Аңдатпа
Background: In the 1990s the Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) experienced major changes in population health, but scientific evidence is scarce. In view of the recent publication by WHO of detailed mortality data for all of the countries, we undertook an age-cause decomposition of differences in life expectancy (LE) over 1998-2012 to identify drivers of these changes. Methods: We used the Auger method to calculate contributions of specific ages and causes to changes in LE in males and females in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan in 1998-2005, 2005-2012 and 1998-2012, where data allowed us to do so. Results: Overall, LE increased in all five countries over this period. In all five countries mortality declines in infants and children under 5, particularly from respiratory and infectious diseases, explain 50-77% of all LE gains in 1998-2005. The second major contributor is cardiovascular diseases in adults over 55. During 2005-2012, mortality in under 5s played an important role in Kyrgyzstan and Uzbekistan, whereas in Turkmenistan it contributed negatively. In Kazakhstan and, to a smaller degree, in Turkmenistan, a decline in mortality from cardiovascular diseases, particularly ischaemic heart disease, explains a vast majority of the increase in LE in 2005-2012. Conclusions: In the early 2000s reduction in mortality in under 5s was the single major driver of LE gains in the region. In the late 2000s some of the countries made larger progress on cardiovascular diseases, but the improvement was not uniform. This study adds to the limited literature on more specific causes behind improvements in LE in the five Central Asian countries. Key messages: In the early 2000s reduction in mortality in under 5s, particularly from respiratory and infectious diseases, was the single major driver of gains in life expectancy in Central Asia. In the late 2000s the main contributor to LE gains was improvement in mortality from cardiovascular disease in adults above 55, but this was not uniform across all countries.