Experts have calculated the damage to the Russian economy from premature deaths

One missed year with the premature death of a Russian brings damage to the economy in the amount of 226–513 thousand rubles. Annual losses are estimated at 15–24 trillion rubles, the Institute of the Russian Academy of Sciences estimated the “price” of early mortality from diseases and accidents

Premature mortality of the population from major diseases and external causes costs the Russian economy with potential losses in the amount of 15 trillion to 24 trillion rubles. in year. The damage from one missed year for a Russian citizen ranges from 226 thousand to 513 thousand rubles. This data was obtained by experts from the Central Economics and Mathematics Institute (CEMI) of the Russian Academy of Sciences.

The study by Alexander Varshavsky and Maria Kuznetsova from CEMI RAS was published in the latest issue of the journal “National Interests: Priorities and Security.” RBC got acquainted with their scientific article “Assessment of economic damage when life expectancy is reduced as a result of major types of diseases.”

Among the main classes of diseases leading to early mortality, the greatest damage is caused by diseases of the circulatory system (RUB 3.5–4.8 trillion in 2019); losses from external causes (road accidents, accidental poisoning, etc.) are comparable in size. ) - up to 5.2 trillion rubles, estimated Varshavsky and Kuznetsova. “Particular attention should be paid to reducing the incidence of neoplasms and reducing the prevalence of cardiovascular diseases,” the authors write.

As the authors believed

In the model, premature death is considered to be death before the age of life expectancy. The analysis was carried out using population mortality data for the pre-Covid year 2019; average life expectancy was also taken for 2019 (73 years, which is almost the same as the estimated value for 2023). The authors estimated the number of prematurely died Russians in 2019, based on Rosstat data, at 981.8 thousand people.

The economic damage from the premature death of Russians was calculated as the sum of the cost of lost years of life and losses in GDP, taking into account the “unfinished” work experience. In particular, the cost of lost years of life was determined based on the “cost of an average life” indicator, which, in turn, was calculated in four ways - hence the wide range of final estimates of economic damage. Depending on the approach, the price of one life was estimated from 16.5 million to 37.5 million rubles. (at 2021 prices). The obtained estimates are conditional and indicative, as indicated in the article.

Loss in GDP was estimated as GDP per person employed multiplied by lost work experience (the number of years a person does not work before retiring as a result of premature death).

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The cost of living of a Russian at CEMI was calculated using the following competing methods:

The first two methods were based on the use of data on per capita GDP or average annual monetary income for the period of expected life expectancy of the average Russian citizen, taking into account the so-called discount rate: in other words, the amount of per capita income (GDP) reduced to today was determined based on the annual interest rate of the Central Bank . Estimates: 16.5 million and 22.3 million rubles. The third method defines the cost of living as annual GDP per capita multiplied by the average number of years of life lost due to premature death (the difference between life expectancy and the average age in the country). According to Rosstat, the average age of the population at the end of 2021 is 40.4 years. Estimate: RUB 30.2 million. Another method is based on the use of data on the costs of maintaining a person’s life activity throughout his life (from state expenses on educating a citizen to the average pension): the authors estimated the cost of living using this method at 37.5 million rubles.

What do the experts think?

Olga Obukhova, Deputy DIRECTOR of the Central Research Institute of Organization and Informatization of HEALTH Care (TsNIIOIZ) of the Ministry of Health, Candidate of Political Sciences, believes that to calculate the cost of living by the third method, it would be more correct to use not the average age of a resident, but the average age of death.

The cost of human life is an important indicator; using these four methods it is calculated in different countries and for different purposes, says Dmitry Kulikov, director of the group of sovereign ratings and macroeconomic analysis at ACRA. “At the same time, in methods for estimating the statistical cost of living that aggregate lifetime income or per capita GDP, the discount rate is a very important parameter. For example, using a rate 3 percentage points higher could reduce the statistical cost of living estimate by about 40%,” he illustrates.

According to the expert, the approach using the key rate as a discount factor has a right to life, but in RUSSIA this is too volatile an indicator. In 2023 alone, the key rate changed from 7.5 to 16%.

The statistical cost of living indicator, according to Kulikov, can be used, in particular, to solve the “trolley problem” (a thought experiment in ethics about the possibility of sacrificing fewer people in order to save more) when planning government spending. For example, given limited resources, this makes it possible to understand what would be more useful for society - to spend a billion on a small but constant reduction in mortality on the roads for car owners, or to spend the same billion on reducing mortality from the seasonal flu epidemic this year. “Both policies will potentially lead to an increase in the total cost of citizens’ lives, but it is a priori unclear which will be more effective for society as a whole. A cost-of-living calculation with a small discount factor will favor policies with long-term effects, while a cost-of-living calculation with a large discount factor will value short-term improvements more highly,” he explains.

There are other methods for assessing the cost of living - based on the amount of insurance compensation for the death of a person, based on sociological surveys, etc. The question may also be relevant in the legal field for determining the amount of judicial penalties in cases of death of a person.

How much do illnesses cost?

