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Cablegate: Russia's Demographic Upturn May Be Short-Lived

VZCZCXRO7278
RR RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHMO #0854/01 0881152
ZNR UUUUU ZZH
R 281152Z MAR 08
FM AMEMBASSY MOSCOW
TO RUEHC/SECSTATE WASHDC 7353
INFO RUEHVK/AMCONSUL VLADIVOSTOK 2749
RUEHYG/AMCONSUL YEKATERINBURG 3091
RUEHZN/EST COLLECTIVE
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHC/DEPT OF LABOR WASHDC
RUEHPH/CDC ATLANTA GA

UNCLAS SECTION 01 OF 04 MOSCOW 000854

SIPDIS

SENSITIVE
SIPDIS

USAID FOR GH, E&E
HHS FOR OGHA

E.O. 12958: N/A
TAGS: TBIO SCUL PREL SOCI RS
SUBJECT: RUSSIA'S DEMOGRAPHIC UPTURN MAY BE SHORT-LIVED

REFS: A. 07 Moscow 1834
B. 07 Moscow 1811
C. 07 Moscow 5522
D. 07 Moscow 1434
E. 07 Moscow 4043
F. 07 Moscow 5221
G. 07 Moscow 5630

MOSCOW 00000854 001.2 OF 004


THIS CABLE IS SENSITIVE BUT UNCLASSIFIED. PLEASE PROTECT
ACCORDINGLY.

1. (SBU) SUMMARY: Russia's demographic results continued to improve
in 2007. Overall births increased by 8.5 percent, deaths declined
by four percent, and a surge in migration helped to offset much of
the natural population decline. The overall population stood at 142
million as of January 1, 2008, representing a decline of 0.14
percent from the previous year. Leading politicians attribute
Russia's improving trends in fertility and mortality to the success
of the National Priority Health Project and the "mother's capital"
financial incentive for families who choose to have a second child
(Refs A, B, C). Demographic experts believe that the health project
has only had a slight impact on reducing mortality, and the
government's pro-birth policies are unlikely to have any long-term
effect on Russia's low fertility rates. While Russia could continue
to see improvements in mortality in the coming years, observers view
the upswing in births as only temporary, and by 2012, overall births
will begin to sharply decline. END SUMMARY.

------------------------------
Demographics Picture Brightens
------------------------------

2. (U) The Russian population stood at 142 million as of January 1,
2008, according to preliminary estimates released by the Federal
Statistics Service (Rosstat). The net population decline (births
minus deaths plus immigration) was 0.14 percent, significantly lower
than the 0.42 percent net population loss recorded in 2006.
Increases in births, a decline in deaths, and a surge in immigration
all contributed to the improved demographic picture.

3. (U) Births increased significantly by 8.3 percent in 2007
compared to the previous year, a marked improvement over 2006, when
births increased by a modest 1.3 percent over 2005. Russia recorded
1,602,000 births in 2007, the highest absolute number of births
registered in Russia since 1991. Significantly, for the first time
in decades, there were fewer abortions than births during 2007.
According to preliminary data from the Ministry of Health and Social
Development, there were 106 births for every 100 abortions in 2007.
(There were 100 births for every 107 abortions in 2006, and 100
births for every 121 abortions in 2005.)

4. (U) Overall mortality dropped by four per cent. A total of
2,080,100 people died in 2007, 86,600 fewer than in 2006. This
improvement in mortality was less pronounced than in 2006, when the
number of deaths declined by six percent. Russia saw improvements
in nearly all of the major causes of death. Deaths from
cardiovascular disease, the major contributor to mortality, declined
by 4.1 percent. Deaths due to external causes dropped by 11.9
percent, of which the most dramatic reduction (36.8 percent) was
observed in deaths from alcohol poisonings. Suicides declined by
4.3 percent and homicides by 13.4 percent. Deaths from lung
diseases fell by 6.9 percent, from gastrointestinal disease by 2.9
percent, and from infectious and parasitic diseases by 5.6 percent.
Among the major causes of death, only cancer deaths and road
accident deaths increased, by 0.7 percent and 2.2 percent,
respectively.

5. (U) Almost half of the natural population decline of 477,700
people (i.e., the difference between births and deaths) was offset
by a net influx of 239,867 legal immigrants, an 81.3 percent
increase over the immigration level recorded in 2006. Nearly all of
the immigration was from CIS countries, and the city of Moscow and
surrounding Moscow Oblast absorbed over half of all legal immigrants
(120,400 people).

