and Zaporizhzhia oblasts of Ukraine, and South Ossetia and Abkhazia in Georgia. Employment and income Unemployment, youth ages 15–24 total: 16%. Country comparison to the world: 83rd male: 15.3% female: 16.9% (2015 est.) Health Russia, by constitution, guarantees free, universal health care for all Russian citizens, through a compulsory state health insurance program. The Ministry of Health of the Russian Federation oversees the Russian public healthcare system, and the sector employs more than two million people. Federal regions also have their own departments of health that oversee local administration. A separate private health insurance plan is needed to access private healthcare in Russia. Russia spent 5.32% of its GDP on healthcare in 2018. Its healthcare expenditure is notably lower than other developed nations. Russia has one of the world's most female-biased sex ratios, with 0.859 males to every female, due to its high male mortality rate. In 2019, the overall life expectancy in Russia at birth was 73.2 years (68.2 years for males and 78.0 years for females), and it had a very low infant mortality rate (5 per 1,000 live births). The principal cause of death in Russia are cardiovascular diseases. Obesity is a prevalent health issue in Russia; 61.1% of Russian adults were overweight or obese in 2016. However, Russia's historically high alcohol consumption rate is the biggest health issue in the country, as it remains one of the world's highest, despite a stark decrease in the last decade. Smoking is another health issue in the country. The country's high suicide rate, although on the decline, remains a significant social issue. COVID-19 pandemic Russia had one of the highest number of confirmed cases in the world. Analysis of excess deaths from official government demographic statistics, based on births and deaths and excluding migration, showed that Russia had its biggest ever annual population drop in peacetime, with the population declining by 997,000 between October 2020 and September 2021, which demographer Alexei Raksha interpreted as being primarily due to the COVID-19 pandemic. Ethnic groups Russia is a multinational state, with many subnational entities associated with different minorities. There are over 193 ethnic groups nationwide. In the 2021 census, roughly 71.7% of the population were ethnic Russians, and the remaining 16.7% of the population were ethnic minorities with 11.6% not stating an ethnicity. In 2010, four-fifths of Russia's population originated from West of the Ural Mountains — of which the vast