Health in Russia

Last updated

Health in Russia deteriorated rapidly following the dissolution of the Soviet Union, and particularly for men, as a result of social and economic changes. [1]

Contents

The Human Rights Measurement Initiative [2] finds that Russia is able to fulfil 78.0% of the requirements for basic health, in relation to Russian income levels. [3]

Life expectancy

Life expectancy in Russia since 1896 Life expectancy in Russia.svg
Life expectancy in Russia since 1896
Life expectancy at birth in Russia Life expectancy in RSFSR and RF (by Human Mortality Database and Rosstat).png
Life expectancy at birth in Russia

Pre-Soviet era

Before the revolution, Russia's annual mortality rate was 29.4 per 1,000 people, and infant mortality was 260 per 1000 births. In 1915 life expectancy at birth was 34 years. The cholera epidemic of 1910 killed 100,000 people. A typhus epidemic between 1918 and 1922 caused 2.5 million deaths, and doctors were particularly affected. There was an outbreak of malaria in 1920. The Institute of Tropical Medicine in Moscow instituted a programme of registration of cases and free distribution of quinine. The famine of 1921-1922 caused widespread starvation. As many as 27 million people were affected. Another cholera outbreak between 1921 and 1923 caused an estimated 13 million deaths. [4] By 1926 life expectancy had reached 31 years. [5]

Post-Soviet era

As of 2013, the average life expectancy in Russia was 65.1 years for males and 76.5 years for females. [6] The average Russian life expectancy of 71.6 [7] years at birth is nearly 5 years shorter than the overall average figure for the European Union or the United States. [8]

The biggest factor contributing to this relatively low life expectancy for males is a high mortality rate among working-age males from preventable causes (e.g., alcohol poisoning, stress, smoking, traffic accidents, violent crimes)[ citation needed ]. Mortality among Russian men has risen by 60% since 1991, four to five times higher than the European average.[ citation needed ]

As a result of the large difference in life expectancy between men and women (the greatest in the world), the gender imbalance remains to this day and there are 0.859 males for every female in Russia. [9]

Major health issues

Common causes of death

In 2008, 1,185,993, or 57% of all deaths in Russia were caused by cardiovascular disease. The second leading cause of death was cancer which claimed 289,257 lives (14%). External causes of death such as suicide (1.8%), road accidents (1.7%), murders (1.1%), accidental alcohol poisoning (1.1%), and accidental drowning (0.5%), claimed 244,463 lives in total (11%). Other major causes of death were diseases of the digestive system (4.3%), respiratory disease (3.8%), infectious and parasitic diseases (1.6%), and tuberculosis (1.2%). [10]

The infant mortality rate in 2008 was 8.5 deaths per 1,000, down from 9.6 in 2007. Since the Soviet collapse, there has been a dramatic rise in both cases of and deaths from tuberculosis, with the disease being particularly widespread amongst prison inmates. [11]

Smoking

Until 2007, Russia was the world leader in smoking.[ citation needed ] According to a survey reported in 2010 by Russia’s Health and Social Development Ministry, 43.9 million adults in Russia are smokers. Among Russians aged 19 to 44 years, 7 in 10 men smoke and 4 in 10 women smoke. [12] It is estimated that 330,000-400,000 people die in Russia each year due to smoking-related diseases. A smoking ban was introduced in 2014.

Alcohol consumption

Alcohol consumption and alcoholism are major problems in Russia. It is estimated that Russians drink 15 litres (26 pints) of pure alcohol each year. This number is nearly 3 times as much as it was in 1990. [13] It has even been reported that excessive alcohol consumption is to blame for nearly half of all premature deaths in Russia. [14]

A recent study blamed alcohol for more than half the deaths (52%) among Russians aged 15 to 54 from 1990 to 2001. [15] For the same demographic, this compares to 4% of deaths for the rest of the world. [16]

