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Cablegate: Russia: Demographic Upturn?

VZCZCXRO1983
RR RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHMO #1834/01 1101241
ZNR UUUUU ZZH
R 201241Z APR 07
FM AMEMBASSY MOSCOW
TO RUEHC/SECSTATE WASHDC 9584
INFO RUEAUSA/DEPT OF HHS WASHDC
RUEHYG/AMCONSUL YEKATERINBURG 2380
RUEHVK/AMCONSUL VLADIVOSTOK 2065
RUEHZN/EST COLLECTIVE
RUEHPH/CDC ATLANTA GA

UNCLAS SECTION 01 OF 03 MOSCOW 001834

SIPDIS

SENSITIVE
SIPDIS

DEPARTMENT FOR OES/IHA AND EUR/RUS
USAID FOR GH, E&E
HHS FOR OGHA
BERLIN ALSO FOR LABOR COUNSELOR HAGEN
ABUJA FOR FERNANDES

E.O. 12958: N/A
TAGS: TBIO SCUL SOCI RS
SUBJECT: RUSSIA: DEMOGRAPHIC UPTURN?

REF: A. MOSCOW 1434
B. 06 MOSCOW 12348
C. 06 MOSCOW 9824
D. 06 MOSCOW 2380
E. 06 MOSCOW 2370
F. 05 MOSCOW 1761

MOSCOW 00001834 001.2 OF 003


THIS CABLE IS SENSITIVE BUT UNCLASSIFIED. NOT FOR INTERNET
DISTRIBUTION.

1. (SBU) SUMMARY: Russia's demographics picture brightened in 2006,
at least compared to 2005. Leading politicians argue the
improvements show the National Priority Health Project is working.
Demographics experts are skeptical, however, and believe the recent
uptick might only be a temporary blip in Russia's continuing
demographics crisis. END SUMMARY.

RUSSIAN DEMOGRAPHICS BY THE NUMBERS
-----------------------------------

2. (U) As of January 1, 2007, the population stood at 142.2 million
people. According to official statistics, Russia's population
declined by 561,184 persons in 2006, a marked improvement over 2005,
when the net population loss (births minus deaths plus immigration)
was 739,068.

3. (U) Improvements in mortality explain the better than expected
net population loss in 2006. A total of 2,165,000 people died in
2006, 138,000 fewer than in 2005. Russia saw declines in almost all
of the major causes of death in 2006 compared to 2005. Deaths from
cardiovascular disease (accounting for over half of all deaths)
declined by 5.3 percent. Cancer deaths declined by a modest 0.7
percent, while road accident deaths declined by 5.3 percent.
Although a spate of poisonings from alcohol surrogates received much
attention in 2006 (Refs B, C), alcohol poisonings actually declined
dramatically by 20.7 percent compared to 2005. Suicides went down
by 7.5 percent, and homicides dropped by 19.7 percent. Deaths from
lung diseases fell by 13.1 percent, from gastrointestinal diseases
by 5.5 percent, and from infectious and parasitic diseases by 9.6
percent.

4. (SBU) Total births only increased modestly by 1.3 percent, from
1,457,400 births in 2005, to 1,476,200 in 2006. The infant
mortality rate improved by seven percent, a continuation of gradual
improvements in infant mortality stretching back to 1994. Russian
infant mortality data should be viewed with a healthy dose of
skepticism. Russia does not follow WHO guidelines on reporting
births and infant mortality statistics, and these data are routinely
understated. If a newborn weighs less than one kilogram and lives
less than one week, the birth is never recorded and is not
considered in calculating infant mortality statistics. In fact,
these births are not even recorded as still-births, and essentially
"disappear" from the official record-keeping system. It is also not
uncommon for local medical officials to fail to report babies who
weigh more than a kilogram at birth but who die within a week. This
is usually done by changing the original birth weight to 990 grams
or another figure slightly less than a kilogram. (NOTE: These
practices seem to be legacies of the older Soviet system, where, as
demographers now acknowledge, the official infant mortality
statistics were routinely reduced by a factor of 25 percent. END
NOTE) Officials from the Ministry of Health and Social Development
worry that infant mortality statistics would rise by 60 percent if
Russia did adopt the WHO standards for birth reporting.

