A significant number of Russian men are drinking products that have either very high concentrations of ethanol or contaminants known to be toxic. These products are untaxed and thus much less expensive than vodka. There is an urgent need for policy responses that target their production and consumption.
The health situation in Russia has often been characterized as a long‐running crisis. From the 1960s until the beginning of the 2000s, the declining life expectancy trend was substantially interrupted only twice: once in the mid‐1980s as a result of Gorbachev's anti‐alcohol campaign, and again at the end of the 1990s as a result of the “rebound” effect following the dramatic rise in mortality associated with the acute socioeconomic crisis. In both cases, the progress made proved to be short‐lived. A third mortality decline in Russia began in 2003 and is still ongoing. We investigate the components and driving forces of this new development, in particular the role played by cardiovascular diseases. Using cause‐specific mortality data, we identify the main features of the recent improvements and compare these features with those observed in selected European countries, specifically France, Poland, and Estonia. Our aim is to gauge whether the features of the improvements in these countries are similar to those of the recent advancements made in Russia. Although the recent improvements in Russia have features in common with initial stages of prior mortality declines in other countries and may support optimism about the future, a return to mortality stagnation cannot be ruled out.
Patterns of diversity in age at death are examined using e † , a dispersion measure that equals the average expected lifetime lost at death. We apply two methods for decomposing differences in e † . The first method estimates the contributions of average levels of mortality and mortality age structures. The second (and newly developed) method returns components produced by differences between age-and cause-specific mortality rates. The United States is close to England and Wales in mean life expectancy but has higher life expectancy losses and lacks mortality compression. The difference is determined by mortality age structures, whereas the role of mortality levels is minor. This is related to excess mortality at ages under 65 from various causes in the United States. Regression on 17 country-series suggests that e † correlates with income inequality across countries but not across time. This result can be attributed to dissimilarity between the age-and cause-of-death structures of temporal mortality reduction and intercountry mortality variation. It also suggests that factors affecting overall mortality decrease differ from those responsible for excess lifetime losses in the United States compared with other countries. The latter can be related to weaknesses of health system and other factors resulting in premature death from heart diseases, amenable causes, accidents and violence.
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