HIV/AIDS

HIV/AIDS, virtually non-existent in the Soviet era, rapidly spread following the collapse, mainly through the explosive growth of intravenous drug use. [17] According to a 2008 report by UNAIDS, the HIV epidemic in Russia continues to grow, but at a slower pace than in the late 1990s. At the end of December 2007 the number of registered HIV cases in Russia was 416,113, with 42,770 new registered cases that year. The actual number of people living with HIV in Russia is estimated to be about 940,000. [18] In 2007, 83% of HIV infections in Russia were registered among injecting drug users, 6% among sex workers, and 5% among prisoners. [19] However, there is clear evidence of a significant rise in heterosexual transmission [ citation needed ]. In 2007, 93.19% of adults and children with advanced HIV infection were receiving antiretroviral therapy. [18] [20]

In April 2006, the State Council met with the Russian President to set goals for developing a strategy for responding to AIDS. This involved improving coordination, through the creation of a high-level multisectoral governmental commission on AIDS; and establishing a unified monitoring and evaluation system. A new Federal AIDS Program for 2007 - 2011 was also developed and adopted. Federal funding for the national AIDS response in 2006 had increased more than twentyfold compared to 2005, and the 2007 budget doubled that of 2006, adding to the already substantial funds provided by the main donor organizations. [20]

Coordination of activities in responding to AIDS remains a challenge for Russia, despite increased efforts. In 2006, treatment for some patients was interrupted due to delays in tender procedures and unexpected difficulties with customs. Additionally, lack of full commitment to an in-depth program for education on sex and drugs in schools hinders effective prevention programs for children. [20]

COVID-19 (2020-2022)

Suicide

In 2008, suicide claimed 38,406 lives in Russia. [21] With a rate of 27.1 suicides per 100,000 people, Russia has one of the highest suicide rates in the world, although it has been steadily decreasing since it peaked at around 40 per 100,000 in the mid-late 90s, [22] including a 30% drop from 2001 to 2006. In 2007 about 22% of all suicides were committed by people aged 40–49, and almost six times as many Russian males commit suicide than females.[ citation needed ]

Heavy alcohol use is a significant factor in the suicide rate, with an estimated half of all suicides a result of alcohol abuse. This is evidenced by the fact that Russia's suicide rate since the mid-90s has declined alongside per capita alcohol consumption, despite the economic crises since then; alcohol consumption is more of a factor than economic conditions. [23]

Tuberculosis

The pulmonary TB death rate in Russia around 1900 was 4 per 1000, more than double the rate in London. The All Russia League for the Struggle Against TB was set up in 1909. In 1919 the Commissariat of Public Health established a TB Commission. The incidence of tuberculosis in Moscow was about three times that in London in 1922. The director of the Institute of Control of Serums and Vaccines in Russia, Tarasevich, brought a serum of the BCG vaccine from the Pasteur Institute in 1925 and a vaccination programme started shortly afterwards, starting with children in homes with an active TB patient, but there was initially very low take up. It was not until the 1930s that rates increased significantly. [24]

Climate change

This section is an excerpt from Climate change in Russia § Health impacts.[ edit ]

Climate change has the potential to affect human health in several ways, both directly and indirectly, through for example, extreme heatwaves, fires, floods or insect-borne diseases.

The predicted increases in average annual temperatures in most parts of Russia, especially the western and south-western regions, imply more frequent extreme heatwaves and forest fires. [25] For example, during the heatwave that affected western Russia in 2010, temperatures in Moscow reached 38.2 °C, the highest temperature since records began 130 years ago. In addition, during the heatwave there were 33 consecutive days of temperatures above 30 °C in the city, increasing the incidence of heat-related deaths and health problems, and leading to forest fires. [26] The heatwave and wildfires of 2010 in Russia resulted in around 14,000 heat and air-pollution related deaths, as well as around 25% crop failure that year, more than 10,000 km2 of burned area and around 15 billion US dollars of economic losses. [27] [28] Throughout the 21st century, extreme heatwaves such as that of 2010 are likely to occur more often. [25]

In consequence of the 2006, 2003 and 2010 heatwaves in Europe and Russia, the IPCC (2012) has outlined mitigation strategies, including approaches to reduce impacts on public health, assessing heat mortality, communication of risk, education and adapting urban infrastructure to better withstand heatwaves (by for example increasing vegetation cover in cities, increasing albedo in cities and increasing insulation of homes). [29]

