Aging: An Achilles Heel in Russian Economic

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Population/Health/Aging: An Achilles Heel in Russian Economic Development Nicholas Eberstadt Henry Wendt Chair in Political Economy American Enterprise Institute [email protected] CSIS Global Aging Initiative Washington, DC July 22, 2005

Russia: Population Sctructure 2000 vs. 2025 (medium variant projection) 100+ 95-99 90-94 85-89 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4

Male

-8000

-6000

-4000

-2000

Female Female

2025 2000

0

2000

4000

Source: UN World Population Prospects: The 2004 Revision Population Database

6000

8000

Projected Total Population: Russia, 2000-2025

Total Population (Thousands)

150000

145000

140000

135000

130000

125000

120000 2000

UN Projections Census Projections

2005

2010

2015

Year

Sources: U.S. Bureau of the Census, International Data Base; United Nations Population Division, World Population Prospects: The 2004 Revision

2020

2025

Births, Deaths, and Natural Increase in Population: 1960, 1965-2004 3000000

2500000

2000000

Population

1500000

1000000

500000

Births

-500000

-1000000

Deaths Natural Increase 1960 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

0

Year

Sources: Source: The Russian Federation Ejegodnik: 2004 (State Committee of the Russian Federation on Statistics, Moscow, 2004), Table 2.25, Source for 2004 figures: U.S. Census Bureau, International Data Base, accessed April 15, 2005

Deaths per Hundred Births for Negative Natural Increase Countries Slovak Republic (2003)

101.04

Greece (2002)

101.06

Italy (2003) Slovenia (2003)

108.51 111.49

Czech Republic (2003)

117.20

Moldova (2003)

117.82

Germany (2003) Romania (2003) Croatia (2003) Lithuania (2003) Estonia (2002) Hungary (2003) Latvia (2003) Russian Federation (2003)

119.77 125.51 132.58 133.71 140.63 144.09 154.44 160.78

Bulgaria (2003)

166.28

Belarus (2002)

166.29

Ukraine (2003)

188.24

Source: Calculated from Recent Demographic Developments in Europe, Council of Europe: Belgium, January 2005.

Projected Population Change, 2000-2025: Russia, Rest of Eastern Europe, and West. Europe Russia

Rest E.Eur.

W.Eur

Total Population

-11.8%

-12.7%

+ 3.8%

Population 15-64

-15.4%

-15.1%

- 2.3%

(Population 15-24)

(-36.3%)

(-45.3%)

(-12.7%)

Population 65+

+25.7%

+30.4%

+44.0%

Source: UN Population Division, World Population Prospects, 2004 Revisions, www.unpopulation.org. NOTE: UNDP’s definition of “Eastern Europe” excludes the Baltic countries, Albania, and most of former Yugoslavia

Basic Demographic Indicators For Europe By Region (UNPD Projections) W.Europe

Russia

E.Europe (w/o Russia)

Population (million) 2005

431

145

143

Pop Growth %/yr 2000/2005

0.33

-0.46

-0.52

Net Reproduction Rate 2000/2005 0.72

0.62

0.58

Life Expectancy 2000/2005 (Years)

65.4

70.5

77.6

NOTE: UNDP’s definition of “Eastern Europe” excludes the Baltic countries, Albania, and most of former Yugoslavia

Total Fertility Rate: U.S. (by state), Russia, and Europe, 2000

Total Fertility Rate

3 2.5 2 U.S. TFRs 2000

1.5

Eur TFRs 2000 EU-15 TFRs 2000 Russia TFR 2000

1 0.5 0

Notes: U.S. TFR includes the 50 and the District of Columbia; blue bars indicate TFRs for European countries outside of the EU-15. Sources: Institut National d'etudes demographiques, "Population en chiffres," available at http://www.ined.fr/population-en-chiffres/paysdeveloppes/index.html (accessed August 4, 2004); National Vital Statistics Report Vol 52, No. 19 (May 10, 2004).