6. (U) Data on 2007 life expectancies are not yet available and will
not be released by the Federal Statistics Service until later in
2008. In 2006, Russia's life expectancy at birth stood at 66.6
years, with a life expectancy of 73.23 years for women and 60.37
years for men (just above the male retirement age of 60 years).

---------------------------------
Politicians Crow Over the Results

MOSCOW 00000854 002.2 OF 004


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

7. (U) Leading politicians, including President Putin and
President-Elect Medvedev, have argued that the positive changes in
both births and deaths show that the National Priority Health
Project and financial incentives for families that choose to have a
second child are reversing Russia's demographic crisis (Refs A, B,
C). In mid-February during the run-up to the Presidential election,
Putin stated that in 3-4 years Russia could reverse its natural
population loss and achieve population stabilization, though he
acknowledged that some demographers, including some of the
government's own experts, do not believe the population will
stabilize for another 10-12 years. Medvedev has pledged to increase
the GOR's pro-birth financial incentives during his presidency.

8. (SBU) In October 2007, the GOR released a National Demographics
Concept, laying out three stages of population planning through
2025, and in February 2008, the GOR released a demographic
implementation plan for 2008-2010. The implementation plan is a
laundry list of measures aimed at reducing mortality and raising
fertility, including reducing deaths from road accidents, socially
significant diseases such as HIV/AIDS and tuberculosis, and
workplace accidents, and expanding social support programs for
families with children, including promoting family values and a
healthy lifestyle.

-----------------------------------------
Births May Be Up Now, But Are Set to Fall
-----------------------------------------

9. (U) Experts note that the increase in births in 2007 continues a
general trend that began in 2000 of increasing births (before 2000,
there was a general 12-year trend during which births declined).
They note that the substantial, 8.3 percent increase in births in
2007 likely resulted from a number of factors: a large absolute
number of reproductive age women (15-49 year olds); some couples who
were reluctant to have children in the late 1990s now feel they are
more able to afford to raise children; and some families chose to
have children after the GOR announced the "mother's capital" program
in 2006, which became effective for births registered after January
1, 2007. The program provides a "virtual" payment of over 250,000
rubles ($10,549) to families that have a second child once that
child reaches three years of age. Families will not receive
payments directly in cash, but instead will receive credits to cover
health care, education or housing expenses, or to make pension
contributions.

10. (SBU) The doyen of Russian demographers, Anatoliy Vishnevskiy,
head of the Institute of Demography at Moscow's Higher School of
Economics, doubts that the GOR's financial incentives to stimulate
births will have any long-term impact on fertility. Russian
families will not have more children overall, although the GOR might
succeed in "accelerating" births (i.e., couples will choose to have
children earlier). He believes that the "mother's capital" program
has had some effect on births among families living "at the margins"
of society, but has not led to a baby boom. For many Russian
families, the sum offered by the government is not significant
enough to affect reproduction decisions. Vishnevskiy told us he was
the guest on a Russian TV show ("The People Want to Know") in March
2008 during which experts and politicians sparred over the
significance of the GOR's pro-birth financial incentives. At the
conclusion of the program, two thirds of the audience members voted
that the "mother's capital" program was not a strong enough
incentive to justify having another child.

11. (SBU) Vishnevskiy and other demographers also predict that over
the next several years, the number of women of reproductive age will
decline sharply, inevitably leading to a decrease in births. There
are nearly two million fewer 10-14 year old girls than the current
number of 15-19 year olds, and the same holds true for 5-9 year old
girls and 0-4 year old girls. (An unfortunate legacy of the
collapse of the USSR and the uncertainty and instability that
followed was that both the absolute number of births and the
fertility rate plummeted from 1991 to 1999.) It is unrealistic to
expect that Russia could achieve population stabilization any
earlier than 2015, in Vishnevskiy's view. Not only will the cohort
of reproductive age women fall, but the overall working age
population will also decline, placing pressure on women to enter the
workforce as the demand for labor and wages rises. The GOR will not
be able to offer enough financial incentives to counteract these
pressures and has so far shown no interest in adopting additional
benefits to stimulate births (e.g., policies allowing women to more
easily work and raise children, and tax incentives).

