Infant Mortality in Moscow: the Perils of Progress in Russia’s World City


This paper examines changes in infant mortality (IM) in Moscow, Russia’s largest and most affluent city. Along with some remarkable improvements in Moscow’s health system over the period between 2000 and 2014, the overall IM rate for Moscow’s residents decreased substantially between 2000 and 2014. There remains, however, substantial intra-city variation across Moscow’s 125 neighborhoods. Our regression models suggest that in higher-income neighborhoods measured by percent of population with rental income as a primary source, the IM rate is significantly lower than in lower-income neighborhoods measured by percent of population with transfer income as primary source (housing and utility subsidies and payments to working and low-income mothers, single mothers and foster parents). We also find that the density of physicians in a neighborhood is negatively correlated with the IM rate, but the effect is small. The density of nurses and hospital beds has no effect. We conclude that overall progress on health outcomes and measures of access does not, in itself, solve the challenge of intra-urban inequalities.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    The Constitution of the Russian Federation Article 41. Russia; 1993. Accessed 17 Feb 2019

  2. 2.

    Cook LJ. Spontaneous privatization’ and its political consequences in Russia’s postcommunist health sector. In: MacLean MCaLM, editor. The politics of Non-State Welfare. Vol the politics of non-state welfare. Ithaca, NY: Cornell University Press; 2014. p. 217–36.

  3. 3.

    Bondarenko NV, Krasil'nikova MD, Shishkin SV. Praktiki oplaty medicinskoj pomoshhi. Vestnik obshhestvennogo mnenija. Dannye Analiz Diskussii. 2015;119:61–80.

    Google Scholar 

  4. 4.

    Shishkin SV, Potapchik EG, Selezneva EV. Oplata pacientami medicinskoj pomoshhi v rossijskoj sisteme zdravoohranenija. Moscow, Russia: Higher School of Economics; 2014.

  5. 5.

    Zasimova L. The use of medical care and out-of-pocket payments in Russia. Scand J Public Health. 2016;44(5):440–5.

    PubMed  Article  Google Scholar 

  6. 6.

    Rodwin VG, Neuberg L. Infant mortality and income in four world cities: New York, London, Paris and Tokyo. Am J Public Health. 2005;95(1):86–90.

    PubMed  PubMed Central  Article  Google Scholar 

  7. 7.

    Houweling TAJ, Kunst AE. Socio-economic inequalities in childhood mortality in low- and middle-income countries: a review of the international evidence. Br Med Bull. 2010;93(1):7–26.

    PubMed  Article  Google Scholar 

  8. 8.

    Schell CO, Reilly M, Rosling H, Peterson S, Ekstrom AM. Socioeconomic determinants of infant mortality: a worldwide study of 152 low-, middle-, and high-income countries. Scand J Public Health. 2007;35(3):288–97.

    PubMed  Article  Google Scholar 

  9. 9.

    Duchon LM, Andrulis DP, Reid HM. Measuring progress in meeting healthy people goals for low birth weight and infant mortality among the 100 largest cities and their suburbs. J Urban Health. 2004;81(3):323–39.

    PubMed  PubMed Central  Article  Google Scholar 

  10. 10.

    Smit W, Hancock T, Kumaresen J, Santos-Burgoa C, Sánchez-Kobashi Meneses R, Friel S. Toward a research and action agenda on urban planning/design and health equity in cities in low and middle-income countries. J Urban Health. 2011;88(5):875–85.

    PubMed  PubMed Central  Article  Google Scholar 

  11. 11.

    Gusmano MK, Rodwin VG, Weisz D, Ayoub R. Health improvements in BRIC cities: Moscow, São Paulo, and Shanghai, 2000–10. World Med Health Policy. 2016;8(2):127–38.

    Article  Google Scholar 

  12. 12.

    Nolte E, McKee CM. Measuring the health of nations: updating an earlier analysis. Health Aff. 2008;27(1):58–71.

    Article  Google Scholar 

  13. 13.

    Nigmatulina D, Becker C. Is high-tech care in a middle-income country worth it? ETIC. 2016;24(4):585–620.

    Google Scholar 

  14. 14.

    Danishevski K, Balabanova D, McKee M, Nolte E, Schwalbe N, Vasilieva N. Inequalities in birth outcomes in Russia: evidence from Tula oblast. Paediatr Perinat Epidemiol. 2005;19(5):352–9.

    PubMed  Article  Google Scholar 

  15. 15.