Illustrative Percentages of Population 65+: Stable Populations, Coale-Demeny “West Model”, Under Alternative Fertility and Mortality Schedules GRR 0.8

GRR 1.0

GRR 1.5

GRR 2.0

GRR 2.5

GRR 3.0

Female LE 20

16.62

13.36

8.51

5.81

4.24

3.21

Female LE 30

17.85

14.25

8.73

5.86

4.16

3.08

Female LE 40

18.87

14.88

8.96

5.89

4.13

3.02

Female LE 50

19.74

15.45

9.27

5.94

4.11

2.97

Female LE 60

20.13

15.67

9.16

5.87

4.03

2.91

Female LE 70

21.24

16.48

9.56

6.10

4.15

2.98

Total Population Age 15-24, Russia, 1975-2025, (medium variant projection)

Total Population (thousands)

30000 25000 20000 15000 10000 5000 0 1975

1980

1985

1990

1995

2000

2005

2010

Year

Source: United Nations Population Division, World Population Prospects: The 2004 Revision.

2015

2020

2025

Changes in 65+ Population As Percentage of Total Population: 2000 vs. 2025 (US Census Bureau Projections) Western Europe

2000 16.3

2025 22.7

Difference + 6.4

Bulgaria Czech Republic Estonia Hungary Latvia Lithuania Poland Romania Russian Federation Slovakia Ukraine

16.6 13.8 15.0 14.6 14.7 13.7 12.3 13.3 12.5 11.4 14.1

23.2 22.9 22.7 21.3 20.7 21.0 21.6 19.0 19.8 19.3 20.6

+ 6.6 + 9.1 + 7.7 + 6.7 + 6.0 + 7.3 + 9.3 + 5.7 + 7.3 + 7.9 + 6.5

Estimated and Projected Population 65+: Russia, United States, and Western Europe, 1975-2025 (percent of total) 25 Russia

20

United States Western Europe

15 10

19 75 19 80 19 85 19 90 19 95 20 00 20 05 20 10 20 15 20 20 20 25

5

Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2002 Revision and World Urbanization Prospects: The 2001 Revision, http://esa.un.org/unpp, 21 January 2005

Percentage of the Population Aged 65+ vs. GDP per Capita: Developed Countries 1950-2000 vs. Emerging Economies 2000

Per Capita GDP (1990 international GearyKhamis dollars)

30,000 Europe

25,000

Japan United States China 2000

20,000

Brazil 2000 India 2000

15,000

Indonesia 2000 Mexico 2000

10,000

Poland 2000 Russia 2000 Thailand 2000

5,000

Turkey 2000

0 0

5

10

15

Percentage of Population Aged 65+

Sources: Maddison (2003); UNDP (2004)

20

Health Equals Wealth: Worldwide LE vs. PPP Per Capita GDP, 2003 100000

10000

1000 0.0723x

y = 46.101e 2 R = 0.6519 100 30

35

40

45

Source: World Development Indicators, 2003

50

55

60

65

70

75

80

85

Estimated Changes in Life Expectancy at Birth in Europe, by Region: 1960/65 to 2000/2005 (years) Overall LE

Male LE

Western Europe

+7.3

+6.8

Eastern Europe (without Russia)

+1.1

-0.8

Russian Federation

-2.5

-4.2

Note: UN definition of "Eastern Europe" excludes the Baltic countries, Albania, and most of the former Yugoslavia. Source: Derived from UN Population Division, World Population Prospects: The 2004 Revision, available electronically at .

Female Life Expectancy at Birth, Switzerland vs. Russia,1970-2003 85.00 83.00 81.00 79.00 Age

77.00 75.00 73.00 71.00 69.00 67.00

Russia Switzerland 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

65.00 Year Sources: The Demographic Yearbook of Russia: 1993 (State Committee of the Russian Federation on Statistics, Moscow, 1993), Table 2.5; The Demographic Yearbook of Russia: 2004 (State Committee of the Russian Federation on Statistics, Moscow, 2004), Table 2.6; Human Mortality Database, available online at www.mortality.org, accessed January 20, 2005.

