The Huge Reduction in Adult Male Mortality in Belarus and Russia: Is It Attributable to Anti-Alcohol Measures?
The Huge Reduction in Adult Male Mortality in Belarus and Russia: Is It Attributable to Anti-Alcohol Measures?
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DOI：
10.1371/journal.pone.0138021
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Andreev EM
中科院分区：
文献类型：
--
作者：
Grigoriev P;Andreev EM
长期以来，有害的酒精消费被认为是前苏联欧洲国家男性过早死亡的主要决定因素。我们这里的重点是白俄罗斯和俄罗斯，这两个斯拉夫国家继续深受有害饮酒负担之害。然而，在长期恶化之后，这些国家的死亡率趋势在过去十年中有所改善。我们的目的是调查在多大程度上，最近在白俄罗斯和俄罗斯的成年人死亡率下降是由于这两个国家在2000年代推出的反酒精措施。我们依赖于1980-2013年期间详细的特定原因死亡率系列。我们的分析集中在男性人口，只考虑了有限的死亡原因，我们标记为酒精相关：意外酒精中毒，肝硬化，缺血性心脏病，中风，交通事故，和其他外部原因。对于每一种原因，我们计算了年龄标准化死亡率。使用寿命表分解方法确定了导致预期寿命随时间变化的年龄组和死亡原因。我们的研究结果并没有使我们得出结论，反酒精措施的时间表对应的死亡率变化的时间表。白俄罗斯和俄罗斯成年男性死亡率持续下降不能完全用这些国家实施的禁酒政策来解释，尽管这些政策可能有助于白俄罗斯和俄罗斯2005-2006年以及白俄罗斯2012年死亡率大幅下降。因此，这些政策的效果似乎不大。我们认为，在白俄罗斯和俄罗斯实施的反酒精措施与过去与酒精有关的死亡率的波动相吻合。如果这些趋势没有发生，这些巨大的死亡率影响就不会发生。
Harmful alcohol consumption has long been recognized as being the major determinant of male premature mortality in the European countries of the former USSR. Our focus here is on Belarus and Russia, two Slavic countries which continue to suffer enormously from the burden of the harmful consumption of alcohol. However, after a long period of deterioration, mortality trends in these countries have been improving over the past decade. We aim to investigate to what extent the recent declines in adult mortality in Belarus and Russia are attributable to the anti-alcohol measures introduced in these two countries in the 2000s. We rely on the detailed cause-specific mortality series for the period 1980–2013. Our analysis focuses on the male population, and considers only a limited number of causes of death which we label as being alcohol-related: accidental poisoning by alcohol, liver cirrhosis, ischemic heart diseases, stroke, transportation accidents, and other external causes. For each of these causes we computed age-standardized death rates. The life table decomposition method was used to determine the age groups and the causes of death responsible for changes in life expectancy over time. Our results do not lead us to conclude that the schedule of anti-alcohol measures corresponds to the schedule of mortality changes. The continuous reduction in adult male mortality seen in Belarus and Russia cannot be fully explained by the anti-alcohol policies implemented in these countries, although these policies likely contributed to the large mortality reductions observed in Belarus and Russia in 2005–2006 and in Belarus in 2012. Thus, the effects of these policies appear to have been modest. We argue that the anti-alcohol measures implemented in Belarus and Russia simply coincided with fluctuations in alcohol-related mortality which originated in the past. If these trends had not been underway already, these huge mortality effects would not have occurred.