DEMOGRAPHIC INDICATORS, 1996
Population at the beginning of 1997 (millions)	50.9
Urban (%)	68
Rural (%)	32
Population density (persons/sq. km))	84.3
Gender composition (%):
Male	46
Female	54
Age composition (%):
Under able-bodied age	21
Able-bodied age	56
Pension age	23
Ethnic composition (%):
Ukrainians	73
Russians	22
Others	5
Natural population movement (thousands):
Number of people born	467.2
Number of people died	776.7
Natural increase (decrease)	-309.5
Vital events rates (┴ ):
Birth rate	9.1
Mortality rate	15.2
Natural increase rate	-6.1
Infant mortality rate (per 1000 born)	14.3
Life expectancy (years)	67.1
Males	61.6
Females	72.8
Decline in 1989-1996 (years)	-3.9
Males	-4.6
Females	-2.4
Marriage rate (┴ )	6.0
Divorce rate (┴ )	3.8

Changes in Population Size

A fundamental factor determining population size in Ukraine is its natural movement. Under the conditions of socio-economic crisis negative tendencies in the dynamics of fertility and mortality rise swiftly, leading to the deepening of depopulation, which began in Ukraine's villages in 1979. The number of deaths in 1991 for the first time exceeded number of births for Ukraine as a whole (by 39,000). In the following years this trend rose rapidly: to 100,000 in 1992, 184,000 in 1993, 243,000 in 1994, 300,000 in 1995, and 310,000 in 1996. During six years, because of natural decline, the population of Ukraine decreased by 1,176,000. For the first time in peace, Ukraine began to develop and accelerate a demographic phenomena which previously took place only during relatively short periods of world or civil wars. Depopulation took on a spontaneous character and no indication of its end is in sight. A special feature of depopulation in Ukraine compared with other countries resides in the fact that it is accompanied by a deterioration in qualitative characteristics of the population and especially of its health, which gives reason to call the demographic situation in Ukraine a deep demographic crisis.
Following the fall in living standards in Ukraine, migration from the former Soviet republics, which increased considerably after Ukraine gained independence, slowed significantly in 1993 and, in 1994, changed to an out-flow. While initial population decreases through higher death rates than birth rates were compensated for by immigration, after 1993 such compensation ceased to take place and the absolute number of people in Ukraine began to decline. While at the beginning of 1993 the population comprised 52,244,000, at the beginning of 1997 it was 50,893,000.
The nature of internal migration has also changed. Traditionally, there had always been negative net migration in rural areas. Starting in 1992 it became positive. From 1992 through 1996 the net migration in rural areas was 78,700; 41,700; 500; 13,000 and 7,600 persons accordingly. This shows that during the period of impoverishment the urban population, which had not lost its connections with the village, sought to save themselves from poverty by returning to work on the land.

