Abstract
In pre-pandemic period (1999‒2019), we analyzed mortality data for the
Krasnoyarsk Territory (Central Siberia, Russia) with population about
2.9 million people. Causes of death affecting life expectancy at birth
(LE) were analyzed based on cause-specific and age-specific indicators.
Based on the cause-elimination life-table analysis, we estimated the
mortality rate and the contribution of a specific cause of death to LE
using an alternative approach (altPGLE) and included the contribution of
a single case of death. In 2019, ischemic heart disease, cerebrovascular
disease, and malignant neoplasms of digestive organs provided the most
significant contribution to LE primarily due to its high mortality rate.
Intentional self-harm, HIV, and tuberculosis provide the most
outstanding contribution of a single case of death to LE since they
affect younger people. Over the period, deaths from cardiovascular
diseases shifted to the elderly groups, but from liver diseases became
ten years ‘younger’. However, circulatory diseases still provide the
most significant impact on LE. Health policymakers should take into
account and improve three leading indicators: mortality rate, the
contribution of all death cases to LE (altPGLE), and the contribution of
a single case of death to LE. The improvement can be achieved by
preventing diseases that affect the younger population (in our case,
intentional self-harm, HIV, tuberculosis, and liver diseases) and
delaying death from diseases that are common in older people
(circulatory system diseases and cancer). It is also important to
identify and govern diseases that get ‘younger’ over time.