On Jan 12, the World Bank released their Systematic Country Diagnostic for the Russian Federation, Pathways to Inclusive Growth. The report provides an in-depth analysis of current economic conditions in Russia, as well as recommendations and a detailed plan for optimising continued economic and social growth. Among the key messages are that the Russian workforce is ageing, premature mortality is unacceptably high, and access to public health services is glaringly inadequate. Unless investment in the health of Russian workers is prioritised, growth of the economy will become stagnant.
The report reveals disturbing facts about the health of Russian citizens. Gains in life expectancy in Russia are eclipsed by countries with much lower income levels. In 2014, the national life expectancy at birth was 70·9 years, compared with 76 years in China. For Russian men, the outlook is astonishingly bleak with a life expectancy of only 65·3 years. Improvements, such as a reduction in disease burden and mortality attributable to non-communicable diseases, have been made. However, public spending on health care remains low, and many of the reported health gains have occurred only in larger cities and among more affluent Russians. Indeed, reporting national averages masks a shocking reality of far worse health outcomes for people living in rural areas than those in urban settings. These statistics should come as no surprise. In a baseline analysis of health measures of the Sustainable Development Goals from the Global Burden of Disease 2015 study, Russia scored 19·5 points lower than expected, and ranked 119th of 188 countries by sociodemographic index.
The World Bank report was written with the primary aim of enhancing Russia’s economic growth. But the value of human capital and the health of the Russian people matter too. Russia’s Government must take efforts to reduce social inequality more seriously and build a safe and effective public health system for all citizens—not for the sake of the economy, but because it is the right thing to do for their people.