Fertility

The fall in living standards, unresolved ecological problems exacerbated by the Chornobyl catastrophe and socio-psychological discomfort, bred by a lack of faith in a better future to a substantially greater degree, than earlier forced couples to limit family size. The main cause for lowering fertility to a level insufficient to replace the population under current conditions was that, satisfying the needs in children, in parenthood competed with a string of other needs more elementary, i.e. lower living standards. The crude birth rate in 1996 was 9.1 children per 1000 population, 31.6% lower than in 1989. The total fertility rate, which is a summary index of fertility, declined from 1.9 in 1989 to 1.3 children in 1996 (from 1.8 to 1.2 in the urban areas and from 2.4 to 1.8 in the rural areas). Even in the villages, where fertility was traditionally higher than in urban areas, starting in 1993 this too has fallen below the level necessary for population replacement ( Table 2.2 ). The difference between this indicator in urban and rural areas during the years of growing economic crisis has grown, with fertility having declined faster in urban than in rural areas.
The declining birth rate is reflected in family structure. Even in 1989 among the 56% of families with children under 18 years, the majority, 52% were one child families. In the urban areas this segment was 55%, and in the rural areas - 44%. 39.5% had two children and only 8.4% had three or more children. As early as 1993, first and second children were 88% of all new-borns. Childlessness is growing. According to "Health-1996" survey data 19.3% of all women are childless. Marriage rates are declining and divorce rates are increasing. That increase lead to a 26% rise in the proportion of all children born out of wedlock during 1989-1996 ( Table 2.3 ).
"Health-1996" survey data indicates that the average of children wanted by married women is 1.95 (de facto two children), but current difficulties make this impossible. In 1996, 43% of women cited inadequate income level as their main reason why they do not have as many children as they would want. Simultaneously, women with primary education have the most children ( Table 2.4 ).
The birth rate in Ukraine must be considered extremely low. Fertility compensates for mortality by only 62% that is, it fails to provide for population replacement level. Changes which might enable women to have the number of children they desire are impossible given the current material conditions, such that the majority of the population has been pushed to the boundaries of poverty. A reversal of these unfavourable fertility dynamics must be connected first of all with overcoming the socio-economic crisis, but even today much can be done in this sphere. Further fertility decline means the loss of favourable demographic prospects for Ukraine.

Mortality and Life Expectancy

The sharp increase in the crude death rate in recent years (from 11.6 per 1000 population in 1989 to 15.2 in 1996) is related not only to the increase in the proportion of the elderly but also to the rise in premature deaths. Male life expectancy decreased from 66.2 in 1989 to 61.8 in 1996. Females fared somewhat better, their life expectancy declined from 75.2 in 1989 to 72.7 in 1996 ( Table 2.5 ). Male life expectancy decreased particularly in urban areas, although regional variations are also evident (Appendix I I: Table 2.6 ).
The increase in the annual number of deaths is accompanied by its rising in all age groups and the increase of premature deaths among men. In all age groups between 20-50, death rates for men are more than three times higher than those of women; and in the 30-34 group, they are four times higher. Today the difference in life expectancy for men and women is 11.2 years.
In the early 1990s infant mortality in Ukraine was lower than in other CIS states and even those of Central and Eastern Europe (CEE), but was double that of the European Union (EU) ( Table 2.7 ). While infant mortality has been decreasing in the EU, it is not decreasing in Ukraine.
There  are  some  striking  gender differences in infant and child mortality ( Table 2.8 ). In 1995, the death rate among infant boys in their first year of life exceeded that of girls by 30%, among 1-3 year olds by 20%, for 4-7 year olds by 44% and in 8-14 year olds by 77%; moreover, mortality among rural boys of this age was 1.2 times higher than for their urban counterparts. There is a tendency for mortality among boys to be higher than among girls. While the death rate of boys is usually higher than that of girls this difference does not generally  increase  with  age.   Factors contributing to this discrepancy in Ukraine may include, the difficulties of raising and caring for children and the increasing numbers of orphaned and homeless. In urban areas, the death rate among boys exceeds that of girls to the greatest extent in provinces with large industrial centres (Kharkiv, Dnipropetrovsk, Luhansk, and Donetsk oblasts) and in regions with large water basins or situated near the sea (Kherson oblast and the Autonomous Republic of the Crimea).

The Crisis of the Health Care System as a Factor Contributing to Negative Demographic Tendencies