MOSCOW 00000854 003.4 OF 004

--------------------------------------------- ---------
Experts Mull Whether Mortality Will Continue Improving
--------------------------------------------- ---------

12. (SBU) Experts disagree over the cause of mortality improvements
in the past two years, though most believe that the National
Priority Health Project had little impact. Dr. Kirill Danishevskiy,
a senior health consultant at the Open Health Institute, believes
the GOR's free drug benefit program for pensioners, veterans, and
other social welfare beneficiaries, did help reduce the number of
overall deaths, despite the program's problems (Ref E).
Danishevskiy also believes quality of life improvements since the
early 1990s has led to an overall decline in deaths. Danishevskiy
and Alexander Nemtsov, the pioneer of Russian alcohol epidemiology
research from the Moscow Institute of Psychiatry, believe the recent
declines in mortality may also result from the cyclical nature of
alcohol-related deaths, which contribute to at least 20 percent of
male mortality and 15 percent of female mortality. They note that
over the last two years Russia has been in a "trough cycle" in which
the ranks of hard core drinkers are being refilled; in a few more
years, alcoholics will again begin dying off in larger numbers.
However, even Nemtsov acknowledges that alcohol-related mortality
has steadily improved since 2004, and if the positive trend
continues, Russia could benefit from an indefinite improvement in
both alcohol-related and overall mortality.

13. (SBU) Vishnevskiy confessed that demographers have yet to find a
satisfactory explanation for the recent improvements in mortality,
and the issue needs to be further vetted. Preliminarily, he thought
the National Health Project had little impact in reducing deaths.
He noted that a number of other factors may have played a role in
reducing mortality, including low levels of unemployment, the
psychological effect of a better quality of life for the average
Russian, healthier generations of Russians now than the generations
that lived through and were born immediately after World War Two,
and general fluctuations in Russian mortality over the last few
decades. Vishnevskiy observed that mortality among working age men
had been "abnormally high" over the last decade and had now started
declining. He stated that it was not yet clear whether the
improving trend in mortality would continue.

14. (U) Yevgeniy Gontmakher, Director of the Center for Social
Policy of the Russian Academy of Sciences' Institute of Economics,
has publicly argued that long-term reductions in mortality and
increases in life expectancy through 2020 will not be possible
unless the GOR increases spending on health care from the current
3.5 percent of GDP to seven percent of GDP. In his view, Russia's
"preventable mortality" (i.e., deaths that could be avoided with
improvements in emergency medicine and primary care, and early
diagnosis of diseases) is three times higher than in the United
Kingdom. He believes that a massive increase in spending well
beyond the budget of the National Health Project is necessary to fix
Russia's crumbling health care system.

--------------------------------
Migration May be a Pandora's Box
--------------------------------

15. (SBU) A change in Rosstat's counting methods may largely explain
the 81.3 percent increase in legal immigration during 2007. The
statistics service included long-term migrants (those who change
their permanent place of residence) in immigration figures for 2007,
whereas in previous years, Rosstat only recorded short-term migrants
(temporary workers) in those statistics. (Note: Official figures
only record legal immigration. According to one leading
demographer, the number of illegal immigrants is at least equal to
the number of officially registered immigrants. End Note.)
Vishnevskiy has also privately criticized Russian immigration
figures as being subject to manipulation from year to year to suit
political expediencies. He pointed out that 95 percent of total
immigration reported by Rosstat in 2005 was not actually
"foreigners" who immigrated to Russia, but rather people who already
held Russian passports and decided to return to Russia from the CIS.


16. (SBU) While GOR plans call for legal immigration of not less
than 200,000 people per year through 2015, and not less than 300,000
people from 2016-2025, to help offset Russia's continuing natural
population decline, Vishnevskiy and other demographers believe these
plans are unrealistic. In his view, Russia is simply not ready to
absorb that many migrants, as the country has no experience or
tradition of accepting significant levels of migration. Vishnevskiy

MOSCOW 00000854 004.4 OF 004


has warned that high levels of immigration could lead to instability
and exacerbate existing social problems, such as xenophobia and
ethnic conflict, and the Russian popular psyche is simply not ready
to accept immigrants (Ref F).

-------
Comment
-------

17. (SBU) For the second year in a row, Russia's overall demographic
situation and net population decline have markedly improved, at
least in part thanks to rising living standards. While a decline in
births seems inevitable over the next few years, the continued
positive changes in mortality give some hope of increased life
expectancies, especially for Russian men. The government is not
likely in the short term to adopt additional financial incentives to
stimulate births. It is also unlikely that the GOR would double the
spending under the National Health Project, as Gontmakher has
advocated. Likewise, both politicians and demographers recognize
that heavy alcohol and tobacco use continue to be the two deadly
habits killing off Russian men and contributing to their low life
expectancy, but there is little political will to tackle those
issues (Refs A, D). However, in a potentially important step
forward for smoking regulation, some observers predict that in April
2008 the Duma will finally ratify the WHO Framework Convention on
Tobacco Control (Ref G). Russia's demographic crisis will remain a
political issue, with the GOR continuing to champion both the
"mother's capital" program and the National Health Project.

BURNS

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