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Mortality in the former Soviet Union
Is it the vodka?
The short answer:
Yes
The Longer Answer:
Mortality Rates
Have fluctuated significantly over the last 20 years
Decreased between 1984 and 1994, then sharply increased
Have since declined to 1984 levels.
Life expectancyEuropean Union
Whole European Region
Central & E. Europe
Former Soviet Union
Causes of death
Alcohol directly (e.g., acute alcohol poisoning)
Alcohol indirectly:– Homicide– Suicide– Accidents– Heart disease
Who is dying?
Somewhat surprisingly, mortality rates for the most vulnerable portions of the population, the elderly and children, have remained stable
The deaths are occurring in 20 -45 year old men and women.
Of what are they dying?
Pneumonias (alcohol related) Sudden cardiac death (alcohol related) Infectious diseases Alcohol related diseases (cirrhosis and
alcohol poisoning) Accidents and violence (alcohol related) Cancer of the female breast (alcohol
related).
CCEE =Countries of Central & Eastern EuropeEU=European Union NIS = newly independent states
Of what are they not dying?
Neoplasms
Lung cancer deaths have actually declined, in spite of heavy tobacco use
Vodka
Tends to be drunk in binges Responsible for the deaths from acute
alcohol poisoning Mortality declined as consumption
decreased in the mid 1980s as a result of Gorbachev’s reforms
Even though consumption of substitutes increased (perfume).
It’s not just what you drink, it’s how you drink it Conventional wisdom held that alcohol had a
cardioprotective effect, regardless of the level of consumption
Data from Russia shows that binge drinking is associated with sudden cardiac death
Supported by data from Scotland “I don’t like Mondays”
Patients with no Hx of CAD likely to die on week ends or Mondays.
Social problems
Interact with alcohol
For example, failure of regulatory bodies
Standards not enforced for building codes, so public safety is compromised
Significant deaths from drowning and fires (e.g., sprinklers do not work)
Enforcement of drunk driving laws lessened.
Crime
Significantly increased
Somewhat area dependent
Accounts for deaths directly and indirectly.
Poverty
Surprisingly, wealthier areas more affected I.e., “the greatest declines in life expectancy
are in those regions that were the wealthiest in 1990 and have subsequently experienced the smallest declines in household income”
Why? Perhaps due to previously high wages for hard manual labour jobs; in Russia the link between income and education was less than elsewhere.
Health Services
Age groups affected are those with the least contact with health services
Causes of death relatively insensitive to medical care.
Rapid Social Change
Has affected alcohol consumption
Is the associated despair also an independent factor?