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.