Why is Russia’s mortality rate so high?
Russia’s mortality is high for a middle-income industrialised country, and the problem is concentrated among men. Life expectancy at birth in 2021 was 70.06 years, 65.51 for men and 74.51 for women, down from 73.34 in 2019 as COVID-19 hit [4]. The main causes of death are cardiovascular diseases, and deaths from injuries, poisoning and violence (what statisticians call external causes) are high among Russian men in middle age. Research links alcohol closely to Russia’s high mortality [5].
The chart above, from the demography channel @populationdemography using Human Mortality Database figures, compares deaths from external causes by age in Russia and the United States in 2021. It shows a striking pattern: Russian men die from external causes at much higher rates than American men from their late 30s onwards, while American women and young American men have higher rates than their Russian counterparts.
Russia vs USA deaths from external causes by age
| Age | US men | Russian men | US women | Russian women |
|---|---|---|---|---|
| 15 to 19 | 72 | 53 | 24 | 23 |
| 20 to 24 | 138 | 101 | 42 | 25 |
| 25 to 29 | 170 | 125 | 51 | 23 |
| 30 to 34 | 185 | 168 | 60 | 29 |
| 35 to 39 | 180 | 208 | 63 | 37 |
| 40 to 44 | 170 | 240 | 61 | 44 |
| 45 to 49 | 155 | 231 | 58 | 46 |
| 50 to 54 | 156 | 222 | 61 | 45 |
| 55 to 59 | 161 | 231 | 61 | 46 |
| 60 to 64 | 150 | 227 | 54 | 45 |
| 65 to 69 | 132 | 217 | 49 | 49 |
| 70 to 74 | 131 | 201 | 57 | 57 |
| 75 to 79 | 179 | 221 | 89 | 81 |
Deaths from external causes per 100,000 people of each age and sex, 2021, from the @populationdemography chart [1], which cites the Human Mortality Database [2].
Russian men in middle age
The biggest difference is among men aged 35 and over. Russian men’s death rate from external causes peaks at 240 per 100,000 at ages 40 to 44, against 170 for American men of the same age, and it stays above 200 all the way to 79 [1]. For Russian men in their 40s the rate is about 40 to 50% higher than in the US (our arithmetic).
The gap between the sexes is even larger. At 40 to 44, Russian men die from external causes at more than five times the rate of Russian women, 240 against 44 per 100,000 (our arithmetic) [1]. In 2021 Russian men’s life expectancy was nine years below women’s, 65.51 against 74.51 years [4].
The role of alcohol
Alcohol is closely tied to Russia’s high death rates. A 2007 analysis of Russian mortality by Davydov and colleagues found alcohol in the blood of 55 to 70% of people whose deaths were put down to external causes, with potentially or actually lethal concentrations in about a third of them. The authors concluded that alcohol intoxication is an important reason for Russia’s high mortality and that official statistics understate it [5]. Russia’s alcohol consumption remains among the highest in the world, although it has fallen sharply over the past decade or so [4].
Why young Americans have higher rates
The chart’s other surprise is that the US rate is higher for men up to their early 30s and for women at almost every age. At 25 to 29, American women die from external causes at more than twice the rate of Russian women, 51 against 23 per 100,000 [1].
Drug overdoses, which count as external causes, are likely to be a large part of the difference, though the chart does not split the causes. The CDC recorded 106,699 drug overdose deaths in the United States in 2021, an age-adjusted rate of 32.4 per 100,000, with the highest rate among adults aged 35 to 44 at 62.0 per 100,000 [6].
What counts as an external cause of death?
In the International Classification of Diseases (ICD-10) used for death statistics, external causes are a separate chapter from diseases. It covers accidents, intentional self-harm, assault, events of undetermined intent, legal intervention and war, and complications of medical care [3]. Deaths from illnesses such as heart disease or cancer are not included, and drug overdoses are [3][6]. The rates are per 100,000 people of each age and sex, so the two countries can be compared even though their populations differ in size.
Russia’s mortality since the pandemic
COVID-19 hit Russia hard. Excess deaths caused its largest peacetime population decline in recorded history between 2020 and 2021, and life expectancy fell by more than three years between 2019 and 2021 [4]. It has since partly recovered, to about 73 years overall in 2023 (68 for men and 79 for women) [4]. Russia’s death rate has exceeded its birth rate in most years since 1992, and the war in Ukraine since 2022 has added military deaths and emigration to the country’s demographic problems [4].
Questions about Russia’s mortality rate
What is the life expectancy in Russia?
About 73 years in 2023: 68 for men and 79 for women. In 2021, during the pandemic, it fell to 70.06 years [4].
Why do Russian men die so young?
Cardiovascular disease is the main cause of death [4], and deaths from injuries, poisoning and violence are high among middle-aged men [1]. Research has found alcohol involved in a large share of these deaths [5].
Do Russian men die from accidents and violence more than American men?
From their late 30s, yes. At 40 to 44 the 2021 rate was 240 per 100,000 in Russia against 170 in the US. Below 35 the US rate was higher at most ages [1].
What is the main cause of death in Russia?
Cardiovascular diseases [4].
Sources
- @populationdemography, Telegram channel, the channel credited on the chart.
- Human Mortality Database, the data source named on the chart.
- World Health Organization, ICD-10 Version 2019, Chapter XX, External causes of morbidity and mortality.
- Wikipedia, Demographics of Russia.
- Davydov MI, Zaridze DG and others, Analysis of mortality in Russian population, Vestnik Rossiiskoi Akademii Meditsinskikh Nauk, 2007 (PubMed abstract).
- Centers for Disease Control and Prevention, NCHS, Drug Overdose Deaths in the United States, 2001 to 2021 (Data Brief 457).
Last reviewed 2 November 2026
