Forventet gjennomsnittlig levetid 20 år kortere i Russland

12.02.2013

"In 2008, the difference in life expectancy between men in some West-European countries and Russia was 20 years. Put in a west–east context, the wide differences in health between countries still exist and constitute one of the greatest challenges for Europe now and in the future" Epidemiologer i Polen og England har via sin artikkel om helsetjenester og sykdommer i Øst Europa, fått et interessant svar fra en patolog i Russland der han forklarer at noe går i riktig retning, bl.a. med hensyn til bruk av alkohol, men beskriver utfordringer i forhold til litteraturtilgang, forskning og implementering av nye behandlinger.

Changing trends of diseases in Eastern Europe: Closing the gap

One of the greatest challenges in Europe at the beginning of the 21st Century is the wide east–west health gap. In 2008, the difference in life expectancy between men in some Western European countries and Russia was 20 years. Whilst trends for life expectancy at birth have improved in many areas around the world, those for Russia, as well as those for some other former Soviet Union countries, have fluctuated greatly and have not shown signs of growth since the middle of the 20th Century. This problem is most acute in Russia and former Soviet Union countries, but is also far from being solved in the states that have made significant progress since 1990 and joined the European Union in the 21st Century
 

Svar: Health care and life expectancy: A letter from Russia
 -Estimates from 2008 on the probability of death before 65 years of age for men are approximately 16% in Western Europe, compared with 31% in Eastern Europe and 54% in Russia.1 As a pathologist, I can comment on the relatively high mortality rates from cardiovascular disease in Russia compared with West Europe, illustrated by Zatoński and Bhala's graphs.1 Since the Soviet time, autopsy has remained obligatory for all patients dying in hospitals; however, the attitude towards post-mortem examinations has become less serious. Autopsies have often been performed incompletely and without much insight.2 If a cause of death is not entirely clear, it is common practice to write on the death certificate: ‘ischaemic heart disease with cardiac insufficiency’ or a similar formulation

It is also common practice to recommend costly placebos11 and 12 or diagnostic procedures without sufficient indications.13 Furthermore, limited access to foreign literature has resulted in progress delays in some practical fields.14 and 15 This, together with policy favouring domestic products,15 can result in the repetition of research already performed abroad, with the purpose of official registration of such products.

Svar Response to letter from S.V. Jargin
- The development of the key phenomena destructive to health began in the 1950s and 1960s. For example: consumption of alcohol increased in Poland between 1950 and the early 1980s from 4 l/adult/year to 12 l/adult/year; while consumption of cigarettes increased from 1065 cigarettes/adult/year to 2648 cigarettes/adult/year; the highest level of consumption in the world at the time. The case was similar in all countries of the Eastern Bloc. These developments resulted in a situation rarely encountered during times of peace: every year, the mortality of young and middle-aged adults, especially men, increased, and the life expectancy after 15 years of age declined

- We must remember that premature mortality of young and middle-aged adult (15–59 years) males in Russia, among the highest in the world during the collapse of the Soviet Union in the 1990s, remains amongst the highest today. It is currently higher not only in the countries of Western Europe with widely available modern health care, but also higher than that in China, India and sub-Saharan African countries.11 It is also important to remember that infant mortality, a good indicator of the functioning of health care, declined steadily in Russia during the 1990s, and is currently almost at single-digit levels. In this respect, Russia is firmly entrenched in the group of well-developed countries, which is not the case if we look at adult and middle-aged male mortality