With changes in temperature and precipitation patterns as a result of climate change, the distribution and occurrence of various disease-bearing insects will also change. For example, mosquitos carrying malaria are expected to pose an increasing threat in Russia in the 21st century. [30] In the Moscow region, the onset of higher average daily temperatures early on in the year has already led to a rapid increase in malaria cases. This trend is projected to continue, as higher average temperatures extend the range of mosquitos northwards. [31] Similarly, prevalence of tick-borne diseases is also projected to increase in Russia in the 21st century, as a result of climate change and changing distribution range of ticks. [25] Sandfly-borne diseases, such as Leishmaniasis, could also expand in Europe and Russia as a result of climate change and increased average temperatures making transmission suitable in northern latitudes. [32]

Floods may also pose and increased risk as a result of climate change in the 21st century. An average increase in precipitation in many areas of Russia as well as rapid snow and glacier melting due to rising temperatures, can all increase the risk of flooding. [25]

See also

Related Research Articles

<span class="mw-page-title-main">Sociology of health and illness</span> Branch of sociology

The sociology of health and illness, sociology of health and wellness, or health sociology examines the interaction between society and health. As a field of study it is interested in all aspects of life, including contemporary as well as historical influences, that impact and alter our health and wellbeing.

<span class="mw-page-title-main">Health in Uganda</span> Overview of health in Uganda

According to the recently conducted national survey in 2024, Uganda's population stands at 45.9 million. Health status is measured by some of the key indicators such as life expectancy at birth, child mortality rate, neonatal mortality rate and infant mortality rate, maternal mortality ratio, nutrition status and the global burden of disease. The life expectancy of Uganda has increased from 39.3 in 1950 to 62.7years in 2021. This is lower below the world average which is at 71.0 years. The fertility rate of Ugandan women slightly increased from an average of 6.89 babies per woman in the 1950s to about 7.12 in the 1970s before declining to an estimate 4.3 babies in 2019. This figure is higher than the world average of 2 and most world regions including South East Asia, Middle East and North Africa, Europe and Central Asia and America. The under-5-mortality-rate for Uganda has decreased from 191 deaths per 1000 live births in 1970 to 41 deaths per 1000 live births in 2022.

Available healthcare and health status in Sierra Leone is rated very poorly. Globally, infant and maternal mortality rates remain among the highest. The major causes of illness within the country are preventable with modern technology and medical advances. Most deaths within the country are attributed to nutritional deficiencies, lack of access to clean water, pneumonia, diarrheal diseases, anemia, malaria, tuberculosis and HIV/AIDS.

Health in the United Kingdom refers to the overall health of the population of the United Kingdom. This includes overall trends such as life expectancy and mortality rates, mental health of the population and the suicide rate, smoking rates, alcohol consumption, prevalence of diseases within the population and obesity in the United Kingdom. Three of these – smoking rates, alcohol consumption and obesity – were above the OECD average in 2015.

<span class="mw-page-title-main">Health in Kenya</span> Health status and problems in Kenya

Tropical diseases, especially malaria and tuberculosis, have long been a public health problem in Kenya. In recent years, infection with the human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), also has become a severe problem. Estimates of the incidence of infection differ widely.

<span class="mw-page-title-main">Health in Tajikistan</span>

The Tajikistan health system is influenced by the former Soviet legacy. It is ranked as the poorest country within the WHO European region, including the lowest total health expenditure per capita. Tajikistan is ranked 129th as Human Development Index of 188 countries, with an Index of 0.627 in 2016. In 2016, the SDG Index value was 56. In Tajikistan health indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease.

<span class="mw-page-title-main">Health in Vietnam</span>

Health in Vietnam encompasses general and specific concerns to the region, its history, and various socioeconomic status, such as dealing with malnutrition, effects of Agent Orange as well as psychological issues from the Vietnam War, tropical diseases, and other issues such as underdeveloped healthcare systems or inadequate ratio of healthcare or social workers to patients.