The state of the health care system is an important complicating factor in the formation of both the quantitative and qualitative parameters of population reproduction. Today there is practically no preventive medicine, and curative medicine is degrading. The quality of medical services is in decline. Weakened by the crisis, the health care system, in the extraordinarily difficult conditions of its current existence, cannot neutralize the negative influence on public health the numerous socio-economic factors which have raised the risks of illness and death. Private and fee-for-service medicine does not compensate for the decline of state health care establishments because these services are too expensive to be used by a wide section of the population. According to the "Health-1996" survey, commercial health care services were reported as too expensive by 68.5% of those interviewed and only 14% had ever visited a private physician. Only 39.8% of those interviewed were able to buy the medicines they needed. 94.8% of the cases related to difficulties buying medicines were related to a lack of money.
The decline in public health is reflected in increasing morbidity. Compared with other countries Ukraine has a relatively high number of people classified as invalids. In addition, outbreaks of infectious diseases such as cholera and diphtheria have been observed at rates unprecedented in peacetime. In 1996, the rate of morbidity from diphtheria was 6.15 per 100,000. There has been a gradual rise of tuberculosis. In 1996 the contingent suffering from this disease rose by 5.7% compared to 1990. Alcoholism, drugs, and substance abuse are spreading. The number of HIV/AIDS cases is growing. The structure of mortality among the population of Ukraine indicates its poor state of health relative to that of the EU states ( Table 2.9 ).
In Ukraine in 1996, cardiovascular diseases were the leading cause of death (57.5% of deaths in 1995), neoplasms were second (16.6%) and the third most common cause of death (10.9%) included: accidents, homicides, suicides and other external events. The most common causes of death in the first year of life are conditions arising in the perinatal period (35%), followed by congenital anomalies (28.2%) and respiratory illness (8.6%) (Table 2.3 of the Appendix II).

Ageing of the Population

While the proportion of the population under 15 decreased by 6.5% during 1989-1996, the proportion of those eligible to receive pensions increased by 6.6%. The most significant  population  decrease  among children was seen in urban areas ( Table 2.10 ).
The age pyramid provides an overview of the impact of the decline in birth rates in recent years on the gender and age composition of the population. A reduction of the base of the pyramid means a reduction in favourable demographic and, consequently, social and economic prospects of Ukraine. From 1989 to 1996, the number of children in the age group up to 8 year old decreased while the age group of 8-14 year olds increased, the latter resulting from increase in birth rates between 1983 and 1986. Ukraine is becoming one of the most aged populations in the world.
As of the beginning of 1996 the mean age of the rural population was 37.6 years and of urban dwellers 36.5 years. Dependency ratio is 1.5 times higher in rural areas compared to urban ( Table 2.11 ), an important demographic factor in forming the standard of living in urban and rural areas.
The ageing of the population diminishes its demo-reproductive potential which resides in the age structure of a population. This will create problems in overcoming depopulation and, simultaneously, will have negative demographic consequences because societal productivity of labour in great measure depends on the age composition of the ablebodied population. The ageing of the population and the worsening of its health constitute factors which hinder overcoming both the demographic and socio-economic crisis.

Table 2.1 Birth Rates, Mortality Rates, and Rates of Natural Increase (Decrease) in Ukraine, 1989-1996 (┴)

YEARS	CRUDE RATES
	Birth rate			Mortality rate			Natural increase (decrease) rate
	Urban and rural areas	Urban areas	Rural areas	Urban and rural areas	Urban areas	Rural areas	Urban and rural areas	Urban areas	Rural areas
1989	13.3	13.6	12.9	11.6	9.8	15.2	1.7	3.8	-2.3
1990	12.7	12.7	12.7	12.1	10.2	16.1	0.6	2.5	-3.4
1991	12.1	11.9	12.6	12.9	10.8	17.2	-0.8	1.1	-4.6
1992	11.4	11.0	12.5	13.4	11.4	17.6	-2.0	-0.4	-5.1
1993	10.7	10.1	12.0	14.2	12.2	18.5	-3.5	-2.1	-6.5
1994	10.0	9.3	11.6	14.7	12.8	18.8	-4.7	-3.5	-7.2
1995	9.6	8.8	11.1	15.4	13.6	19.1	-5.8	-4.8	-8.0
1996	9.1	8.4	10.7	15.2	13.3	19.2	-6.1	-4.9	-8.5
1996 as percentage of 1989	68.4	61.8	82.9	131.0	135.7	126.3	-	-	369.6
Source: Data of the State Statistics Committee of Ukraine

 

