Disparities in Health: Equity Aspects of Avoidable Mortality

Health inequity, that is socially determined, and preventable disparities in health, hinders the advancement of life expectancy. In Russia, which has witnessed the collapse of a social system rooted in the principles of social equality in a remarkably brief historical period, both the topic itself and the search for methods to investigate it are of utmost importance. The purpose of the study is to evaluate the manifestations of health inequity through the lens of their social dependence and preventability in terms of avoidable mortality. Material and methods. The calculation of avoidable mortality is based on the cause classification in ages under 65, proposed by Walter W. Holland in 1993. The analysis was conducted using data for the period between 2000 and 2019.The subsequent period is marked by turbulence. The study used official data provided by Rosstat as its information base. Standardized mortality rates for preventable death causes were calculated using the direct method (European standard population). Results. The disparity in life expectancy between urban and rural populations, as well as its regional variations, is largely attributable to avoidable mortality. The example of a substantial reduction in the rural-urban gap in avoidable mortality over the first two decades of the 21st century, including a convergence in treatable deaths, suggests that significant progress has been made in addressing health disparities between urban and rural populations within a remarkably short timeframe. In terms of regional disparities, progress is minimal. The economically prosperous regions of the country have much greater potential for improving the life expectancy of their populations by reducing preventable deaths, compared to poorer regions. In both cases, priority should be given to prevention interventions aimed at lifestyle modification, as the social component of avoidable mortality dominates, and interventions aimed at reducing it are the most cost-effective strategy.