We examined mortality among working-age Russian men whose identity could not be determined, focusing on where and how they died.
Employing micro-data from deaths that occurred in Izhevsk (Ural region) between June 2004 and September 2005, we analysed the characteristics of decedent men aged 25-54 (n = 2158). Differences between completely identified (n = 1699) and unidentified deaths (n = 282) were compared via logistic regression. Data on all deaths in Russia in 2002 were used for supplemental comparisons.
We found that relative to identified men, unidentified men were at a higher risk of death from exposure to natural cold, violence, alcoholic cardiomyopathy, acute respiratory infections and poisonings. Our results also revealed that alcohol played an important role in the mortality of unidentified men. The places and causes of death among these unidentified men provide substantial evidence of their homelessness and social isolation.
The increase in deaths among unidentified men of working-age indicates the emergence of a health threat associated with homelessness and social marginalization. This vulnerable group is exposed to different levels and causes of mortality compared with the larger population and represent a new challenge that requires serious and immediate scholarly attention and policy responses.
We examined the role of socio-economic status (SES) and marital status in premature mortality among working-age Russian males. Life expectancy among this group dropped sharply following the collapse of the Soviet Union and has yet to recover despite the relative economic and political stability of the last decade.
We employed individual-level data from a large-scale, population-based, case-control study (n = 3500). Adjusting for age group, hazardous drinking and smoking status, we estimated mortality odds ratios to determine the impact of SES and marital status on premature mortality due to all, alcohol- and non-alcohol-related causes of death.
Results revealed clear protective effects of SES and marital status against premature mortality. Although the effects for marital status were significant across alcohol- and non-alcohol-related causes of death, the effects of SES were largely limited to non-alcohol-related causes of death. When heavy drinkers were excluded from the analysis, however, SES was found to protect against premature mortality for alcohol-related causes.
While hazardous drinking is known to be a leading cause of premature mortality among working-age Russian males, it is unwise to ignore other factors. Given the substantial social and economic impacts in Russia of the dissolution of the Soviet Union, it is important to examine the health effects of SES and marital status and other social forces in the nation. Our results reveal that while Russia has a very different past in terms of medicine, public health and economic institutions, it currently faces public health threats that follow similar patterns to those found in Western nations.
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The aim of this study was to determine the impact of a set of 2006 Russian alcohol policies on alcohol-related mortality in the country.
We used autoregressive integrated moving average interrupted time series techniques to model the impact of the policy on the number of sex-specific monthly deaths of those aged 15+ years due to alcohol poisoning, alcoholic cardiomyopathy, alcoholic liver cirrhosis, and alcohol-related mental and behavioral disorders. The time series began in January 2000 and ended in December 2010. The alcohol policy was implemented in January 2006.
The alcohol policy resulted in a significant gradual and sustained decline in male deaths due to alcohol poisoning (?o = -92.631, p
To determine the impact of a suite of 2006 Russian alcohol control policies on deaths due to traffic accidents in the country.
We used autoregressive integrated moving average (ARIMA) interrupted time-series techniques to model the impact of the intervention on the outcome series. The time-series began in January 2000 and ended in December 2010. The alcohol policy was implemented in January 2006, providing 132 monthly observations in the outcome series, with 72 months of pre-intervention data and 60 months of post-intervention data.
The outcome variables were the monthly number of male- and female-specific deaths of those aged 15+ years due to transport accidents in Russia.
The 2006 set of alcohol policies had no impact on female deaths due to traffic accidents (?0 ?= -50.31, P = 0.27). However, the intervention model revealed an immediate and sustained monthly decrease of 203 deaths due to transport accidents for males (?0 ?= -203.40, P = 0.04), representing an 11% reduction relative to pre-intervention levels.
The implementation of the suite of 2006 Russian alcohol control policies is partially responsible for saving more than 2400 male lives annually that would otherwise have been lost to traffic accidents.
To estimate the association between hazardous drinking and suicide among working-age Russian males.
Data are from the Izhevsk Family Study (IFS), a population-based case-control study of premature mortality among working-age Russian men. The present study used two sets of cases: all men aged 25-54 years living in Izhevsk who, during October 2003-October 2005, (i) died of suicide (n?=?120) or (ii) died of suicide or of injuries of undetermined intent (n?=?231). Controls were selected at random from a city population register. Drinking data were obtained from proxy informants living in the same household as cases and controls. Drinking exposures were defined by liters of ethanol consumed as a continuous variable, liters of ethanol as a categorical variable, frequency of consumption of non-beverage alcohol (e.g. colognes, medicines, cleaning fluids) and a measure of problem drinking based on behavioral indicators. The association between hazardous drinking and suicide was estimated by mortality odds ratios, adjusting for age, marital status, education and smoking status.
