
3. Integration of migration into Russia's social policy
• Consideration of migration issues separately from • Include a migrant element to both federal and regional eduRussia's social policy
cation development, public health and social support, as well
as housing programs
50
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Challenges
Recommendations
4. Develop institutions to assist migrants find employment and access legal and medical assistance
• Lack of regulation for migrants searching for jobs from • Create and develop a network of agencies to provide
countries not requiring visas, creating an informal for information services to migrants and employers
employment services
Create regional banks of vacancies and a central bank of
candidates
• Limited migrant access to housing
• Support the construction of low-cost hotels
• Develop a market for affordable housing through tax
breaks for developers
• Lack of systematic and consistent information on migrant • Integrate foreign workers into the national health insurance
health45
system
• Develop bilateral agreements with relevant countries of
origin to create a compulsory health insurance system for
foreign workers
• Encourage the creation of medical examination centers for
migrants in countries of departure
• Issue work permits to foreigners46 only upon presenting a
medical clearance
• Migrants' lack of access to legal protection
• Create legal advice centers and law offices with migration
agencies
5. Anti-corruption initiatives in migration
• Law enforcement practices often do not respect regula- • Increase controls and liabilities for abuse of power by
tions or legislation
police
• Abuse of power by police because of migrants' low • Develop anti-corruption programs
awareness about their legal rights
6. Negative attitudes towards migrants and low tolerance for migrants
• Strong negative attitudes towards migrants
• Organize public campaigns to communicate the positive
• Weak federal policy to encourage the integration of contribution of migrants to Russia's economy and public life
migrants and encourage public tolerance
• Introduce national culture days and other events to introduce Russian to the culture of migrants
• Greater engagement between media, NGOs and migrant
communities
7. Developing and increasing the positive effects of domestic migration
• Internal migration stalls the demographic development of
certain regions
• Lack of an investment policy to strengthen urban planning in cities receiving migrants
• Develop an investment policy to create jobs for migrants
in regions suffering population losses
• Shift to a more equitable distribution of urban planning
institutions across the country
• Lack of policies to redirect migration flows to different
regions and cities
8. Engaging NGOs and the private sector as partners in migration issues
• Civic organizations addressing migration issues are not • Develop a federal program to support NGOs working on
supported by government
migration issues
• Increase the involvement of civic organizations and specialists in labor migration decision-making processes
45
According to the Ministry of Health and Social Development, ten percent of labor migrants working in Russia have tuberculosis, AIDS or hepatitis ('Migration. Your right', No 16, 2007). According to the new procedure of work permit issue, migrants arriving
in Russia not requiring visas can first obtain a work permit and then, within 30 days of the work permit issue, deliver a medical certificate
to the FMS. According to the Moscow Administration of the Federal Migration Service, many migrants start jobs, sometimes involving babysitting and a direct contact with people or food. Another acute issue is medical assistance to migrants. In the event of a disease a migrant,
without a medical insurance, would either not obtain any medical assistance, or would refer to the market of paid medical services.
46
Incorporation of amendments in the Decree of the RF Government On Issue of Temporary Work Permits to Foreign Nationals
in the Russian Federation dd. 15 November 2006, No 681.
51
4.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Challenges
Recommendations
9. Migration registration
• Lack of legal expertise on issues of migration registra- • Organize information programs to explain the rules of regtion
istration and private property rights
• Lack of liability for providing for rent apartments without having paid the necessary taxes
10. Improving the collection and use of data different categories of migrants for migration policy
• Lack of reliable and comprehensive statistical data on
international migration
• Lack of information exchange between government agencies
• Outstanding issues regarding the State Information
System to Count Migration and Central Database of
Foreign Citizens
• Launching regional modules of the Central Databank of
Foreign Citizens
• Establish deadlines for FMS to release comprehensive
reports on key performance indicators from databanks
• Develop guidelines for sharing data with statistics agencies
• Oblige an annual statistical report by the FMS on key indicators
• Release of statistics on issued visas, both through the
FMS and through the Ministry of Foreign Affairs of the RF.