Neoplasms as a cause of early mortality cause damage of 1.8–2.6 trillion rubles. per year and even more, if we assume that on average Russians work not 40, but 45 years (in this case, the lost work experience will be greater).

“The incidence of neoplasms is rapidly increasing, including malignant ones,” the authors state. According to Rosstat, if in 2020 7.13 million people with neoplasms were registered, then in 2022 the figure increased to almost 7.62 million (an increase by 4.4% by 2021).

Specialists from CEMI RAS have noticed that the incidence of neoplasms is increasing in children under the age of 14 years. They hypothesize that this may be due to the influence of electromagnetic radiation and "distressing innovations" (mobile phones, food ).

The authors estimated the economic damage from mortality due to diseases of the digestive system at 1.3–1.7 trillion rubles. per year depending on the valuation method.

The increase in incidence itself is largely associated with an increase in the detection of diseases, including in the early stages, Obukhova retorts. “This situation is especially relevant for oncological diseases, where the state has implemented large-scale infrastructure projects to strengthen the material and technical base for diagnosing and treating patients, significantly improved drug supply, and established patient routing in the regions,” she says. In addition, according to her, an increase in morbidity, especially cancer, may be a consequence of increased life expectancy due to the widespread use of innovative targeted therapy and new medical technologies.

Authorities in Russia also have tools for calculating the cost of mortality and disease to the economy. In 2012, by order of the Ministry of Economic Development, the Ministry of Finance, the Ministry of Health and Rosstat, the “Methodology for calculating economic losses from mortality, morbidity and disability of the population” was approved. According to it, economic damage is considered to be losses associated with underproduction of gross domestic product due to a person’s retirement from work.

The report of Rospotrebnadzor on the sanitary and epidemiological well-being of Russian citizens for 2022 states that the economic damage from 33 infectious diseases alone (excluding tuberculosis, covid-19 , HIV infection) amounted to about 1.15 trillion rubles. At the same time, it is recognized that cardiac and cancer morbidity are the most common causes of mortality in the working-age population.

The approaches recommended by the order to assessing economic losses from morbidity are used by the Central Scientific Research Institute of Public Health, making calculations, including at the request of relevant departments, for the purpose of economic justification for health care programs. The institute’s work includes preparing methodological tools for assessing the economic efficiency of programs and projects in healthcare, including with the aim of prioritizing areas for investing public funds, notes Obukhova.

According to the presidential decree on the national development goals of Russia until 2030, it is expected that life expectancy will increase by 2030 to 78 years, healthy life expectancy to 67 years, and the mortality rate of the working age population will decrease (up to 350 cases per 100 thousand population), and also reducing morbidity from major diseases. According to Rosstat, in 2022, the mortality rate of the working-age population was 491 cases per 100 thousand population, which is higher than the pre-pandemic rate in 2019 (470 cases per 100 thousand population), but less than in 2021 (560).

How to prevent early losses

“All methods for calculating the economic damage from premature mortality are always quite conditional. This approach assumes that all deaths at older ages are, roughly speaking, “timely.” But in fact, many deaths of older people may be preventable,” says demographer Igor Efremov.

“On the other hand, among deaths at ages younger than the conventional cutoff, some are inevitable and could neither be prevented nor postponed to a later age,” he adds.

In addition, older people older than this conventional limit, even without working, continue to make a significant contribution to the economy as consumers, and as the population of most countries of the world, including Russia, ages, this contribution will grow, he points out.

The authors of the study conclude that the state must take measures to reduce the level of morbidity and mortality, which requires an increase in health care costs.

It is important to take into account economic losses from mortality in government policy, including demographic policy, argues Efremov. “Unfortunately, government stakeholders often resist implementing measures that accelerate the reduction of preventable deaths because it harms industries involved in the production and sale of hazardous products (ALCOHOL , cigarettes). But the causes of disease and mortality in working age in a significant proportion of cases are alcohol abuse and smoking, so just increasing spending on health care is not enough,” he notes.

The Accounts Chamber stated that in 2022, the indicators of the federal project “Strengthening Public Health” to reduce tobacco and alcohol consumption were not fully met. In December 2023, the government approved the concept of reducing alcohol consumption, one of the goals of which is to reduce per capita alcohol consumption to 7.8 liters of ethanol (compared to 8.9 liters in 2023). Under the previous concept, which was in force from 2009 to 2020, it was possible to reduce the average per capita alcohol consumption in Russia to 8.82 liters of ethanol by 2021, while at the time of its adoption the figure was 18 liters per year, the government noted. “The task set in the concept until 2020 to change the structure of consumption of alcoholic products by the population by reducing the share of consumption of strong alcoholic beverages while simultaneously significantly reducing the total volume of consumption of alcoholic products has been achieved,” states the new program.

Earlier, demographer Alexey Raksha told RBC that smoking ranks first in terms of its negative impact on life expectancy, alcohol is second, and problems in the healthcare system are only third.

RBC sent requests to Rosstat , Rospotrebnadzor and the office of Deputy Prime Minister Tatyana Golikova.