Medical and Demographic Processes in the Republic of Karelia in 2011–2021: Trends and Risks

Introduction: The Republic of Karelia is a part of the Northwestern Federal District and, being a sparsely populated constituent entity of the Russian Federation, is characterized by a difficult medical and demographic situation.
Objective: To assess trends in medical and demographic processes in the Republic of Karelia in 2011–2021.
Materials and methods: We analyzed official statistical data provided by the Territorial Body of the Federal State Statistics Service in the Republic of Karelia for the years 2011 to 2021. Both absolute and relative values and time series indicators were used to characterize the processes under study.
Results: A long-term depopulation process has been taking place in the region: since 2011, the size of population has decreased by 39.5 thousand people, which was mainly attributed to the rural population decline and a shrinking number of women. In 2011–2021, the natural population growth rate was negative (–2.8 and –12.1 per 1,000 population in 2011 and 2021, respectively), began to worsen in 2015 due to a decrease in the birth rate, and even aggravated during the COVID-19 pandemic of 2020–2021 owing to increased mortality rates. Diseases of the circulatory system and neoplasms were found to be the leading causes of death during the study period. In 2011–2020, the infant mortality rate ranged from 44.2 to 76.3 per 10 thousand births. We observed a regressive population age structure in the republic characterized by a decrease in the young-age to old-age population ratio from 0.70 in 2011 to 0.67 in 2021. The proportion of residents aged 60 years and older rose from 18.3 % in 2011 to 24.5 % in 2021. The share of working adults, on the opposite, decreased from 61.1 % in 2011 to 54.6 % in the year 2021. In 2020, a gradual increase in life expectancy traced in 2011–2019 turned into a decrease caused by the COVID-19 pandemic.
Conclusions: The unfavorable medical and demographic situation in the Republic of Karelia requires special attention of the scientific community and governmental structures. Applying the principle of a systematic approach to solving the problem will help improve the current situation.

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