    Semenova VG, Zemlyanova EV. Tendencii i osobennosti smertnosti naselenija Moskvy; Тенденции и oсобенности cмертности населения Москвы. In: Rybakovskij LL, editor. Demograficheskaja situacija v Moskve i tendencii ee razvitija; Демографическая ситуация в Москве и тенденции ее развития. Moscow, Russia: Center of Social Forecasting and Marketing; 2006. p. 70–164.

  16. 16.

    Glei DA, Goldman N, Shkolnikov VM, et al. To what extent do biomarkers account for the large social disparities in health in Moscow? Soc Sci Med. 2013;77:164–72.

    PubMed  Article  Google Scholar 

  17. 17.

    Palosuo H, Uutela A, Zhuravleva I, Lakomova N. Social patterning of ill health in Helsinki and Moscow: results from a comparative survey in 1991. Soc Sci Med. 1998;46(9):1121–36.

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    Rosstat. Regions of Russia; Регионы России. Moscow, Russia: Federal State Statistics Service; 2017.

  19. 19.

    Andreev E, Kvasha E, Kharkova T. Mortality in Moscow and other megacities of the world: similarities and differences. Demogr Obozr. 2017;3(5):79–115.

    Google Scholar 

  20. 20.

    Rosstat. Pokazateli municipal'nyh obrazovanij database. База данных показателей муниципальных образований. Federal State Statistics Service. Available at: Accessed 16 Feb 2019.

  21. 21.

    MosGorStat. Об итогах Всеросийской переписи населения 2010 года по г.Москве. Moscow Statistics Agency; Территориальноый орган Федеральной службы государственной статистики по г. Москве. Available at: Accessed 16 Feb 2019.

  22. 22.

    Assembly UG. United Nations Millennium Declaration, Resolution adopted by the General Assembly. 2000.

  23. 23.

    Washington DUSDoHaHS, Office of Disease Prevention and Health Promotion. Healthy people 2020. Available at: Accessed 17 2019

  24. 24.

    Tabutin D, Masquelier B. Mortality inequalities and trends in low- and middle-income countries, 1990-2015. Population. 2017;72(2):221–96.

    Article  Google Scholar 

  25. 25.

    Kvasha E. Mortality of children under one year of age in Russia: what has changed after the transition to the new definition of live birth and stillbirth. Demogr Obozr. 2014;1(2):38–56.

    Google Scholar 

  26. 26.

    Пояснительная записка к программе модернизации здравоохранения города Москвы на 2011–2013 годы. Moscow, Russia: Moscow Government; 2013.

  27. 27.

    Grafova IB, Freedman VA, Kumar R, Rogowski J. Neighborhoods and obesity in later life. Am J Public Health. 2008;98(11):2065–71.

    PubMed  PubMed Central  Article  Google Scholar 

  28. 28.

    Morenoff JD, House JS, Hansen BB, Williams DR, Kaplan GA, Hunte HE. Understanding social disparities in hypertension prevalence, awareness, treatment, and control: the role of neighborhood context. Soc Sci Med. 2007;65(9):1853–66.

    PubMed  PubMed Central  Article  Google Scholar 

  29. 29.

    Yourkavitch J, Kane JB, Miles G. Neighborhood disadvantage and neighborhood affluence: associations with breastfeeding practices in urban areas. Matern Child Health J. 2018;22(4):546–55.

    PubMed  PubMed Central  Article  Google Scholar 

  30. 30.

    Kane JB, Miles G, Yourkavitch J, King K. Neighborhood context and birth outcomes: going beyond neighborhood disadvantage, incorporating affluence. SSM - Population Health. 2017;3:699–712.

    PubMed  PubMed Central  Article  Google Scholar 

  31. 31.

    Daoud N, Sergienko R, O’Campo P, Shoham-Vardi I. Disorganization theory, neighborhood social capital, and ethnic inequalities in intimate partner violence between Arab and Jewish women citizens of Israel. J Urban Health. 2017;94(5):648–65.

    PubMed  PubMed Central  Article  Google Scholar 

  32. 32.

    Kimani-Murage EW, Schofield L, Wekesah F, Mohamed S, Mberu B, Ettarh R, et al. Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya. J Urban Health. 2014;91(6):1098–113.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  33. 33.

    Kirkpatrick SI, Tarasuk V. Housing circumstances are associated with household food access among low-income urban families. J Urban Health. 2011;88(2):284–96.

    PubMed  PubMed Central  Article  Google Scholar 

  34. 34.

    Russian Statiststical Yearbook. Российский статистический ежегодник. Moscow, Russia: Federal State Statistics Service; 2016.