Male Life Expectancy at Birth, Switzerland vs Russia, 1970-2003 80.00 Russia 75.00

Switzerland

Age

70.00 65.00 60.00

1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

55.00 Year

Sources: The Demographic Yearbook of Russia: 1993 (State Committee of the Russian Federation on Statistics, Moscow, 1993), Table 2.5; The Demographic Yearbook of Russia: 2004 (State Committee of the Russian Federation on Statistics, Moscow, 2004), Table 2.6; Human Mortality Database, available online at www.mortality.org, accessed January 20, 2005.

Age-Standardized Mortality, 1965-2001: Deaths from All Causes 2,400

Mortality Rate (deaths per 100,000 population)

2,200 2,000 1,800 1,600 Males

1,400

Females

1,200 1,000

20 00

19 95

19 90

19 85

19 80

19 75

19 70

19 65

800

Year

Source: The Demographic Yearbook of Russia: 2002 Statistical Handbook, State Committee of the Russian Federation on Statistics (Goskomstat of Russia), Moscow, 2002, Table 6.4.

Age Standardized Mortality, Deaths from Cardiovascular Diseases: Russia, 1965-2001 1,200

Males

Mortality Rate: Chapter IX Causes (deaths per 100,000 population)

1,100

Females

1,000

900

800

700

600

500

20 00

19 95

19 90

19 85

19 80

19 75

19 70

19 65

400

Year

Source: The Demographic Yearbook of Russia: 2002 Statistical Handbook, State Committee of the Russian Federation on Statistics (Goskomstat of Russia), Moscow, 2002, Table 6.4.

Deaths from diseases of the circulatory system, 25-64 years: Russia and Selected European Countries Russian Federation (2001) Turkmenistan (1998) Kazakhstan (2001) Belarus (2001) Ukraine (2000) Kyrgyzstan (2001) Uzbekistan (2001) Republic of Moldova Latvia (2001) Bulgaria (2001) Azerbaijan (2001) Tajikistan (1999) Estonia (2001) Romania (2001) Georgia (2001) Yugoslavia (2000) Lithuania (2001) Bosnia and Herzegovina Hungary (2001) TFYR Macedonia (2000) Slovakia (2000) Poland (2000) Armenia (2000) Croatia (2001) Czech Republic (2001) Albania (2000) Ireland (2000) Slovenia (2001) Greece (1999) United Kingdom (2000) Finland (2001) Germany (1999) Luxemburg (2001) Austria (2001) Denmark (1999) Belgium (1996) Netherlands (2000) Malta (2001) Portugal (2000) San Marino (2000) Israel (1998) Sw eden (1999) Norw ay (1999) Iceland (1997) Italy (1999) Spain (1999) Sw itzerland (1999) France (1999)

378.1 361.4 344.0 320.4 293.9 290.5 288.8 272.6 254.9 254.1 250.2 233.3 220.1 217.5 215.3 209.7 189.9 188.1 175.5 172.8 153.1 135.9 115.9 102.9 98.0 97.5 91.2 91.0 87.7 85.6 84.1 83.7 79.3 76.6 76.0 74.7 72.0 71.3 70.1 69.9 67.6 65.0 63.6 56.8 55.2

0

100

200

300

400

442.7 441.9 419.8

Post-communist countries Countries which have never been communist

500

Per 100,000 persons

Source: Atlas of Health in Europe, The World Heath Organization at www. Euro.who.int/document/E79876.pdf

Age Standardized Mortality, Deaths from Accidents & Injuries: Russia, 1965-2001 500

Mortality Rate: Chapter XIX Causes (deaths per 100,000 population)

Males

Females

400

300

200

100

20 00

19 95

19 90

19 85

19 80

19 75

19 70

19 65

0

Year

Source: The Demographic Yearbook of Russia: 2002 Statistical Handbook, State Committee of the Russian Federation on Statistics (Goskomstat of Russia), Moscow, 2002, Table 6.4.