• Incomplete data on domestic migration, particularly tem- • Develop statistical accounting guidelines to count longporary migrants
term migrants
• Automated systems to count people are rarely used and • Utilize systems to count citizens to obtain data on migrainformation is not in an electronic format
tion, including data from civil record offices, tax authorities,
and pension funds
• Encourage regional population registers
An inflow of migrants partially compensates
for demographic losses and migrants significantly
contribute to Russia's demographic and economic
development. Policy-makers need to acknowledge
that migrants are a valuable resource for which
many countries compete. As an attractive destina-
52
tion for migrants, Russia should use their labor
effectively and take measures to protect migrants,
who contribute to Russian society. Policy decisions
on domestic migration should focus on redirecting
investment to create jobs for regions with high outmigration.
Demographic Policy
as an Element of Social Policy
5.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
5. Demographic Policy as an Element
of Social Policy
5.1. Demographic ccomponents
of social policy
5.1.1. Economic growth has not yet
resulted in improved demographics
Russia's economic growth in 2000-2006 has
significantly increased quality of life and
decreased poverty levels. Growing employment,
wages and pension transfers have increased
income, which was higher in 2006 than in 1991.
However, this improved standard of living has not
led to expected improvements in demography,
although could lead to decreased mortality,
increased fertility and migration to economic
growth centers.
The Concept of Demographic Development in
the Russian Federation until 2015 was developed and
approved by the Russian government in 2001. In
October 2007, the government approved the Concept
of Demographic Development in the Russian
Federation until 2025. Sections concerning demographic issues are an integral part of medium-term
socio-economic development programs. They also
have an important place in the Concept of Long-Term
Socio-Economic Development of the Russian
Federation (see Box 11), which was developed in 2007.
Though demographic challenges are
addressed in policy documents, it is too early
to speak of a comprehensive demographic
policy.
Social policies addressing demographic challenges focus on family policy measures, particularly
housing policies, reducing the incidence of disease
and mortality, and the regulation of migration.
BOX 11 DEMOGRAPHIC CHALLENGES IN
THE CONCEPT OF LONG-TERM SOCIO-ECONOMIC DEVELOPMENT OF THE RUSSIAN
FEDERATION
The Concept of Long-Term SocioEconomic Development of the Russian
Federation, published in 2006, aims to provide
increase living standards by strengthening national
security and ensuring long-term economic development (2008-2020).47 The concept proposes three
main goals, one of which is to increase the role
of human capital in development. Russia's economic competitiveness is to a large degree determined by the quality of skilled labor. Thus it would
be difficult for Russia to sustain competitive by
lowering labor costs and spending on education and
healthcare. The quality of human capital is crucial in
this respect, which is greatly affected by demographic trends.
The Concept proposes that current demographic challenges are to be overcome through a
proactive demographic policy. Its key priorities
are to stabilize the population to 140 million in
2015-2020 and create the conditions to further
increase the population to 143-145 million by 2025,
as well as to increase life expectancy to 75 years.
The demographic policy has the following
medium-term and long term objectives:
Policy Priorities
Long-Term Measures
Medium-Term Measures
1. Reduce mortality, especially external mortality among working-age
groups of the population, maternal
and infant mortality, and enhance
reproductive health, child and adolescent health, and promote healthier
lifestyles
• Implement a program to encourage
healthy lifestyle models
• Gradually eliminate jobs with working
conditions hazardous to reproductive
health
• Ensure prevention and timely diagnosis of job-related disease among workers
• Lower mortality due to cardiovascular
diseases and cancer through prevention
and timely diagnosis
• Provide effective, qualified medical
assistance and enhancing medical technology by equipping facilities with diagnosis
and treatment equipment
• Conduct events to reduce mortality from
traffic accidents
• Ensure prevention and timely diagnosis
of job-related diseases
47
Concept of Long-Term Socio-Economic Development of the Russian Federation. Russian Ministry of Economic Development.