<span class="mw-page-title-main">Health in Finland</span> Overview of health in Finland

The major causes of deaths in Finland are cardiovascular diseases, malignant tumors, dementia and Alzheimer's disease, respiratory diseases, alcohol related diseases and accidental poisoning by alcohol. In 2010, the leading causes of death among men aged 15 to 64 were alcohol related deaths, ischaemic heart disease, accident, suicides, lung cancer and cerebrovascular diseases. Among women the leading causes were breast cancer, alcohol related deaths, accidents, suicides, ischemic heart disease and lung cancer.

<span class="mw-page-title-main">HIV/AIDS in the Democratic Republic of the Congo</span>

The Democratic Republic of the Congo was one of the first African countries to recognize HIV, registering cases of HIV among hospital patients as early as 1983.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).

HIV/AIDS in Namibia is a critical public health issue. HIV has been the leading cause of death in Namibia since 1996, but its prevalence has dropped by over 70 percent in the years from 2006 to 2015. While the disease has declined in prevalence, Namibia still has some of the highest rates of HIV of any country in the world. In 2016, 13.8 percent of the adult population between the ages of 15 and 49 are infected with HIV. Namibia had been able to recover slightly from the peak of the AIDS epidemic in 2002. At the heart of the epidemic, AIDS caused the country's live expectancy to decline from 61 years in 1991 to 49 years in 2001. Since then, the life expectancy has rebounded with men living an average of 60 years and women living an average of 69 years

<span class="mw-page-title-main">Health in Niger</span>

Niger is a landlocked country located in West Africa and has Libya, Chad, Nigeria, Benin, Mali, Burkina Faso, and Algeria as its neighboring countries. Niger was French territory that got its independence in 1960 and its official language is French. Niger has an area of 1.267 million square kilometres, nevertheless, 80% of its land area spreads through the Sahara Desert.

<span class="mw-page-title-main">Health in Ghana</span>

In precolonial Ghana, infectious diseases were the main cause of morbidity and mortality. The modern history of health in Ghana was heavily influenced by international actors such as Christian missionaries, European colonists, the World Bank, and the International Monetary Fund. In addition, the democratic shift in Ghana spurred healthcare reforms in an attempt to address the presence of infectious and noncommunicable diseases eventually resulting in the formation of the National Health insurance Scheme in place today.

The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.

<span class="mw-page-title-main">Health in North Korea</span>

North Korea has a life expectancy of 74 years as of 2022. While North Korea is classified as a low-income country, the structure of North Korea's causes of death (2013) is unlike that of other low-income countries. Rather, causes of death are closer to the worldwide averages, with non-communicable diseases – such as cardiovascular disease – accounting for two-thirds of the total deaths.

The health status of Namibia has increased steadily since independence, and the government does have focus on health in the country and seeks to make health service upgrades. As a guidance to achieve this goal, the Institute for Health Metrics and Evaluation (IHME) and World Health Organization (WHO) recently published the report "Namibia: State of the Nation's Health: Findings from the Global Burden of Disease." The report backs the fact that Namibia has made steady progress in the last decades when it comes to general health and communicable diseases, but despite this progress, HIV/AIDS still is the major reason for low life expectancy in the country.

<span class="mw-page-title-main">Health in Malawi</span>

Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.

<span class="mw-page-title-main">Health in Rwanda</span>

The quality of health in Rwanda has historically been very low, both before and immediately after the 1994 genocide. In 1998, more than one in five children died before their fifth birthday, often from malaria. But in recent years Rwanda has seen improvement on a number of key health indicators. Between 2005 and 2013, life expectancy increased from 55.2 to 64.0, under-5 mortality decreased from 106.4 to 52.0 per 1,000 live births, and incidence of tuberculosis has dropped from 101 to 69 per 100,000 people. The country's progress in healthcare has been cited by the international media and charities. The Atlantic devoted an article to "Rwanda's Historic Health Recovery". Partners In Health described the health gains "among the most dramatic the world has seen in the last 50 years".

