Distinctive features and components of mortality decrease in Moscow in 1989-2017

Moscow is the region with the highest life expectancy in Russia. The country’s largest city, it has high incomes, a special population structure and a high concentration of all resources, including in the healthcare sector, which is given special attention by the city authorities. In some periods, the changes in life expectancy in Moscow have been unique compared to most other regions of Russia. The  difference in life expectancy between Moscow and Russia in the  period from  the  mid-1990s to the  mid-2000s was mainly  due  to lower mortality in middle age. Since the mid-2000s, the main contribution to the difference in life expectancy has been shifting to old age mortality. Given the overall rapid decline of mortality in Moscow since then, changes in the mortality rates and life expectancy of certain age groups seem implausible. The quality of population and mortality data has a significant impact on the accuracy of estimates of mortality indicators and requires special attention in the case of Moscow. In particular, the number of people at advanced ages in Moscow is likely to be overestimated, which affects mortality rates in this age group. Peculiarities of mortality by causes of death in Moscow generally correspond to the average Russian trends; however, in Moscow a more rapid decrease in mortality from  neoplasms is observed, as well as more realistic age-specific death rates in older age groups