Economics of diagnosis of disabilities among adults and children: evidence from Russia

This paper examines the economic and institutional determinants of disability registration in the Russian Federation between 2018 and 2024, with a particular focus on differences between adults and children. Using regional panel data across 86 regions grouped into eight federal districts, the study employs regression analysis to explore how GRP per capita, physician density, educational conditions, and crisis events affect disability detection and reporting. Results show that adult disability prevalence decreases with higher regional income and healthcare access, reflecting poverty-related morbidity and long-term health risks. In contrast, childhood disability registration is positively associated with regional affluence and physician supply, highlighting the role of diagnostic infrastructure rather than underlying morbidity. During systemic disruptions such as the COVID-19 pandemic and the Russia-Ukraine war, adult disability rates remained relatively stable, while childhood disability detection fell sharply, particularly in less resourced regions. A possible explanation of these findings is that adult disability rates primarily capture structural deprivation and chronic illness, whereas childhood disability reflects the strength and resilience of local diagnostic systems.