A total of 57% of cases and 20% of controls were problem drinkers. Men who drank 20+ liters of ethanol in the prior year were 2.7 times more likely [95% confidence interval (CI)?=?1.5-5.0] to die from suicide than moderate drinkers. Men who drank non-beverage alcohols one to two times/week were 3.9 times more likely (95% CI, 1.3-11.0) to die from suicide than men who rarely or never drank them. Problem drinkers were 3.7 times more likely (95% CI, 2.5-5.6) to die from suicide relative to non-problem drinkers. Forty-three per cent of suicides were attributed to hazardous drinking (problem drinking or consuming non-beverage alcohol at least once/week or both).
Hazardous drinking substantially increases the risk of suicide among working-age Russian males, with nearly half of all suicides attributed to this drinking pattern.
The Russian homicide rate more than tripled between 1988 and 1994 and is now among the highest in the world. This dramatic increase, together with newly available data from a post-Soviet Russian government that is becoming more transparent, has led to a growing number of studies of homicide in Russia. As of yet, however, there has been no systematic evaluation of the homicide reporting systems in the country. This article examines the comparability of the two main sources of homicide estimates in Russia, crime data from the Ministry of the Interior and mortality data from the vital statistics registration system. These estimates are compared annually and by administrative region. Annual estimates from the vital statistics reporting system have reported an average of nearly 40% more homicides than the crime reporting system over the last decade and a half. Regionally, mortality estimates are higher than crime estimates in 66 of 78 regions, and eight of the 12 regions where crime estimates are higher are in areas where previous validation procedures suggest mortality data are suspect. As the regional homicide rate increases, so does the gap between the two estimates. Case definitions of these sources lead us to expect small discrepancies between them, but this does not account for the large differences revealed here. Both systems under-report, for different reasons, and some of the under-enumeration in both systems is purposeful and/or results from a lack of human and monetary resources. Mortality data are probably better for most purposes, especially when comparing Russia to other nations and when estimating causal models. Both systems should be used with caution, however, and the choice between them should depend on the nature of each study.
While Russia perennially has one of the highest suicide rates in the world, researchers had little access to valid data during the Soviet era to examine this issue. Transparency increased following the dissolution of the USSR, and this article employs newly available vital statistics data to describe the demographic, temporal, and spatial patterns of suicide in Russia. The discussion reveals that suicide mortality in Russia is among the highest in the world and is more than three times higher than in the United States; exhibited radical changes between 1984 and 1994; varies widely within the country, with a general increase in rates from west to east; and is highest among working-age males.
William Alex Pridemore is with the Department of Criminal Justice and Criminology, Andrew Young School of Policy Studies, Georgia State University, Atlanta. Mitchell B. Chamlin is with the Department of Criminal Justice, Texas State University-San Marcos. Evgeny Andreev is with the Center for Demographic Research, the New Economic School, Moscow, Russia.
We took advantage of a natural experiment to assess the impact on suicide mortality of a suite of Russian alcohol policies.
We obtained suicide counts from anonymous death records collected by the Russian Federal State Statistics Service. We used autoregressive integrated moving average (ARIMA) interrupted time series techniques to model the effect of the alcohol policy (implemented in January 2006) on monthly male and female suicide counts between January 2000 and December 2010.
Monthly male and female suicide counts decreased during the period under study. Although the ARIMA analysis showed no impact of the policy on female suicide mortality, the results revealed an immediate and permanent reduction of about 9% in male suicides (Ln ?0 = -0.096; P = .01).
Despite a recent decrease in mortality, rates of alcohol consumption and suicide in Russia remain among the highest in the world. Our analysis revealed that the 2006 alcohol policy in Russia led to a 9% reduction in male suicide mortality, meaning the policy was responsible for saving 4000 male lives annually that would otherwise have been lost to suicide. Together with recent similar findings elsewhere, our results suggest an important role for public health and other population level interventions, including alcohol policy, in reducing alcohol-related harm.
Assess the impact of heavy drinking on homicide and suicide mortality in Russia between 1956 and 2002. MEASURES AND DESIGN: Alcohol-related mortality was used as a proxy for heavy drinking. We used autoregressive integrated moving average techniques to model total and sex-specific alcohol-homicide and alcohol-suicide relationships at the population level.
We found a positive and significant contemporaneous association between alcohol and homicide and between alcohol and suicide. We found no evidence of lagged relationships. These results held for overall and sex-specific associations.
Our results lend convergent validity to the alcohol-suicide link in Russia found by Nemtsov and to the alcohol-homicide associations found in cross-sectional analyses of Russia. Levels of alcohol consumption, homicide and suicide in Russia are among the highest in the world, and the mounting evidence of the damaging effects of consumption on the social fabric of the country reveals the need for intervention at multiple levels.