  35. 35.

    Potapchik EG, Selezneva EV, Shishkin SV. Dostupnost' Medicinskoj Pomoshhi dlja Naselenija; Доступность Медицинской Помощи для Населения. Moscow, Russia: Higher School of Economics; 2011.

  36. 36.

    Lane D. Dynamics of regional inequality in the Russian Federation: circular and cumulative causality. Russian Analytical Digest. 2013;139:2–8.

    Google Scholar 

  37. 37.

    Russian Statiststical Yearbook; Российский статистический ежегодник. Moscow, Russia: 2012.

  38. 38.

    Gosudarstvennaja informacionnaja sistema "Regional'nyj jelektronnyj bjudzhet Moskovskoj oblasti"; Государственная информационная система "Региональный электронный бюджет Московской области". Ministerstvo jekonomiki i finansov Moskovskoj oblasti; Министерство экономики и финансов Московской области. 2018. Available at: Accessed 24 July 2018.

  39. 39.

    Andreev EM, Nolte E, Shkolnikov VM, Varavikova E, McKee M. The evolving pattern of avoidable mortality in Russia. Int J Epidemiol. 2003;32(3):437–46.

    PubMed  Article  Google Scholar 

  40. 40.

    Aris B. Money for health in Russia, at long last. Lancet. 2005;366(9493):1254–5.

    PubMed  Article  Google Scholar 

  41. 41.

    P. M. Public Spending in Russia for health care: issues and options. Washington, DC: World Bank; 2008.

  42. 42.

    Shishkin S, Potapchik E, Selezneva E. Private health care sector in Russia: present state and development prospects. Voprosy Economiki. 3013(4):94–112.

  43. 43.

    Baranov A, Namazova-Baranova L, Albitsky V, Ustinova N, Terletskaya R, Komarova O. Paediatrics in Russia: past, present and future. Arch Dis Child. 2017;102(8):774–8.

    PubMed  PubMed Central  Article  Google Scholar 

  44. 44.

    Vlassov VV. Russian experience and perspectives of quality assurance in healthcare through standards of care. Health Policy Technol. 2016;5(3):307–12.

    Article  Google Scholar 

  45. 45.

    PWC. Data-driven cities: from concept to applied solutions: Moscow, Russia: PricewaterhouseCoopers; 2016.

  46. 46.

    Integrated medical information and analytical system: taking Moscow healthcare online. Moscow Mayor official website. 2016;12:00. Available at: Accessed 17 Feb 2019

  47. 47.

    Vse o sisteme EMIAS – elektronnikh meditsinskih uslugah v poliklinikah Echo of Moscow. 2017. Available at: Accessed 17 Feb 2019

  48. 48.

    Rodwin VG, Neuberg LG. Infant mortality and income in 4 world cities: New York, London, Paris, and Tokyo. Am J Public Health. 2005;95(1):86–90.

    PubMed  PubMed Central  Article  Google Scholar 

  49. 49.

    Padilla CM, Kihal-Talantikit W, Vieira VM, Deguen S. City-specific spatiotemporal infant and neonatal mortality clusters: links with socioeconomic and air pollution spatial patterns in France. Int J Environ Res Public Health. 2016;13(6)

    PubMed Central  Article  CAS  Google Scholar 

  50. 50.

    Zayonchkovskaya J, Florinskaya Y, Poletaev D, Ksenia D. Migranty glazami moskvichej. Demoscope Weekly. 2014;605–606.

  51. 51.

    Rocheva A. A swarm of migrants in our maternity clinics! The study of stratified reproduction regime in the case of Kyrgyz migrants in Moscow. Journal of Social Policy Studies. 2014;12(3):367–80.

    Google Scholar 

  52. 52.

    Gusmano MK, Rodwin VG, Weisz D. Persistent inequalities in health and access to health services: evidence from New York City. World Med Health Policy. 2017;9(2):186–205.

    Article  Google Scholar 

  53. 53.

    Butrin D. Ot Tverskoj do samyh do okrain; От Тверской до самых до окраин. Kommersant. 2018;2018:1.

Download references


This work was not grant supported.

Author information



Corresponding author

Correspondence to Irina B. Grafova.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Grafova, I.B., Gusmano, M.K., Martirosyan, K. et al. Infant Mortality in Moscow: the Perils of Progress in Russia’s World City. J Urban Health 96, 813–822 (2019).

Download citation


  • Infant mortality
  • Moscow
  • Intra-city health inequalities