Moscow, July 2007.
54
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Policy Priorities
Long-Term Measures
Medium-Term Measures
• Jointly develop measures to improve
work conditions, in cooperation with
employers
• Develop programs that promote healthy
living, establish medical offices in schools,
as well as to serve hot meals to students,
develop sports programs and discourage
student use of alcohol, narcotics, and
tobacco products
• Provide state support to families with
children
• Develop special measures to encourage
the employment for women with children
• Improve quality of medical services for
pregnancy and birth
• Provide support to families taking care
of orphaned children
2. Increase fertility, strengthen families and positive family relations, and
increase families' desired number of
children
• Adopt measures to increase the
birth of second and third children
• Improve living conditions for families
with children
• Implement special measures to
encourage the employment of women
with children
• Implement additional steps to assist
families to locate housing and quality
preschool education
• Promote family values among youth
and introduce mechanisms to support
young families and help them become
independent
• Introduce preventive measure for
social orphans
3. Greater employment and active
lifestyle opportunities for disabled
people
• Improve health and social care and
inclusion for disabled
• Ensure the rehabilitation and integration of disabled people, including
equipping all new houses and social
facilities with access ramps
• Improve physical infrastructure for
medical, social care, rehabilitation and
prosthetic and orthopedic facilities
4. Management of migration to
reduce labor shortages
• Implement efforts to attract work- • Conduct proactive regional socio-ecoing-age immigrants for permanent res- nomic policy to retain people in geopolitiidence in the Russian Federation.
cally important regions, such as the Far
East, Siberia, and Central Russia.
Svetlana Seregina
5.1.2. Addressing issues in maternal
support policies
Support for mothers in Russia meet minimum
standards by international norms and exceed them
for several aspects, including insurance, as well as
the duration and benefits offered for maternity support.48
Nevertheless, challenges remain to implement these norms, particularly for maternity support:
• Labor legislation is not always respected as
federal labor inspections detected nearly 1 million
cases of violated workers' rights in the half of 2006
• Pregnant women do not always take maternity leave because of low maternity support, as well
as the fear of losing their jobs
• Informal wage payments are common in
Russia, which excludes workers from the social
insurance system
• Some workers receive wages below the
minimum living wage, particularly women, whose
average wage is less than half that of men
48
Concept of Long-Term Socio-Economic Development of the Russian Federation. Russian Ministry of Economic Development.
Moscow, July 2007.
55
5.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
5.1.3. Low maternal and child supportı
In addition to lump sum transfers after childbirth, there are periodic maternity and child payments:
• Monthly transfers for children up to 18
months for insured mothers total 40 percent of the
average wage. Payment cannot exceed 6000 rubles
per month, where minimum aid totals 1500 rubles
for first born child and 3000 for subsequent children. The same assistance is offered to the unemployed.
In accordance with minimal international standards,49 family transfers must total 3 percent of
unskilled male wages. Other international norms for
family transfers such as the European Social
Charter increase requirements based on the minimum wage, the average wage and pensions. In
Russia, the base rate of monthly aid per child is 6.4
percent of the minimum wage (as of March 2007)
and less than 0.6 percent of the average monthly
wage. Family transfers are considerably higher in
developed countries such as the United Kingdom,
where transfers per child total 3-4 percent of the
average wage.
5.1.4. Living conditions as a crucial
issue for young families
Nearly two-thirds of Russians are dissatisfied
with their housing. One in four families live in poor
or very poor housing. Nearly 4.5 million families are
on waiting lists to receive housing. The state is
required to provide housing to 1.2 million families but
the average waiting time for housing is 15-20 years.
In 2006, the national project “Available and
Comfortable Housing for Russian Citizens” was initiated, prompting considerable housing construction.
Within the framework of the federal program
“Housing” for 2002-2010, mortgage housing credit
support will be offered. Eligibility will be based on
income, such that 25-30 percent of families will be
eligible.
