Causes of declining life expectancy in Russia
Causes of declining life expectancy in Russia
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DOI：
10.1001/jama.279.10.793
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发表时间：
1998-03-11
影响因子：
120.7
通讯作者：
Sempos, EV
中科院分区：
文献类型：
--
作者：
Notzon, FC;Komarov, YM;Sempos, EV
背景。俄罗斯人的预期寿命在1990年代急剧下降，但主要死亡原因对这一下降的影响尚未得到衡量。为了评估苏联解体后俄罗斯预期寿命急剧下降的原因，设计。死亡率和出生率数据来自俄罗斯和美国的生命统计系统，设置。俄罗斯，1990- 1994年，人口俄罗斯的全部人口，主要结果变量。死亡率，预期寿命和预期寿命变化的贡献，方法。应用标准寿命表方法按年计算预期寿命，并采用分区方法评估特定死亡原因和年龄组对预期寿命总体下降的贡献，美国数据用于比较目的，结果。1990年至1994年间，俄罗斯的经性别调整的死亡率上升了近33%，在此期间，俄罗斯男性和女性的预期寿命分别从63.8岁和74.4岁急剧下降到57.7岁和71.2岁，而在美国，男性和女性的预期寿命分别从71.8岁和78.8岁增加到72.4岁和79.0岁，预期寿命下降的75%以上是由于25至64岁年龄段的死亡率增加。总体而言，心血管疾病（心脏病和中风）和伤害占预期寿命下降的65%，而包括肺炎和流感在内的传染病占5.8%，慢性肝病和肝硬化占2.4%，其他酒精相关原因占9.6%，癌症占0.7%。心血管疾病死亡率的增加占女性预期寿命下降的41.6%，占男性预期寿命下降的33.4%，而腿部受伤、福尔斯、职业伤害、机动车碰撞、自杀和凶杀的死亡率增加占男性预期寿命下降的32.8%，占女性预期寿命下降的21.8%。俄罗斯死亡率的惊人上升超出了工业化国家和平时期的经验，预期寿命在4年内下降了5年，许多因素似乎同时起作用，包括经济和社会不稳定，烟草和酒精消费率高，营养不良，抑郁症和医疗保健系统恶化，数据质量和报告方面的问题似乎无法解释这些调查结果，这些结果清楚地表明，健康和预期寿命的大幅下降可能会迅速发生。
Context.-Russian life expectancy has fallen sharply in the 1990s, but the impact of the major causes of death on that decline has not been measured.Objective.-To assess the contribution of selected causes of death to the dramatic decline in life expectancy in Russia in the years following the breakup of the Soviet Union,Design.-Mortality and natality data from the vital statistics systems of Russia and the United States,Setting.-Russia, 1990-1994,Population.-Entire population of Russia,Main Outcome Variables.-Mortality rates, life expectancy, and contribution to change in life expectancy,Methods.-Application of standard life-table methods to calculate life expectancy by year, and a partitioning method to assess the contribution of specific causes of death and age groups to the overall decline in life expectancy, United States data presented for comparative purposes,Results.-Age-adjusted mortality in Russia rose by almost 33% between 1990 and 1994, During that period, life expectancy for Russian men and women declined dramatically from 63.8 and 74.4 years to 57.7 and 71.2 years, respectively, while in the United States, life expectancy increased for both men and women from 71.8 and 78.8 years to 72.4 and 79.0 years, respectively, More than 75% of the decline in life expectancy was due to increased mortality rates for ages 25 to 64 years. Overall, cardiovascular diseases (heart disease and stroke) and injuries accounted for 65% of the decline in life expectancy while infectious diseases, including pneumonia and influenza, accounted for 5.8%, chronic liver diseases and cirrhosis for 2.4%, other alcohol-related causes for 9.6%, and cancer for 0.7%. Increases in cardiovascular mortality accounted for 41.6% of the decline in life expectancy for women and 33.4% for men, while increases in mortality from injuries leg, falls, occupational injuries, motor vehicle crashes, suicides, and homicides) accounted for 32.8% of the decline in life expectancy for men and 21.8% for women.Conclusion.-The striking rise in Russian mortality is beyond the peacetime experience of industrialized countries, with a 5-year decline in life expectancy in 4 years' time, Many factors appear to be operating simultaneously, including economic and social instability, high rates of tobacco and alcohol consumption, poor nutrition, depression, and deterioration of the health care system, Problems in data quality and reporting appear unable to account for these findings, These results clearly demonstrate that major declines in health and life expectancy can take place rapidly.