5. (U) Immigration played a role in the demographics picture, with
128,316 more people immigrating to Russia than emigrating in 2006,
and this population influx helped to offset some of the natural
population decline (births minus deaths). The vast majority of
immigration was from CIS countries.

6. (U) 2006 data on life expectancy are not yet available, as those
derived figures will be calculated from other mortality and
fertility data and will not be released until later in 2007. In
2004, Russia's life expectancy at birth stood at 65.3 years, with a
life expectancy of 58.9 years for men, and 72.3 years for women.
(NOTE: Compared to the average life expectancy of the 25 EU
countries in 2004, this represents a "mortality gap" of minus 16.2
years for men and minus 8.9 years for women. Compared to the Czech
Republic, this represents a "mortality gap" of minus 13.7 years for
men and minus 6.9 years for women. END NOTE)

POLITICANS CROW OVER 2006 DEMOGRAPHICS

MOSCOW 00001834 002.2 OF 003


--------------------------------------

7. (SBU) Russia's top political leaders, including President Putin
and First Deputy Prime Minister Medvedev, say the launch of the
national health project in 2006 (Septel) led to the improved
demographics data in 2006. They make much of the fact that these
positive trends continued in early 2007, with a 9.5 percent
reduction in mortality and 8.5 percent increase in the birth rate.
Demographics experts have been skeptical of these claims, but they
acknowledge that the national health project could lead to long-term
improvements in the demographics picture if the increased funding
for health care is sustained over several years and preventive
health measures which reinforce a healthy lifestyle are widely
promoted.

GOVERNMENT NOT ADDRESSING ROOT CAUSES
-------------------------------------

8. (U) Demographics experts generally agree that the two main
drivers of Russia's high mortality are hard alcohol consumption and
smoking. Experts estimate tobacco-related deaths account for 25
percent of total mortality in Russia.
Aleksandr Nemtsov, the pioneer of Russian alcohol epidemiology
research from the Moscow Institute of Psychiatry, attributes 22
percent of male mortality and 15 percent of female mortality to
alcohol consumption.

9. (SBU) Demographers and health policy experts argue Russia should
take measures to shift consumers to beer-drinking, by either heavily
taxing hard alcohol, or strictly limiting the places at which hard
alcohol can be sold (Ref A). There is little political appetite for
such measures, however, given heavy political lobbying by hard
alcohol producers and distributors, and bitter memories from
Gorbachev's unpopular attempts to influence drinking habits in the
mid-1980s.

10. (SBU) The government has done little to change smoking habits.
Some 65 percent of Russian men, 35 percent of women, and more than
30 percent of teenagers are smokers. Russia is the world's largest
importer of tobacco, ranks fourth world-wide in the number of
smokers, and is considered an attractive growth market by
international tobacco companies. Proposals to regulate smoking in
restaurants and public accommodations have repeatedly died in the
Duma after heavy lobbying by tobacco producers and distributors.
Nor has the government made a serious attempt to introduce an
effective "sin tax" on cigarettes. Gradual increases in the excise
tax on cigarettes over the next four years will still leave the
price for the cheapest pack of cigarettes roughly equal to the price
of a loaf of bread or a single ride on public transport (less than
58 cents).

11. (SBU) Despite dramatic increases in the treatment of infectious
diseases in 2006, the government has not made much of an effort to
establish prevention activities against infectious diseases, such as
HIV/AIDS, which could be targeted at schools, young people, and most
at risk populations. Much of this work has instead been financed by
international donors.