Another federal program, started in 2006,
offers young families subsidies to obtain housing for
up to 35-40 percent of estimated housing costs.
Support increases by 5 percent with the birth or
adoption of a child. However, only applicants under
30 are eligible, while mothers over 30 are increasingly common. Increasing eligibility to 35 years would
48
56
widen participation and deepen the program's impact
on fertility. This will increase the program's impact
over time with increasing postponed births, as mothers over 30 bear up to 50 percent of all children in
other developed countries.
Unfortunately, the program “Providing
Housing for Young Families” does not reach a large
number of families. In 2006-2007, 69,500 young
families planned to improve housing conditions,
including 41,700 in 2007. The low level of housing
construction and its consequently high price is a
main challenge for families wishing to obtain
housing.
Young families believe that accessible housing is scarce or not available. Young families also
lack information on housing programmes. Although
two-thirds of young families would benefit from
improved housing conditions, only one-third are
aware of national support projects.
5.1.5. New measures to support
families
In 2007, Russia will enact measures to support maternity, increase fertility, and encouraging
women with children to work, including:
• Increasing the size of lump sum transfers
upon childbirth, as well as monthly payments for
children care, up to 18 months
• Compensating parents for money spent on
preschool education, up to 20 percent for firstborns, 50 percent for second children, and 70 percent for subsequent births
Setting maternal transfers to 250,000 rubles
for the birth or adoption of a second child.
Legislation for maternal transfers was enacted in
January 2007, while transfers will effective in 2010.
Funding will be spent on children's education,
improved housing for families and contributions to
pensions. More than 130,000 state certificates for
maternal transfers were issued as of 31 August 2007.
5.2. Influence of social policy on
demographics
5.2.1. Can new measures be effective?
Time will tell how the 2007 measures will
impact Russia's demography. However, initial
estimates suggest that the overall impact will be
Principally the International Organization of Labor Convention 102.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
insignificant as the target groups are quite small.
Although the measures will have a significant
effect on demographic trends in targeted
groups:
• Increasing child transfers up to 18 months
will reduce those requiring government support by
6 percent and will reduce the gap for poor families receiving transfers by an average of 5 percent
of their minimum living standard
• Distributing maternal transfers to 6 percent
of families receiving state certificates will help to
resolve housing problems and enable more than
one-third of targeted families to make their first
deposit in the mortgage credit program and pay off
debt.49
Experts believe that proactive socio-demographic policies could considerably slow negative
demographic trends. Estimates by World Bank specialists suggest that implementing policy to prevent non-contagious diseases and accidents,
increase road safety, and improve the ambulance
system could substantially increase life expectancy
in Russia. Reducing mortality from cardiovascular
diseases by 20 percent could increase male life
expectancy by 5 years.50
The family policy measures that could most
increase fertility are often considered social
measures, including child transfers and family
subsidies. It is estimated that increasing family,
maternal, and child transfers by 25 percent would
increase fertility by 4 percent (0.07) in developed
countries with low fertility.51 Child care services
are positively correlated with fertility, as well as
an adaptive labor market that supports working
mothers.52 Generous assistance to families paired
with a strong network of state preschools is seen
as one reason for Norway's high level of fertility.53 Large family transfers do not guarantee a
high level of fertility, however. In Austria, longterm, higher than average spending on family policy failed yield increased fertility. Research suggests that it is possible to increase fertility in
Russia by increasing spending on family transfers.
Income has a positive effect on the reproductive
intent of women, although income is not the
determining factor in deciding to have children.
Research demonstrates that the unavailability of
housing is a significant barrier to increasing fertility. Addressing this challenge is result in a
greater and more rapid impact than increasing
family subsidies.
5.2.2. Opportunities to reduce space
shortages in pre-schools
Access to nurseries and kindergartens are
limited due to a shortage of available spaces, estimated at nearly 1 million in mid-2007. President
Putin proposed in his 2006 state of the nation
address that regional and local governments should
provide kindergartens and day nurseries.
