The Russian Constitution guarantees free, universal health care for all citizens. While Russia has more physicians, hospitals, and health care workers than almost any other country in the world on a per capita basis, since the collapse of the Soviet Union the health of the Russian population has declined considerably as a result of social, economic, and lifestyle changes. As of 2007, the average life expectancy in Russia is 61.5 years for males and 73.9 years for females. The average Russian life expectancy of 67.7 years at birth is 10.8 years shorter than the overall figure in the European Union. 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). Mortality among Russian men rose by 60% since 1991, four to five times higher than in Europe. As a result of the large difference in life expectancy between men and women and because of the lasting effect of World War II, where Russia lost more men than any other nation in the world, the gender imbalance remains to this day and there are 0.859 males to every female.Heart diseases account for 56.7% of total deaths, with about 30% involving people still of working age. About 16 million Russians suffer from cardiovascular diseases, placing Russia second in the world, after Ukraine, in this respect. Death rates from homicide, suicide and cancer are also especially high. According to a 2007 survey by Romir Monitoring, 52% of men and 15% of women smoke. More than 260,000 lives are lost each year as a result of tobacco use. HIV/AIDS, virtually non-existent in the Soviet era, rapidly spread following the collapse, mainly through the explosive growth of intravenous drug use. According to official statistics, there are currently more than 364,000 people in Russia registered with HIV, but independent experts place the number significantly higher. In increasing efforts to combat the disease, the government increased spending on HIV control measures 20-fold in 2006, and the 2007 budget doubled that of 2006. Since the Soviet collapse, there has also been a dramatic rise in both cases of and deaths from tuberculosis, with the disease being particularly widespread amongst prison inmates.
In an effort to stem Russia’s demographic crisis, the government is implementing a number of programs designed to increase the birth rate and attract more migrants to alleviate the problem. The government has doubled monthly child support payments and offered a one-time payment of 250,000 Rubles (around US$10,000) to women who had a second child since 2007. In 2007, Russia saw the highest birth rate since the collapse of the USSR. The First Deputy PM also said about 20 billion rubles (about US$1 billion) will be invested in new prenatal centres in Russia in 2008–2009. Immigration is increasingly seen as necessary to sustain the country's population.