Deaths from external causes of injury and poisoning, 0-64 years: Russia and Selected European Countries Russian Federation (2001) Belarus (2001) Estonia (2001) Lithuania (2001) Kazakhstan (2001) Ukraine (2000) Latvia (2001) Republic of Moldova (2000) Kyrgyzstan (2001) Hungary (2001) Romania (2001) Poland (2000) Turkmenistan (1998) Finland (2001) Slovenia (2001) Slovakia (2000) Uzbekistan (2000) Czech Republic (2001) Bulgaria (2001) Luxemburg (2001) Albania (2000) Croatia (2001) Belgium (1996) France (1999) Tajikistan (1999) Austria (2001) Greece (1999) Portugal (2000) Ireland (2000) Iceland (1997) Denmark (1999) Yugoslavia (2000) Spain (1999) TFYR Macedonia (2000) Sw itzerland (1999) Armenia (2000) Georgia (2001) Norw ay (1999) Germany (1999) Azerbaijan (2001) Sw eden (1999) Israel (1998) Italy (1999) United Kingdom (2000) Malta (2001) Netherlands (2000)

82.0

56.0 57.3 52.1 61.0 49.4 52.6 41.7 32.7 22.1 23.7 18.5 29.4 24.9 17.8 17.1 23.7 17.9 16.8 25.1 17.5 16.4 23.6 21.4 13.6 16.8 15.4 13.2 13.7 13.6 19.2 14.8 12.5 11.7 15.2 9.1 7.9 14.6 13.8 11.3 15.3 Per 100,000 10.1 9.9 Females 11.7 10.9 11.7 -200

-100

278.5 270.3 264.7 263.8 246.8 246.3

369.6

Post-communist countries Countries which have never been communist

162.2 134.2 94.2 94 92.3 91.7 91.7 87.1 86.6 78.2 70.3 70.2 69.9 69.5 68.8 63 62.9 57.1 55.2 54.4 53.1 52.9 52.4 52 51.6 48 45.4 44.6 44.2 43.9 43.6 41.5 40.3 40.1 39.9 Per 100,000 37.5 M ales 35.9 30 28.8 0

100

200

300

400

Source: Atlas of Health in Europe, The World Heath Organization at www. Euro.who.int/document/E79876.pdf

Total Alcohol Consumption and Russian Male Life Expectancy, 1992-2001 57

17

Per capita alcohol consumption* 58

Male life expectancy

15

59

14

60

13

61

12

62

11

63

1992

1993

1994

1995

1996

1997

1998

1999

2000

Years

Liters

16

2001

Note: inverted to scale for life expectancy Sources: Julie DaVanzo and Clifford Grammich, Dire Demographics: Population Trends in the Russian Federation. RAND, 2001; Clifford Grammich updates provided to Nick Eberstadt, 2004

Increase in Age-Standartized Mortality Rate (percent)

Rise in Mortality, Russia: 1970/71-2003 0.9 0.8 0.7 0.6 0.5

Males Females

0.4 0.3 0.2 0.1 0 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69

Years Source: The Russian Federation Ejegodnik: 2004, State Committee of the Russian Federation on Statistics (Goskomstat of Russia), Moscow, 2004; US Census Bureau, International Data Base website at http://www.census.gov/ipc/www/idbprint.html, accessed on April 12, 2005

A 20-year old Man's Odds of Dying Before Age 65: Europe, U.S., Russia, 2000 60 50 40 30 20 10

Russia Europe USA EU-15

Note: Calculations based upon current "life tables" for the year 2000. "Europe" includes countries outside of the EU-15. Source: World Health Organization Life Tables, 2000, available at http://www3.who.int/whosis/life_tables/life_tables.cfm?path=evidence,life_tables&language=english (accessed on September 20, 2004).

