Regional deprivation and cause-specific mortality in Russian adults in 2006-2022

Objective:The relationship between cause-specific mortality and regional socio-economic and environmental indicators remains poorly studied in Russia.The study first aims to study regional differences in cause-specific mortality among the population aged 20 years and older in Russia,and second to investigate the association between regional deprivation and cause-specific mortality.Material and methods:Russian deprivation index was used to measure level of deprivation.The index consists of three components:social,economic and environmental.The index measures general deprivation,and its compo-nents measure social,economic and environmental deprivation.The mortality data by age(five-year groups)and sex in the subjects of Russia from 2006 to 2022 were extracted from the Russian Fertility and Mortality Database of the Center of Demographic Research of the New Economic School.Results:In the most general deprived areas,mortality rate from infectious and parasitic diseases increased by more than twice in the total population,women and men as compared to the least deprived quantile(Q1).Fully adjusted negative binomial regression showed an increase in mortality rate from injuries,poisoning and external causes and infectious and parasitic diseases in more social deprived areas as compared to Q1 in the total population,women and men.In men,there was a significantly higher mortality rate from neoplasms and from infectious and parasitic diseases in more economic deprived areas as compared to Q1.Both in total population and in women,there was a trend towards an increase in mortality from neoplasms depending on the level of environmental deprivation.Conclusions:This is the first study examining the relationship of contextual factors with cause-specific mortality that takes into account sex,age and year of death at the population level in Russia.General,social,economic and environmental deprivation are associated with cause-specific mortality.