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Mortality in the former Soviet Union

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 expectancy.

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Mortality in the former Soviet Union

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  1. Mortality in the former Soviet Union

  2. Is it the vodka?

  3. The short answer: Yes

  4. The Longer Answer:

  5. Mortality Rates • Have fluctuated significantly over the last 20 years • Decreased between 1984 and 1994, then sharply increased • Have since declined to 1984 levels.

  6. Life expectancy European Union Whole European Region Central & E. Europe Former Soviet Union

  7. Causes of death • Alcohol directly (e.g., acute alcohol poisoning) • Alcohol indirectly: • Homicide • Suicide • Accidents • Heart disease

  8. 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.

  9. 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).

  10. CCEE =Countries of Central & Eastern EuropeEU=European Union NIS = newly independent states

  11. Of what are they not dying? • Neoplasms • Lung cancer deaths have actually declined, in spite of heavy tobacco use

  12. 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).

  13. 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.

  14. 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.

  15. Crime • Significantly increased • Somewhat area dependent • Accounts for deaths directly and indirectly.

  16. 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.

  17. Health Services • Age groups affected are those with the least contact with health services • Causes of death relatively insensitive to medical care.

  18. Rapid Social Change • Has affected alcohol consumption • Is the associated despair also an independent factor?

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