Russia

Belarus

Ukraine

Estonia

Latvia

Hungary

Lithuania

Romania

Bulgaria

Poland

Slovakia

Bosnia and Herzegovina

Albania

Croatia

Czech Republic

Yugoslavia

Slovenia

Portugal

Finland

USA

Denmark

France

Luxembourg

Austria

Germany

Belgium

Spain

Greece

Ireland

U.K.

Italy

Netherlands

Sweden

0

12

"More Aged Than Their Years": Mortality At Age 30 for Men In Selected Post-Socalist Countries Compared With The Dutch Male Mortality Schedule, c. 2003

10

Dutch male survival schedule Bulgarian male at age 30

8

Czech Republic male at age 30 East German male at age 30

6

Hungarian male at age 30 Latvian male at age 30

4

Lithuanian male at age 30

2

Russian male at age 30

30 31 32 33 34 35 36 37 38 39 40 4 41 1 .5 42 43 44 45 46 47 48 49 50 5 51 1 .5 52 53 54 55 56 57 58 59 60

0 Age

Source:www.mortality.org

"Positive Health Momentum": Male Mortality in Japan by birth cohort 1920-1969

Mortality rate (deaths per 1000 persons)

100.00

1920

10.00

1930 1940 1950 1960

1.00

1969

0.10 Age Source: www.mortality.org, accessed on 11 April 2005

"Negative Health M omentum": M ale M o rtality in Russia by birth cohorts 1920-1970

Mortality rate (deaths per 1000 persons)

100

1920

10

1930 1940 1950 1960

1

1970

0 Ages

Source: www.mortality.org, accessed on 11 April 2005

Male Life Expectancy at Birth: Russia vs. Indian Subcontinent, 1989-2025 Life Expectancy at Birth (years)

70

65

Russia Bangledesh India Pakistan

60

55 1989

1995

2001

2007

2013

2019

2025

Source: U.S. Bureau of the Census, International Data Base. Available online at http://www.census.gov/ipc/www/idbnew.html, accessed January 19, 2005.

Median Age for Persons 15-65 in Select Countries, 2000 and 2025 46 44

Age

42 40

2000

38

2025

36 34

Country Source: U.S. Census Bureau International Data Base

e kr ai n U

us si a R

ni a

Li th ua

La tv ia

ia Es to n

Sl ov ak ia

om an

ia

d R

Po la n

H

un g

ar y

lic ep ub

R

C

ze ch

Bu lg a

ria

32

Intercensal Population Change: January 1989-October 2002

Source: "The 2002 Census in Russia: Preliminary Results" by Timothy Heleniak, Eurasian Geography and Economics, 2003, 44, No. 1, pp. 432-444

HIV/AIDS Prevalence in Russia: Selected Estimates Source

Total

% Adult Population (15-49)

Russia Ministry of Health

286,642

0.4%

UNAIDS Yearend 2003, Central Estimate

860,000

1.1%

Dr. V. Pokrovsky Nov. 2004, Low Estimate

1,000,000

1.3%

UNAIDS Yearend 2003, Upper Estimate

1,400,000

1.8%

Dr. V. Pokrovsky Nov. 2004, High Estimate

1,500,000

1.9%

U.S. National Intelligence Council Oct. 2002, Upper Estimate

2,000,000

2.5%

Note RMOH Prevalence taken as cumulative HIV registrations minus cumulative HIV/AIDS Deaths. Sources: U.S. National Intelligence Council; UNAids; “AIDS in Russia: An Analysis of Statistics” (Dr. Murray Feshbach and Cristina M. Galvin, January 2005.

Projected Life Expectancy: Russia, 2000-2025 75

Life Expectancy at Birth (years)

70

65

60

Cens us projections Mild Epidem ic Intermediate Epidemic Severe Epidem ic 55

50 2000

2005

2010

2015

2020

Ye ar

Source: Nicholas Eberstadt, "Projecting HIV in Eurasia: Our Methodology (Charts)," available online at http://www.aei.org/docLib/20021222_pseber021112a.pdf.

2025

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