Montenegro is a country with an area of 13,812 square kilometres and a population of 620,029, according to the 2011 census. The country is bordered by Croatia, the Adriatic Sea, Bosnia, Herzegovina, Serbia, Kosovo and Albania. The most common health issues faced are non-communicable diseases accounting for 95% of all deaths. This is followed by 4% of mortality due to injury, and 1% due to communicable, maternal, perinatal and nutritional conditions. Other health areas of interest are alcohol consumption, which is the most prevalent disease of addiction within Montenegro and smoking. Montenegro has one of the highest tobacco usage rates across Europe. Life expectancy for men is 74 years, and life expectancy for women is 79.

The Health Sector in Eswatini is deteriorating and four years into the United Nations sustainable development goals, Eswatini seems unlikely to achieve the goal on good health. As a result of 63% poverty prevalence, 27% HIV prevalence, and poor health systems, maternal mortality rate is at a high of 389/100,000 live births, and under 5 mortality rate is at 70.4/1000 live births resulting in a life expectancy that remains amongst the lowest in the world. Despite significant international aid, the government fails to adequately fund the health sector. Nurses are now and again engaged in demonstrations over poor working conditions, drug shortages, all of which impairs quality health delivery. Despite tuberculosis and AIDS being major causes of death, diabetes and other non-communicable diseases are on the rise. Primary health care is relatively free in Eswatini save for its poor quality to meet the needs of the people. Road traffic accidents have increased over the years and they form a significant share of deaths in the country.