Table 2.2 Total Fertility Rates* in Ukraine, 1989-1996 

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Years	Urban and rural areas	Urban areas	Rural areas	Urban as % of Rural
1989	1.935	1.781	2.390	74.5
1990	1.848	1.682	2.328	72.3
1991	1.771	1.590	2.317	68.6
1992	1.667	1.465	2.242	65.3
1993	1.551	1.353	2.096	64.6
1994	1.453	1.259	1.984	63.5
1995	1.379	1.192	1.879	63.4
1996	1.315	1.135	1.787	63.5
1996 as % to 1989	71.2	67.5	76.8	63.5
* The average number of children one woman would bear during her lifetime maintaining the existing birth rate for given year. Calculated by one-year age intervals as sum of age-specific fertility rates

 

Table 2.3 Proportion of Children Born Out of Wedlock 1990-1995 (as % of total number of births) 

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	1989	1990	1991	1992	1993	1994	1995	1996
Urban and Rural Areas	10.8	11.2	11.9	12.1	13.0	12.8	13.2	13.6
Urban areas	10.1	10.5	11.6	12.0	13.1	13.0	13.4	13.8
Rural areas	12.4	12.6	12.5	12.4	12.8	12.6	12.8	13.3
Source: Data of the State Statistics Committee of Ukraine

 

Table 2.4 Number of Children per Women by Education Level

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Education level	Urban and rural areas	Urban areas	Rural areas
No education or less than 4 years at school	0.76	0.55	1.17
Primary	1.90	1.40	2.40
Incomplete secondary or vocational school	1.31	1.08	1.58
Completed secondary or special vocational school	1.43	1.28	1.68
Special secondary or incomplete higher	1.29	1.24	1.46
Higher education	1.34	1.30	1.50
All levels of education	1.35	1.25	1.56

 

Table 2.5 Life Expectancy for the Newly Born in Ukraine in 1989-1996 (in years)* 

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Years	Urban and rural areas			Urban areas			Rural areas
	Males	Females	Total	Males	Females	Total	Males	Females	Total
1989	66.2	75.2	71.0	66.8	75.2	71.2	64.8	75.0	70.1
1990	65.4	74.9	70.5	66.3	74.9	70.8	64.2	74.6	69.4
1991	64.7	74.3	69.7	65.5	74.4	70.1	63.0	73.9	68.5
1992	63.9	74.1	69.1	64.5	74.1	69.4	62.5	73.7	68.1
1993	63.3	73.4	68.4	63.7	73.4	68.6	62.1	73.1	67.6
1994	62.5	73.0	67.8	62.9	72.9	67.9	61.6	72.8	67.1
1995	61.3	72.6	66.9	61.5	72.4	66.9	61.0	72.6	66.6
1996	61.6	72.8	67.1	61.9	72.8	67.3	61.0	72.7	66.7
e0° (1989)- e0° (1996)	-4.6	-2.4	-3.9	-4.9	-2.4	-3.9	-3.8	-2.3	-3.4
Source: Data of the State Committee on Statistics of Ukraine According to shortened life tables created by the Department of Demography and Labour Resources Reproduction of the Institute of Economics of the National Academy of Sciences of Ukraine.

 

Table 2.6 Infant Mortality Rates in Ukraine, 1989-1996

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	Deaths of children in the first year of life per 1000 births
	1989	1990	1991	1992	1993	1994	1995	1996
Total	12.9	12.8	13.9	14.0	14.9	14.5	14.7	14.3
Urban areas	12.9	12.5	13.5	13.8	14.7	14.1	14.3	14.4
Rural areas	12.9	13.5	14.7	14.4	15.4	15.2	15.3	14.3
Source: Data of State Statistics Committee of Ukraine

 

Table 2.7 Infant Mortality Rates in Europe (1990-1996) (per 1000 live births)* 

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Countries	1990	1991	1992	1993	1994	1995
Ukraine	12.8	13.9	14.0	14.9	14.5	14.7
USSR	22.0	-	-	-	-	-
CIS	-	23.0	24.0	24.5	23.5	-
Central and Eastern Europe	18.3	16.1	15.9	14.7	15.5	14.9
EU	7.6	7.4	6.9	6.5	6.2	-
*Differences in estimation of infant mortality across regions occur

