Upload
david-paul
View
224
Download
0
Embed Size (px)
DESCRIPTION
Life expectancy of some ethnic groups in the Former USSR in Source: Andreev et al., 1992
Citation preview
Ethnic Differentials of Mortality in Russia and the
Role of Socio-economic ConditionsNatalia S. Gavrilova*
Alla E. Ivanova**Victoria G. Semyonova**
Leonid A. Gavrilov*
Center on Aging, NORC and the University of Chicago, Chicago*
Institute of Public Health and Social Development, Moscow, Russia**
Background Ethnic Russians in the Former Soviet Union had
higher mortality at working ages compared to many other ethnic groups.
In 1989 ethnic Russians had the lowest life expectancy compared to many other ethnic groups (Andreev et al., 1992).
Earlier study: Differences between Latvians and Russians were equal to 16-17 years for life expectancy, and more than two-fold differences for infant mortality (Novoselsky 1916). These differences were related not only to the living conditions but also to religion and cultural traditions.
Life expectancy of some ethnic groups in the Former USSR in
1988-1989
Source: Andreev et al., 1992
In Many Republics of the Former Soviet Union Ethnic
Differentials in Mortality Increased After the
Independence
Ethnicity and Mortality in Estonia:Ethnic differences increased after
independence
Ethnic Composition 2009
Data from Statistics Estonia Leinsalu, 2004, Figure 1, p. 584
Ethnicity and Mortality in Kyrgyzstan:Ethnic differences also increased after
independenceRecorded trends in adult mortality (20-60 years)
0.10
0.20
0.30
0.40
q206
0
1960 1970 1980 1990 2000y ear
russian ky rgy zslv cas
Males
0.10
0.20
0.30
0.40
q206
0
1960 1970 1980 1990 2000y ear
russian ky rgy zslv cas
Females
Kyrgyzstan, 40q20
Source: Guillot et al., 2007
Current problems in studying ethnic mortality
in Russia1997 Russian state law on vital
statistics: Ethnicity (and many other
characteristics) was excluded from the official (ZAGS) death certificates and hence from the official mortality statistics
This information still remains in medical death certificates, although in many cases it is not recorded
Our Approach To use a proportion of ethnic Russians
in population (taken from 2002 census) as a measure of ethnic composition that may affect mortality
Outcome variable: Mortality at working ages (15-59 years) in 78 Russian regions in 2003.
Control for alcohol consumption and socio-economic and demographic variables (Rosstat publications and database)
Mortality of men at working ages and proportion of Russians in population
r=0.51 (p<0.001)
Mortality of women at working ages and proportion of Russians in
population
r=0.33 (p<0.005)
Explanatory variables Proportion of ethnic Russians in region Proxy for alcohol consumption (deaths per
100,000 persons of working age due to alcohol poisoning)
Socio-economic characteristics: Gini coefficient, gross regional product, unemployment, poverty, price index (measure of inflation), percent of educated workforce
Demographic characteristics: divorce rate, net migration rate, number of women per 1000 men
The Model Ordinary least squares regression
Initial model: Ln (Mortality rate15-59) = α + β1 (gini) + β2
(grp)+β3 (migration) + β4 (russians) + β5 (poverty) + β6 (divorce) + β7 (sex ratio) + β8 (unemployment) + β9 (urban) + β10 (alcohol) + β11 (education) + β12 (price index)
Statistically significant variable interactions were also found and added to the model.
Variables with significant effects on mortality for both men and
womenRegression coefficients (p-value)
Variable Men Women
Russians 0.0018 (0.007) 0.0025 (0.003)
Unemployment 0.3175 (0.032) -0.0217 (0.001)
Price Index (Inflation) 0.0435 (0.001) 1.3316 (0.015)
% Urban population 0.3175 (0.032) 0.0052 (0.001)
Unemployment x Alcohol
0.0004 (<0.001) 0.0005 (<0.001)
Migration x Alcohol 0.00003 (0.003) 0.00005 (0.002)
Adjusted R2 0.82 0.81
Russians and alcohol
Studies of ethnic mortality in Estonia and Kyrgyzstan showed that significant proportions of excess deaths among Russians is due to causes related to alcohol consumption.
Alcohol-related Causes of Death(Chronic alcoholism, Alcohol psychoses, Alcohol cirrhosis
of the liver, Accidental poisoning by alcohol) Age-standardized Death Rates at working ages (per
100,000)
0
5
10
15
20
25
30
35
40
45
50
Males Females
CASlavs
Source: Guillot et al., 2007
Russians and alcohol
We may expect that proportion of Russians and alcohol consumption should be strongly correlated
However, correlation between these two variables turn out to be small and non-significant: r=0.13 (p=0.26)
Alcohol consumption and proportion of ethnic Russians in population
r=0.13 (p=0.26)
Alcohol consumption and proportion of ethnic Russians in population
when Tyva and Altay are excluded
r=0.31 (p=0.0063)
What about interaction between alcohol and
unemployment? This may be an indicator of population
marginalization (high proportion of socially disadapted people – unemployed, homeless, low-skilled, etc.)
Source: Ivanova AE, Semyonova VG , Dubrovina E (2004). Marginalization of Russian mortality. Demoscope Weekly [Russian electronic edition].
Social structure of young men (16-39) died in 2004 in Kirov region
Source: Ivanova et al., 2004
Conclusions Proportion of Russians is a significant
independent predictor of regional mortality at working age in Russia (for both men and women)
However, correlation between proportion of Russians and alcohol consumption is more complex, because some ethnic minorities in Russia demonstrate both high mortality and high consumption of alcohol
Limitations: cross-sectional study, problems with measurement