12. (SBU) How do demographers explain the improvements in 2006 data?
Many argue that general stability and a higher quality of life
explain the drop in mortality and the modest gains in fertility in
2006. It is certainly true that some regions, including Moscow,
have seen a steady rise in the birth rate in recent years, probably
because of continuing economic prosperity and an increasing sense
among would-be parents that they can now afford more than one child.
Observers note the average Russian is under a lot less stress in
Putin's Russia than in the uncertain years of the breakup of the
Soviet Union under Gorbachev and the chaos and financial crises that
characterized the Yeltsin era. Other demographers, such as alcohol
expert Nemtsov, believe 2006 may be a blip on the radar screen. In
his view, alcohol deaths tend to be cyclical, and Russia is in a
trough cycle in which the ranks of hard core drinkers are being
refilled. In a few years, the alcoholics will again begin dying
off.

13. (SBU) Demographers are also somewhat suspicious of the 2006
numbers, and note that the data may be significantly revised later
in the year. The continued improvements in early 2007
(January-February), which politicians cite, are also very
preliminary numbers and in too short of a period to constitute a
trend. They also note that early 2007 birth figures are likely
distorted. Many expectant mothers, who might otherwise have had a

MOSCOW 00001834 003.2 OF 003


baby in late December, made every effort (often with their doctor's
assistance) to delay the birth until January, to take advantage of
the new "Mother's Capital" program. Under the program, every family
that bears a second child after January 1, 2007 receives a 250,000
Ruble payment once that child reaches age three.

14. (SBU) The renowned Russian demographer, Anatoliy Vishnevskiy,
Director of the newly established Institute of Demography at the
Higher School of Economics, has suggested Russia adopt more liberal
policies on child care at work, and provide for longer and
higher-paying maternity leave and benefits. In general, Vishnevskiy
and other demographers have been skeptical that the government's
efforts thus far to stimulate births will pay off. They note that
historically similar programs have rarely worked in other countries.
At best, these efforts will only affect the timing of births, as
couples will choose to have children earlier (i.e., earlier in the
career path before higher salaries and promotions provide a stronger
disincentive to go on leave to have a child and subsist on modest
government benefits). In the end, however, couples will not choose
to bear a greater number of children.

15. (SBU) There is also evidence that the benefits the government
has offered thus far are too low to be attractive to some working
women. A real estate lawyer earlier this year won a court case in
the Supreme Court, where she argued that the cap on maternity
benefits was discriminatory, since her monthly salary far exceeded
the modest government stipend. The court agreed, and noted that the
cap actually worked against government efforts to encourage births.
The Duma has since promised to introduce legislation to eliminate
the cap on maternity benefits.

16. (SBU) Some experts have argued Russia cannot solve the
demographic crisis without much greater levels of immigration.
However, there is little interest within the government to establish
more liberal immigration policies. Realistically, the amount of
potential Russian-speaking migrs from the CIS is limited, and it
would be difficult to attract many people from the Russian diaspora
in the West, who already enjoy a high standard of living and hefty
salaries. Xenophobia and strict immigration laws are major
obstacles to attracting non-Russian speaking immigrants.

17. (SBU) Many demographers have complained of the unrealistic
expectations of politicians about how quickly demographic trends can
be reversed. Federation Council Speaker Mironov, for example, has
stated that it is realistic for Russia to have a population of 250
million people by 2050. This bold statement stands in stark
contrast to the dire predictions of only 100 million people by 2050
(demographic predictions vary between 75 and 135 million). Health
and Social Development Minister Zurabov recently stated that within
three to four years, Russia will easily overcome its natural
population decline. Leading demographer Vishnevskiy, however,
believes it would be impossible for the population to increase
within the next few years, that even population stabilization is
unlikely, and that a decline in the working age population is
inevitable.

18. (SBU) Because of the attention that Russia's top politicians pay
to the issue, including First Deputy PM and likely presidential
candidate Medvedev, efforts to address the demographics picture are
likely to continue to receive much political attention in the run-up
to the Duma and Presidential elections.

BURNS

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