 

Table 2.8 Mortality of Children up to 14 Years by Sex, 1995 (┴) 

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Age	Total			Boys			Girls
	Urban and rural areas	Urban areas	Rural areas	Urban and rural areas	Urban areas	Rural areas	Urban and rural areas	Urban areas	Rural areas
0	14.7	14.3	15.3	16.5	16.2	17.1	12.7	12.2	13.5
1-3	1.19	0.91	1.71	1.30	1.01	1.83	1.08	0.80	1.59
4-7	0.55	0.46	0.73	0.65	0.54	0.87	0.45	0.38	0.59
8-14	0.42	0.39	0.48	0.53	0.50	0.58	0.30	0.26	0.38
0-14	1.27	1.12	1.58	1.47	1.31	1.79	1.06	0.91	1.36

 

Table 2.9 Mortality by Cause of Death in the European Region in 1992 (per 100,000) 

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Cause	Ukraine	CIS	Central & Eastern Europe	EU
Cardiovascular diseases	690.3
Including:
Ischaemic heart disease	384.7	342.7	192.6	124.5
Malignant neoplasms	201.3	186.0	207.3	199.6
Including:
Cervical cancer	9.3	6.8	9.6	3.3
Breast cancer	25.9	19.7	24.8	31.0
Suicides, self-inflicted injury	22.5	24.7	19.5	12.0
Infectious, parasitic diseases	13.1	17.5	8.6	5.7
Diseases of respiratory system	73.8	72.2	58.4	52.3
Diseases of digestive system	36.4	38.1	49.1	35.0
Maternal mortality	31.3	42.0	21.0	7.4
Perinatal mortality	14.0	16.1	14.0	7.8
Infant mortality (under 1 year)	14.0	24.0	15.9	6.9
Early neonatal mortality	6.1	7.7	7.1	3.2
Source: Health For All Database, 1997; Data of the State Statistics Committee of Ukraine '1992 is latest comparative data available for the region. Classification systems may differ across regions.

 

Table 2.10 Age Composition of the Ukrainian Population in 1989 and 1996, % 

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Age	Urban and rural areas			Urban areas			Rural areas
	1989	1996	1996 as % of 1989	1989	1996	1996 as % of 1989	1989	1996	1996 as % of 1989
0-15	23.0	21.5	93.5	23.4	21.3	91.0	22.1	21.9	99.1
16-54(59)	55.8	55.9	100.2	59.0	59.2	100.3	49.6	48.9	98.6
55(60) and more	21.2	22.6	106.6	17.6	19.5	110.8	28.3	29.2	103.2
Total	100.0	100.0		100.0	100.0		100.0	100.0
Children
0	6.5	4.8	73.8	6.5	4.5	69.2	6.6	5.4	81.8
1-3	20.6	16.1	78.2	20.4	15.4	75.5	20.8	17.6	84.6
4-7	27.2	26.7	98.2	27.5	26.9	97.8	26.8	26.3	98.1
8-14	45.7	52.4	114.7	45.6	53.2	116.7	45.8	50.7	110.7
0-14	100.0	100.0		100.0	100.0		100.0	100.0

 

Table 2.11 Dependency ratio in 1989 and 1996, ┴ 

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	Urban and rural areas			Urban areas			Rural areas
	1989	1996	1996 as % to 1989	1989	1996	1996 as % to 1989	1989	1996	1996 as % to 1989
Total dependants	791	791	100.0	696	690	99.1	1017	1044	102.7
Including:
Children and adolescents	412	385	93.4	397	361	90.9	447	448	100.2
Persons older than able-bodied	379	406	107.1	299	329	110.0	570	596	104.6

 

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         Sourse: The Health of Women and Children in Ukraine. Kyiv 1997