External causes as a major factor of premature mortality of the population in the Sakha Republic (Yakutia)

This study aims to examine the regional features of mortality from external causes in the Sakha Republic (Yakutia) in the period of 1990-2012. As sources, we used the data of the Federal Statistics Service, Territorial Department in the Sakha Republic (Yakutia); medical certificates of death (form No. 106/у-02); forensic examination reports; certificates of death of the Civil Registry Office in the SR(Y) for the given period. The study was conducted using the statistical, analytical, and mathematical methods, and the methods of comparative analysis. It has revealed the negative impact of human losses from accidents in children and working-age people on the demographic situation in the republic. In the children aged from 1 to 14 years, those dying of external causes made 65% of the total deaths in this age group, 91% in children aged 15-17 years, and 37% in able-bodied persons. The structure of external causes of death was dominated by homicides (16.0%) and suicides (22.3%), with all road accidents accounting for 12.0%. According to the 2012 data, the mortality rate from suicide (40.1 per 100 thousand people) was by 48% higher than the average rate (20.8) in the Russian Federation and by 23% higher than the corresponding rate in the Far Eastern Federal District (30.8). The mortality rate from homicide in Yakutia (28.0 per 100 thousand people) was by 61% higher than the average rate (10.8) the Russian Federation and by 22% higher than in the Far Eastern Federal District (21.7). In addition, the suicide rate in Yakutia exceeded by almost 2.5 times the critical parameters defined by WHO experts (20 suicides per 100 thousand people). The study has also revealed the intra-regional differentiation of mortality from external causes. The most unfavorable situation was observed in the Arctic group of regions with a relatively low level of social and economic development. Lower death rates from external causes, including violence, were recorded in the industrial regions with more favorable social and economic environment, better infrastructure, and a developed network of health institutions.