However, increasing pre-school spaces
without federal fiscal assistance seems not feasible. Increased transfer payments could potentially enable families to pay for preschool and
encourage mothers to work. However, those
unable to afford preschool are placed in a difficult situation. Will families tolerate reduced
income because a mother is unable to find a
place in a subsidized preschool and accept that
they will be rendered ineligible for state compensation for preschool? This situation could be
addressed by giving additional support to mothers who cannot find subsidized preschool
places.
5.2.3. Encouraging responsible parenthood
Marital status or presence of a partner
in an unregistered marriage is one the
strongest determinants of women's intent to
have children, which create special demands
for family support and the need to strengthen support for both registered and unregistered marriages. When designing fertility pol-
49
Pishnyak, A. “Effect of new social support measures for mothers and children on the quality of life for families with children.”
Fifth scientific conference Social Policies: Challenges for the 21st Century. 20-21 February 2007.
50
Addressing Premature Mortality and Ill Health Due to Non-Communicable Diseases and Injuries in the Russian Federation. World
Bank, 2005. 2005.
51
Gauthier, A. and Hatzuis, J. “Family benefits and fertility: an econometric analysis” Population studies. n. 51, 1997. 1997. ‹51.
52
Castles, F. “The world turned upside down: below replacement fertility, changing preferences and family-friendly public policy
in 21 OECD countries.” Journal of European Social policy 13 (3): Kravdal. How the local supply of day-care centres influences fertility in
Norway: A parity-specific approach. Population Research. 1996. 5(6).
53
Ronsen, M. “Fertility and family policy in Norway: SPERO. n.5, Fall-Winter 2006.
57
5.
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
icy, it is important to understand that higher
fertility is common among women with lower
income, or who come from families with many
children, which are more inclined to alcohol
abuse. 53
For this reason, support to families with
children, including poor families (see Box 12),
must include measures to increase the responsibility of parents for raising children.
5.3. Options to improve
socio-demographic policy
5.3.1. Long-term and short-term
impact of demographic policies
Developing and implementing a demographic
policy that aims to stabilize Russia's demography is
a difficult task, requiring research to identify esti-
BOX 12. SOCIAL SUPPORT OF LOW INCOME
FAMILIES IN TOMSK OBLAST
Russia ranks first worldwide in the share of
orphans per 10,000 children. Over 80 percent of children
in orphanages have lost their parents for reasons other
than death. In the past 15 years, the number of new
orphans and children without parental care has grown 2.7
times and the incidence of orphans has nearly quadrupled.
The total number of orphans and children without parental
care has increased by 155 percent and their share of people under 18 has doubled. Economic growth has
decreased the number of socially vulnerable families.
Research suggests that transfers are less important
than measures to encourage economic self-sufficiency
among vulnerable families. The program “Assistance
to Orphans in Russia”54 has substantially contributed
to recent social reforms. Tomsk Oblast was selected
as a pilot region for experiments to shift from a system based on orphanages to one aiming to reduce the
number of orphans through prevention and elaboration
of a Concept on prophylactics of orphanage.
The reforms focus on early detection of children at risk to becoming orphans and on prevention
measures. Orphaned children are placed in families
before being sent to orphanages and will be assisted with life and educational choices just as children
raised in families would receive. The reform includes:
Prevention of social orphans,
Rehabilitation of families with children suffering
from severe disabilities
Continuous mentoring of and support to foster
families
Labor adaptation of orphans at vocational educational facilities
53
These measures aim to decrease the risk of losing parental care. Six of every 1,000 children lacked
parental care in Tomsk Oblast in 2005, comparing to 4
children as the national average. The Center for Fiscal
Policy's predicts that without an intervention, the risk for
losing parental care would fall to 5 per 1,000 only by
2050, while reform could reduce the risk to the national
average by 2017.55 As well, supporting foster parents will
increase life success among foster children and it is predicted that foster children will be more likely to study and
work (60 percent against 40 percent in the control scenario) with support. Indeed, life success has increased
(60 percent against 40 percent in the control scenario).
