Demographic trends of the Pskov oblast

The peculiarity of the Pskov Oblast is the fact that it has been holding leading positions in Russia in terms of natural population decline since 1992. There were demographic crises in the Pskov Oblast formerly: in the period from 1914 till 1924 and in the 1930s [6]. At that time the rate of population decline accounted for 0.6% per year largely due to the migration to other regions. There was population loss during World War II and in the postwar period. The average population decline accounted for 1% per year in the 1950s and during the first half of the 1960s due to the outflow of population from the region.

The Oblast lost more than 155 thousand people in 1991 – 2010 (18.4%), including 90.6 thousand rural people (29.1%). Nowadays, the annual population decline in the Pskov Oblast has exceeded 1%.

For the first time the natural population decline in the Pskov Oblast began in 1966 due to the sharp decrease of a birth rate and the tendency of increased mortality (tab. 1) [7, 8, 10, 11, 12].

The echo of World War II was the main reason for the decline in a birth rate in 1966 – 1973, when the women, who were born during the war period, reached childbearing age.

Table 1. Population change dynamics in the Pskov Oblast

Year	Total population, thsd.pers.	Including		The share in the total rural population, %	Per 1000 persons
		urban	rural		born	dead	natural increase (+), decline (-)
1960	934.8	264.2	670.6	71.7	17.0	10.0	+7.0
1965	882.6	315.3	567.3	64.3	12.0	11.0	+1.0
1970	878.0	370.4	507.6	57.8	11.4	13.2	-1.8
1975	856.7	431.2	425.5	49.7	12.4	14.4	-2.0
1980	842.7	471.9	370.8	44.0	13.2	15.8	-2.6
1985	844.2	509.7	334.5	39.6	13.4	16.0	-2.6
1990	844.1	533.0	311.2	36.9	11.9	15.1	-3.2
1995	830.1	535.4	294.6	35.5	7.8	20.9	-13.1
2000	793.3	518.6	274.6	34.6	7.4	22.3	-14.9
2010	688.6	468.1	220.5	32.0	10.5	21.2	-10.7

Table 2. Health situation in the Pskov Oblast

Year	Number at the year-end		Per 10000 persons
	polyclinics and hospitals	feldsher-midwife stations	hospital beds	doctors	nursing staff
1960	140	646	85.1	13.1	63.9
1965	116	668	104.1	16.9	70.2
1970	110	684	126.0	21.2	93.7
1975	87	687	134.8	26.4	110.5
1980	86	677	140.5	32.2	118.5
1985	86	673	146.0	35.2	127.1
1990	86	671	142.3	37.7	127.9
1995	86	610	125.3	33.2	105.8
2000	86	565	125.8	34.5	106.7
2005	61	529	132.5	34.5	114.1
2010	48	381	103.4	34.6	109.0

The birth rate was increasing during the period from 1973 to 1985, because there were more women of childbearing age, who were born in the 1950s. In the 1990s the daughter of parents, who were born during the war, reached the childbearing age, and, as a result, the birth rate declined in 1999 to the lowest level – seven children per 1000 persons. Such decline in the birth rate was also caused by the significant deterioration of life quality and the decrease in population incomes after 1990. The decline in a poverty rate caused a trend of the slow increase in a birth rate after 1999.

The dynamics of population mortality varies in a different way. The mortality rate increased with the reduction in medical institutions in 1965 – 1975, which is continued in the XXI century (tab. 2) .

Currently, the total number of medical institutions is two times lower than their level was in 1940. The number of emergency stations has been decreased from 31 in 1990 down to 26 in 2010. The number of feldsher-midwife stations has been halved.

Medical institutions were liquidated mostly in rural areas. The access to health care for the rural population declined, so a mortality rate in rural areas increased 1.6-fold in comparison with the urban population mortality.

The share of the rural population in the Pskov Oblast is 3.5% higher than the average rural population in the Russian Federation, and it exceeds the rural population of the NorthWest Federal District by 1.8 times. This influences the mortality rate that exceeds the average mortality rate in Russia by 1.5 times.

Due to the complex causes, the mortality rate and natural decline in population reached the highest level in 2003, and they accounted for 24.9 and 15.9 persons per 1000 people, respectively.

Closing feldsher-midwife stations caused the increase in the number of difficult pregnancies, childbirths and postpartum periods. There was the following number of such cases per 100,000 women aged from 15 to 49: 1795 cases in 1990, 2465 in 1995, 2651 in 2000, 2701 in 2005 and 4153 in 2010. Children disability has grown more than 6-fold per 10,000 children over twenty years. An increase in the number of doctors and nurses per 10,000 people did not compensate for the liquidation of polyclinics and hospitals. Low motivation to work and the principle of payment for medical staff in attendance, but not for the results of treatment compounded the situation. There was no preventive medicine in practice.