References

  1. ↑ Leonard, William R (April 2002). "Declining growth status of indigenous Siberian children in post-Soviet Russia". Human Biology. p. 1. Archived from the original on 2011-10-28. Retrieved 2007-12-27.
  2. ↑ "Human Rights Measurement Initiative – The first global initiative to track the human rights performance of countries". humanrightsmeasurement.org. Retrieved 2022-03-04.
  3. ↑ "Russian Federation - HRMI Rights Tracker". rightstracker.org. Retrieved 2022-03-04.
  4. ↑ Khwaja, Barbara (2017). Health Reform in Revolutionary Russia. U.K: Socialist Health Association.
  5. ↑ Aaron, O'Neill (2022-06-21). "Russia: Life expectancy 1845-2020". Statista.
  6. ↑ "Россия побила свой рекорд по продолжительности жизни женщин - 76,5 лет" [Russia breaks its record for women's life expectancy - 71.6 years]. RIA Novosti (in Russian). 2014-04-18. Retrieved 2022-08-08.
  7. ↑ "Скворцова: средняя продолжительность жизни россиян составила 71,6 года - ТАСС" [Skvortsova: Average life expectancy of Russians is 71.6 years]. TASS (in Russian). Retrieved 2022-08-08.
  8. ↑ "European Union". Central Intelligence Agency (CIA). Retrieved 2008-01-20.
  9. ↑ The World Factbook. "Russia". Central Intelligence Agency (CIA). Retrieved 2007-12-26.
  10. ↑ Rosstat demographics report for the year 2008 Archived 2010-12-15 at the Wayback Machine Federal State Statistics Service, Retrieved on June 3, 2009
  11. ↑ "TB an epidemic in Russia's prisons". Newsline (People with AIDS Coalition of New York): 33. 1993. PMID   11367347 – via PubMED.
  12. ↑ http://www.itar-tass.com/eng/level2.html?NewsID=15664613&PageNum=0%5B%5D
  13. ↑ Halpin, Tony (April 13, 2007). "Health alert as Russias alcohol consumption triples". The Times. London. Archived from the original on July 6, 2008.
  14. ↑ Laurance, Jeremy (June 15, 2007). "Alcohol blamed for half of Russia's premature deaths". The Independent. London. Archived from the original on January 15, 2010.
  15. ↑ See, e.g., Korotayev A., Khaltourina D. Russian Demographic Crisis in Cross-National Perspective. Russia and Globalization: Identity, Security, and Society in an Era of Change. Ed. by D. W. Blum. Baltimore, MD: Johns Hopkins University Press, 2008. P. 37-78; Khaltourina, D. A., & Korotayev, A. V. 'Potential for alcohol policy to decrease the mortality crisis in Russia', Evaluation & the Health Professions, vol. 31, no. 3, Sep 2008. pp. 272–281 Archived 2018-07-01 at the Wayback Machine .
  16. ↑ Burlington Free Press, June 26, 2009, page 2A, "Study blames alcohol for half Russian deaths"
  17. ↑ "HIV/AIDS in the Russian Federation". The World Bank. Retrieved 2007-12-27.
  18. 1 2 Eastern Europe and Central Asia AIDS epidemic update UNAIDS Retrieved on May 3, 2008
  19. ↑ UNAIDS Russia UNAIDS Retrieved on July 11, 2008
  20. 1 2 3 UNAIDS: Russian Federation Archived 2008-04-09 at the Wayback Machine UNAIDS Retrieved on March 15, 2008
  21. ↑ H1 2009 demographic figures Archived 2012-02-18 at the Wayback Machine Rosstat Retrieved on August 28, 2009
  22. ↑ WHO Russia suicide statistics WHO retrieved on March 21, 2008
  23. ↑ Demoscope - Demographic, social and economic consequences of alcohol abuse in Russia Demoscope Retrieved on July 6, 2010
  24. ↑ Khwaja, Barbara (26 May 2017). "Health Reform in Revolutionary Russia". Socialist Health Association. Retrieved 26 May 2017.
  25. 1 2 3 4 "Health in Russia". Climatechangepost.com. Retrieved 2021-05-19.
  26. ↑ Folland, Chris K.; Boucher, Olivier; Colman, Andrew; Parker, David E. (June 2018). "Causes of irregularities in trends of global mean surface temperature since the late 19th century". Science Advances. 4 (6): eaao5297. Bibcode:2018SciA....4.5297F. doi:10.1126/sciadv.aao5297. ISSN   2375-2548. PMC   5990305 . PMID   29881771.
  27. ↑ Barriopedro, D.; Fischer, E. M.; Luterbacher, J.; Trigo, R. M.; Garcia-Herrera, R. (2011-04-08). "The Hot Summer of 2010: Redrawing the Temperature Record Map of Europe". Science. 332 (6026): 220–224. Bibcode:2011Sci...332..220B. doi: 10.1126/science.1201224 . ISSN   0036-8075. PMID   21415316. S2CID   24947372.
  28. ↑ Shaposhnikov, Dmitry; Revich, Boris; Bellander, Tom; Bedada, Getahun Bero; Bottai, Matteo; Kharkova, Tatyana; Kvasha, Ekaterina; Lezina, Elena; Lind, Tomas; Semutnikova, Eugenia; Pershagen, Göran (May 2014). "Mortality Related to Air Pollution with the Moscow Heat Wave and Wildfire of 2010". Epidemiology. 25 (3): 359–364. doi:10.1097/EDE.0000000000000090. ISSN   1044-3983. PMC   3984022 . PMID   24598414.
  29. ↑ Field, Christopher B.; Barros, Vicente; Stocker, Thomas F.; Dahe, Qin, eds. (2018-09-18), "IPCC, 2012: Summary for Policymakers", Planning for Climate Change, Routledge, pp. 111–128, doi:10.4324/9781351201117-15, ISBN   978-1-351-20111-7, S2CID   240164028 , retrieved 2021-05-19
  30. ↑ Human development report 2007/2008 : fighting climate change : human solidarity in a divided world. United Nations Development Programme. New York: United Nations Development Programme. 2007. ISBN   978-0-230-54704-9. OCLC   187311028.{{cite book}}: CS1 maint: others (link)
  31. ↑ Karaman, Ana (2018-04-17), "Russia and global climate change", Climate Change, Policy and Security, Abingdon, Oxon: Routledge, pp. 216–234, doi:10.4324/9781351060479-10, ISBN   978-1-351-06047-9 , retrieved 2021-05-19
  32. ↑ Semenza, Jan C; Menne, Bettina (June 2009). "Climate change and infectious diseases in Europe". The Lancet Infectious Diseases. 9 (6): 365–375. doi:10.1016/S1473-3099(09)70104-5. PMID   19467476.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.