Orphans graduating from provided vocational education
have also better chances at life success as they are better prepared for entering the labor market. These would
result from including them in the system of social and
labor adaptation. Results suggest that reforms not only
reduce children without parental care but also reduce
budget expenditures. While the program has high startup costs (50 million rubles in the first 4 years) and require
the establishment of special administrative structures
with extra staff, the reforms will pay for themselves by
2015-2016. It is forecast that expenditures on the social
protection of children will be reduced by 25-30 percent
after the reforms. The reform will help in early detection
of families in crisis, decrease crime committed by children, lower the number of children sent to orphanages,
increase employment for parents with disabled children,
and decrease in the number of at-risk families.
Svetlana Seregina
Maleva, T. And Sinyavskaya, T. “Socio-economic factors of fertility in Russia: its empirical size and challenge in social policy;” Roshchina, A. “Modeling of factors promoting families to have children in Russia.”
54
Implemented by the National Foundation for the Protection of Children from Abuse together with the American Council of
International Research and Exchange with financial support from the US Agency of International Development (USAID), including Äêé programs 1,2, and 3.
55
See Andreeva, E. Estimates of the long-term socio-economic consequences of reforms in the child social protection system
in Tomskaya Oblast. (Edited by Andreeve, E) FPC, 2007 // http://www.fpcenter.ru/
58
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
mate the impact of the most effective measures.
The best measures will have the greatest impact on
population while minimizing negative consequences.
Fertility policies designed to increase labor
resources have effects only in the long-term, as
children must be 16-18 years before entering the
labor market.
In the short-term, successful implementation may actually reduce labor supply. Optimistic
scenarios for increased fertility forecast would
be accompanied by reduction of workers available by 7 million or 10 percent of the overall
workforce.
Reduced labor supply, growing
unemployment and an increased dependency
ratio will slow GDP per capita growth in 20202025.56
It is therefore necessary to develop measures
to offset the negative short-term consequences of
increased fertility.
Challenges
5.3.2. Challenges and recommendations for Russia's demographic crisis
The following challenges and recommendation in
the are of social policy aimed at increased efficiency
of demographic situation could be suggested (Table 10)
5.3.3. Implementing demographic
policies
Implementing these measures and increasing
funding could significantly improve Russia's demographics. After 2011-2012, the number of women of
active reproductive age will begin to decrease,
which will make stabilizing Russia's population considerably more difficult. Failure to actively develop
and implement policies to resolve demographic
issues could lead to pessimistic demographic scenarios with high population declines.
Recommendations
1. Lack of data and limited research
• Evaluate efficacy of policy options across different population groups
and regions
• Develop policy measures based on analytical results
• Monitor success and feedback to policy measures
2. Lack of quality housing for families,
especially young families
• Encourage housing construction, as new housing per million rubles of
annual personal income decreased from 4.7 m2 to 3.7 m2 in 1999-2006.
Thus, construction is decreasing despite growing purchasing power, which
raises housing prices and makes housing less affordable.57
• Increase access to mortgage credit programs, including credit programs
for young families. According to the Federal Registration Service and the
Mortgage Agency, mortgages were involves in 9 percent of all real estate
deals in 2006, an increase from 4 percent in 2005.58
• Expand the age eligibility for mortgage credit programs for young families
• Build public awareness of mortgage credit programs for young families
• Evaluate increasing subsidies offered by mortgage credit programs,
especially for the birth of children
3. Lack of flexible employment for women
• Develop flexible employment to attract workers with family responsibilities to the labor market
4. Shortage of preschools, day nurseries
and kindergartens
• Increase construction of preschools
• Analyze options to assist regions and municipalities to construct
preschools with federal budget assistance
• Develop new, flexible services for childcare, including family kindergartens and half-day care
• Analyse possibilities for child transfers for families unable to access
preschools
5. Low income in families with children
• Increase the minimum wage and public service wages
• Increase federal and regional family assistance
56
Tatiana Maleva. Fertility-boosting measures: Long-term demographic policy
or a new social project? Fifth scientific conference Social Policies: Challenges for the 21st Century. February 20-21, 2007.
www.socialpolicy.ru; Dmitriev, M. Russia-2020: Demographic challenges of economic growth // Economic policy. 2007. ‹2.