The regional authorities, who enacted and implemented the solutions to reduce the number of medical institutions, thought about economic efficiency due to lower expenditures. However, health effectiveness should be based on humanistic principles and it should be socially-oriented in such regions as the Pskov Oblast where the demographic situation is specific [3].

Another feature of the Pskov Oblast is a higher share of pensioners (tab. 3) . Demographic pressure in this region is 1.1 times higher than in other regions of the North-West Federal

District [4, 5]. This share of the older people also determines an increased mortality rate.

A socio-economic factor is also important. The income level of the Pskov Oblast population is 1.7 times lower than the average income level in the North-West Federal District, and the investment level is 4 times lower. The rapid transition from socialism to free markets led to a significant increase in mortality rate: +3.8 pers. to the previous year in 1993 and +2.4 pers. after the financial crisis in 1998. This affected mainly the male population: average men life expectancy dropped from 62.8 years in 1990 down to 53.7 years in 2005. In rural areas men life expectancy was equal to 50.8 years in 2005, i.e. it became 4.4 years shorter than the life expectancy of the urban population due to the low life quality of villagers. There was a significant share of able-bodied people in the total number of deaths (27.5% in 2010): there were 43% of men and 11% of women among the dead persons. In 2010 the main causes of able-bodied people deaths were circulatory diseases (38.2% among men and 31.3% among women of the total number of deaths). Unnatural deaths of able-bodied population are on the second place – 30.2% of men and 23.8% of women. The prevailing accidents were traffic injuries (12%), suicides (11.2%), homicides (5.9%), accidental poisoning by alcohol (5.1%). The stabilization of the socioeconomic situation led to the tendency of a slow reduction in a mortality rate (see table 1).

Table 3. Age structure of the population by in Russia and the Pskov Oblast,% (census data)

Age groups	Russian Federation		Pskov Oblast
	2002	2010	2002	2010
Total population: under able-bodied age	18.1	16.2	16.2	14.2
able-bodied age	61.4	61.6	58.3	59.4
over able-bodied age	20.5	22.2	25.5	26.4
Total	100	100	100	100
Rural population: under able-bodied age	21.4	18.7	15.3	13.1
able-bodied age	56.0	59.2	50.3	55.4
over able-bodied age	22.6	22.1	34.4	31.5
Total	100	100	100	100

The natural population decline was compensated by the migration from neighboring countries and other regions [2]. But a migration outflow exceeded a migration inflow (tab. 4) .

Population decline leads to territorial desertification, especially in the rural areas, which is very undesirable for a border region. Thus, the number of villages devoid of inhabitants doubled in the Pskov Oblast in the period between the censuses in 2002 and 2010; less than 10 people lived in 47% of rural settlements, and more than 100 people lived only in 5% of villages. The total population density was less than 8 persons per 1 sq.km in most regions of the Pskov Oblast. The rural population density was below 2.5 persons per 1 sq.km in Bezhanitsky, Plyussky, Krasnensky and Usvyatsky Districts.

Despite the positive dynamics of natural population increase rates, it is expected a sharp decline in a birth rate in 2015 – 2025 because small women population born in the 1990s of the last century will come of childbearing age [6]. The half of the families should have two children and the other half – three children in order to have simple reproduction and the total birth rate – 2.11 – 2.15 [9]. The total birth rate accounted for 1.4 in 2010 in the Pskov Oblast: 1.3 in urban areas, 1.7 in rural areas. The share of third children is only 8.3%, and the share of fourth children is 3.9%. Therefore, there are no sufficient demographic resources for stabilizing the population size in the Pskov Oblast.

According to the Demographic Concept of the Russian Federation until 2025, the target programme “Population policy in the Pskov Oblast for the period from 2012 to 2015” with the financial support of 579 million rubles from the regional budget was developed and approved in March 1, 2012. The main objectives of the programme include creating good conditions for family life, preventing social orphanhood, promoting healthy lifestyles and reducing the mortality rates.

The Oblast’s Law “On the Regional Maternity Capital” has been adopted in order to increase a birth rate. Since January 1, 2011 the women, who give birth to the third and each subsequent child, and the persons, who are the adoptive parents of the third and each subsequent child, have been provided with the payment of 100 thousand rubles. The regional maternity capital can be used for the improvement of living conditions or education of children. The right to dispose of the regional maternity capital will occur when the third child or subsequent children are three years old.

