Ukrainians’ health condition is so comprehensive a problem that it should be tackled by not only doctors but also demographers, psychologists, social services, sociologists, and sports coaches. After all, all the governmental structures that we hire must work to increase the quality and duration of human life — naturally under a condition that every individual cares for him/herself. But on Medics Day, June 20, we tend to thank doctors for their care, unaware of the fact that doctors themselves cannot do much with health and quality of life if, for example, an individual has lost his/her job or if there is no gas in the village where they live or children walk to school through the woods.
Our health is the reflection of our way of life and the culture in which we have grown and still remain. Unfortunately, public health in Ukraine is not surveyed as often as political preferences are — for obvious reasons — but still, for example, the Kyiv International Institute of Sociology (KMIS) has been periodically monitoring the health of Ukrainians over the past 10 years or so. The monitoring showed that self-assessment of health by individuals had been growing since 2001, whereas it had been decreasing before. Ukraine’s demographic picture also began to show positive trends in 2008: for the first time since the early 1990s, the birth rate exceeded the death rate in some regions of Ukraine and infant mortality dropped by 10 percent. So there are at least some grounds for being pleased. This means the state should work to preserve the still remaining potential. Pavlo SHEVCHUK, a senior research associate at the Institute of Demography and Social Studies of the National Academy of Sciences, told The Day in greater detail about the demographic trends in Ukraine and the risks and opportunities for our development.
Mr. Shevchuk, let us begin with the most important thing: how many of us are there?
“At the beginning of 2009 the population was 45,963,000, including 31,332,000 in urban areas and 14,600,000 in the countryside. What has caused reduction of the population in the past few years was the fact that the deceased outnumbered the newborns. Besides, the migration factor (at least, in the case of registered migration) has approached zero — in other words, it does not have an essential effect. Meanwhile the dead have outnumbered the newborns by almost 2,300,000. These data embrace a period from 2002, when the latest census was held, until 2008 inclusive. Over this period, 3,900,000 were born and 5,339,000 died in Ukraine.”
Were those who died mostly old-age pensioners?
“In most cases they were, but the question is that we have a very high intensity of mortality. What is very special for Ukraine and Russia, like nowhere else, is the age-related structure of mortality. The point is, particularly in Ukraine, that we have a very high mortality rate among people of working age (we can see now a low death rate among children and a high one among adults).
“In other words, if we take different patterns of dying, we will see that children’s mortality does not greatly differ from that in Europe: for example, the mortality rate of 10-year-olds is one and a half times higher than in Europe, while the mortality rate of 30-to-35-year-olds, especially males, is six times as high as in the EU. The difference is clearly out of proportion. “Ukraine’s losses can be compared to those in wartime. This is the country’s main demographic problem. Meanwhile, compared to Europe, mortality among pension-age people is not so striking, although it is twice as high (it is more stable and remains at about the same level from year to year). As for mortality among the younger generation, the cause is, unfortunately, ‘traditional:’ binge drinking. If we take the age span of 15 to 60 years, 61 percent of men and 89 percent of women live long enough to be pensioners. “These are the rates of last year. If you compare these figures with the data furnished by, say, Swedish demographers, you will see that 92 percent of their men and 95 percent of women live from 15 to 60.”
Our women outlive men by 10 years. What causes this, and is this also a thing specific to us?
“Women live longer, and this is in many cases determined physiologically: a woman is supposed to live, on average, three to four years longer than a man. Besides, this trend also prevails in the vast majority of countries. Just a few decades ago an opposite picture could be observes in Muslim countries, but now women live longer even there. Incidentally, Eastern Europe speaks of the so-called ‘Russian (sometimes, wrongly, ‘Slavic’) man phenomenon,’ for in all ex-Soviet countries the mortality of men is much higher than that of women. In Sweden, men live three to four years less than women, not 10 to 12, as is the case in this country.”
The aging of the population, a common European trend, also occurs in Ukraine. What are your outlooks about the aging rate of Ukrainians and how fast will aging occur?
“The number of old-age pensioners will steadily rise with every passing year until the mid-21st century. This trend is discernible throughout the word. The peak is expected to be reached approximately in 2050 — some counties will come to this earlier, others will come later. We will reach it at approximately the same time because Ukraine will be most heavily ‘burdened’ with elderly people: under the exiting pension-age limits, these people will account for 30 to 40 percent of the entire population.”
You said there were positive trends in Ukraine’s demographic situations last year. Do you mean that the birth rate exceeded the death rate in some regions?
“Yes, the positive trend that we noticed in 2008 is that newborns outnumbered the dead in Transcarpathian, Rivne and Kyiv oblasts. On the whole, the birth rate in Ukraine has drastically risen in the past few years: the overall nationwide index has gone up from 1.3 to 1.45, which is a significant difference. Let us hope that these trends will continue. Another positive factor: infant mortality has notably dropped in Ukraine — by about 10 percent. In general, we have had a downward trend in child and infant mortality since the mid-1990s. The figures may vary in different years, but the overall trend is comfortable.”
Ukraine has adopted the Strategy of Demographic Development until 2015. What does it call for and what is demographic development?
“A part of our institute took part in drawing it up, and development means that we must improve the demographic situation because it will be worse later, especially as far as payment of pensions is concerned. The point is that there will be, in fact, nobody to care about pensioners: no matter how hard the state tries to attract contributions to the Pension Fund, in any case the able-bodied population must support the rest.
“I believe we must first think about the able-bodied population and give it a chance because the share of these people will be shrinking later. We have already passed the ‘demographic window,’ or the ‘window of demographic opportunities’ — we totally lost it in the 1990s. I will remind you that we had the largest share of the able-bodied population at the time, but it is shrinking now, and this trend is going to continue.”
The Institute of Demography and Social Studies has made a demographic forecast for Ukraine until 2050. What is interesting in it?
“The population is going to decrease and will have dropped to an estimated 36 million by 2050. This is a mildly pessimistic view. Conversely, the UN issued its own forecast in 2008, which says there will be 35 million of us at the time.
“The practice of demographic forecasting shows that all forecasts are, in the long run, wrong. For example, even in the early 1990s nobody in the world, much less our demographers, could foresee that the birth rate in Ukraine will drop and mortality will rise so dramatically. Therefore, we are taking a dual approach: in the ‘high’ model, we will be 42 million, but in this case there will be a very large number of migrants in Ukraine (besides, migration varies very much). In the ‘low’ model, there may be 26 million of us (if we take into account the worst birth and death rates).”