57
Kosoreva, N., Tumanov, A., Can the Russians afford to buy housing? Demoscope Weekly. _ 307 - 308, 29 October - 11
November 2007.
58
See Credit refinancing - more money for mortgages // First Mortgage information and analytical magazine. 2006.
59
DEMOGRAPHIC POLICY IN RUSSIA: FROM REFLECTION TO ACTION
Conclusion
Current policies to support mothers and
families with children, as well as national health
project, aim to halt the growing demographic crisis, move towards a proactive demographic policy, establish better conditions for having children and build national awareness about health.
In a public address, President Putin stated
that “the reduction in mortality and increase in
fertility achieved in 2006 and the first few
months of this year clearly indicate the correct
target for our efforts. In line with these efforts,
I would like to declare 2008 the Year of the
Family in Russia. I believe this will encourage
government, society, and the private sector to
unite in addressing important issues such as
strengthening families and family values.”59
Slightly increased fertility and decreased
mortality in 2006-2007 should not support complacency or the belief that the demographic situation
will improve without substantial effort. Current support to families with children is insufficient to
achieve higher fertility, which must ensure that families have more children. This requires a shift in the
social value placed on having children and multiple
child families. Accordingly, addressing such a challenging demographic situation requires adopting
and implementing a long-term and costly strategy.
The Concept of Demographic Development in
Russia (2001) aimed to be such a strategy, whose
goal was to stabilize Russia's population level and
create conditions for demographic growth.
However, the strategy was never fully implemented
at the federal level. The main achievement of the
concept was that it triggered the development of
regional demographic concepts, programs and
plans. Those efforts have taken time to mature and
it is still early to evaluate their impact.
Presidential Decree No. 1351 of October 9,
2007 introduced the new Concept of Demographic
Policy in Russia until 2025.
This new policy aims to increase Russia's
population to 142-143 million people by 2015 and
create the conditions for an increase to 145 million
47
60
by 2025. As well, the policy aims to improve living
standards and increase average life expectancy to
70 years by 2015 and to 75 years by 2025. The policy document details the principles, objectives and
stages for implementation. However, experts
believe that the targets are overly ambitious and
cannot be realistically achieved.
The goal to decrease mortality by 60 percent
by 2025 is a good example. Reducing mortality
from 2.2 million to 1.4 million by 2025 is unrealistic
without a significant decrease in population, which
would contradict the goal of increasing the population to 145 million. The reduction in mortality from
15.2 to 9.5 percent in 2007-2025 would increase life
expectancy to Western European rates of 78-80
years.
Even if life expectancy of 75 years was
achieved by 2025, overall mortality rates would be
considerably higher due to the ageing population.
It will be equally difficult to maintain high fertility throughout 2007-2025. Fertility was at its lowest in 2000, such that there simply will not be
enough people of active reproductive age (20-29
years) to significantly increase birth rates.
Achieving this level of fertility is even less likely
given that younger generations have mostly come
from one-child families and it is unrealistic to
expect them to have fertility rates 50 percent higher than their parents.
These realities mean that the Concept's targets, tasks and objectives need clarification and
adjustment to the level of government where they
are to be implemented. The implementation costs
and financing mechanisms must also be identified.
Other aspects of the policy must also be
addressed, including dimensions such as information collection, the legal framework, policy design
and human resources.
Addressing Russia's demographic situation
also requires further study, evaluating policy
options and learning from the experience of other
countries. These challenging issues require extensive discussion between partners in government,
civic organizations, the private sector, as well as
social policy and demography experts.
http://kremlin.ru/appears/2007/04/26/1156_type63372type82634_125401.shtml
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