The Law “On providing the citizens, who have three or more children, with land in the territory of the Pskov Oblast” was adopted in 2011. The document allows the persons, who have three or more children under the age of 18, to receive a free one-time ownership of a land plot in size from 10 to 15 acres for individual housing, if this family has been living for one year and more in the Pskov Oblast. The programme provides for funding of cadastral work and cadastral survey of land plots. 1177 families have declared their desire to get land plots, 587 of these families live in Pskov. In April 2012, four families got their certificate titles to land in Pustoshkinsky District.

It has been pronounced that 160 multi-child families are in need of improved housing conditions. They will be provided with subsidies totaling 143 million rubles. The programme provides opening 440 additional seats in the pre-school educational establishments,

Table 4. Migration of the population in the Pskov Oblast, pers.

Indicators 2000 2005 2009 People, who arrived from other regions 7858 4586 4580 People, who left the region 6959 5228 5078 Migration gain (+), loss(-) +899 -642 -498 including 220 seats in the city of Pskov in 2015. Multi-child families receive benefits and pay 70% of the communal services cost regardless of ownership within the social norm of living space and standards of their consumption. They are informed of the availability of free medicines in a particular hospital. Large families also receive free textbooks in schools.

Authorities allocated 2.4 million rubles to promote a healthy lifestyle till 2015.

It is planned to establish two schools for preventing cardiovascular diseases, diabetes and bronchial asthma in order to preserve health and prolong the working period of the older people.

It is planned to decrease a mortality rate through:

• •    providing emergency teams with two reanimobiles for aiding emergency care for children, including newborns (2015);

• •    bringing 10 medical institutions in conformity with the sanitary requirements, which is supposed to be provided with 74.4 million rubles of financial support in the period from 2012 to 2013.

The Pskov Oblast has spent 1.7 billion rubles for the realization of the national project “Health” over the period from 2006 to 2010. Diagnostic equipment, 124 ambulance cars and a reanimobile have been purchased. It is planned to build a cardiovascular center in future.

The measures aiming at the reducing road traffic injuries are implemented. The share of traffic accidents on public roads due to the poor road conditions is 16 – 18% in the Pskov Oblast. In addition, there is no year-round connection with the highways of public service in 3639 rural settlements, which hampers aiding emergency and preventive medical care. The Programme for the Highway Development in the Pskov Oblast for the period from 2011 till 2015 has been adopted in order to improve the situation. The programme has the financial support of 17.7 billion rubles, including 13.6 billion rubles from the Oblast budget and 37.9 million rubles from the municipal budgets. According to the programme, the following measures will have been implemented by 2016:

• ✓    increasing the share of regional highways of public service that meet the regulatory requirements up to 36.1%;

• ✓    increasing the length of artificial structures on the regional highways of public service with the assessment of technical condition of “good” and “satisfactory” from 40 to 65.8%;

• ✓    reducing the number of traffic accidents due to the poor road conditions down to 15.5%;

• ✓    increasing the length of the regional highways of public service, which are commissioned after the reconstruction and construction, by 17 km;

• ✓    increasing the number of rural settlements, which are provided with the yearround connection with the hard-surface roads of public service, by 20 units;

• ✓    repairing of roads, yards and driveways to them in the city of Pskov.

Additional efforts are necessary along with the implemented programmes to solve the demographic problem in the Pskov Oblast. There are 70 thousand families with children in this region. The income per a family member is below the subsistence level in almost half of them.

Multi-child families, single-mother families and families with disabled children are most vulnerable. In our opinion, it is reasonable to pass a Federal law on benefit payment in the case of caring for a child under 3 years of age and to increase the size of the benefit as an immediate economic measure of increase in a birth rate (as an experiment for the Pskov Oblast), because family incomes dropped during the period of caring for a child under 1.5 – 3 years of age. It is necessary to eliminate the deficit kindergartens and to increase the number of nursery groups for the children under 1.5 – 3 years of age. The rural feldsher-midwife stations should be restored in the settlements, where girls and women of childbearing age live, and additional emergency medical stations should be opened. It is necessary to carry out preventive work with the citizens in high-risk groups, aimed at preventing suicides, and to organize free medical compulsory treatment for alcoholism.

It is necessary to create attractive conditions for migration inflow of young people aged 20 – 30 from other regions. It is important to promote tolerance among the local population to migrants. Existing and proposed measures will be able to improve the demographic situation in the Pskov Oblast.