Evgeny Andreev

Reduction in Male Suicide Mortality Following the 2006 Russian Alcohol Policy: An Interrupted Time Series Analysis

OBJECTIVES We took advantage of a natural experiment to assess the impact on suicide mortality of a suite of Russian alcohol policies. METHODS 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. RESULTS 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 ω0 = -0.096; P = .01). CONCLUSIONS 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.

The effects of the 2006 Russian alcohol policy on alcohol-related mortality: An interrupted time series analysis

BACKGROUND 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. METHODS 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. RESULTS The alcohol policy resulted in a significant gradual and sustained decline in male deaths due to alcohol poisoning (ωo = -92.631, p < 0.008, δ1 = 0.883, p < 0.001) and in significant immediate and sustained declines in male (ω0 = -63.20, p < 0.05) and female (ω0 = -64.28, p < 0.005) deaths due to alcoholic liver cirrhosis. CONCLUSIONS The 2006 suite of alcohol policies in Russia was responsible for an annual decline of about 6,700 male alcohol poisoning deaths and about 760 male and about 770 female alcoholic liver cirrhosis deaths. Without the alcohol policy, male alcohol poisoning deaths would have been 35% higher and male and female alcoholic liver cirrhosis deaths would have been 9 and 15% higher, respectively. We contextualize our findings in relation to declining mortality in Russia and to results from recent studies of the impact of this law on other causes of death.

The impact of a national alcohol policy on deaths due to transport accidents in Russia

AIMS To determine the impact of a suite of 2006 Russian alcohol control policies on deaths due to traffic accidents in the country. DESIGN, SETTING AND PARTICIPANTS 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. MEASUREMENTS The outcome variables were the monthly number of male- and female-specific deaths of those aged 15+ years due to transport accidents in Russia. FINDINGS The 2006 set of alcohol policies had no impact on female deaths due to traffic accidents (ω0  = -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 (ω0  = -203.40, P = 0.04), representing an 11% reduction relative to pre-intervention levels. CONCLUSION 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.

Long-term trends in the longevity of scientific elites: Evidence from the British and the Russian academies of science

National science academies represent intellectual elites and vanguard groups in the achievement of longevity. We estimated life expectancy (LE) at age 50 of members of the British Royal Society (RS) for the years 1670–2007 and of members of the Russian Academy of Sciences (RAS) for the years 1750–2006. The longevity of academicians was higher than that of their corresponding national populations, with the gap widening from the 1950s. Since the 1980s, LE in the RS has been higher than the maximum LE among all high-income countries. In each period, LE in the RS was greater than in the RAS, although since the 1950s it has risen in parallel in the two academies. This steep increase shared by academicians in Britain and Russia suggests that general populations have the potential for a substantial increase in survival to high ages.

The Huge Reduction in Adult Male Mortality in Belarus and Russia: Is It Attributable to Anti-Alcohol Measures?

Background and Aim 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. Data and Methods 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. Conclusion 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.

Do people who experience incarceration age more quickly? Exploratory analyses using retrospective cohort data on mortality from Ontario, Canada

Objectives We aimed to explore whether mortality data are consistent with the view that aging is accelerated for people with a history of incarceration compared to the general population, using data on mortality rates and life expectancy for persons in Ontario, Canada. Methods We obtained data from the Ontario Ministry of Community Safety and Correctional Services on all adults admitted to provincial correctional facilities in Ontario in 2000, and linked these data with death records from provincial vital statistics between January 1, 2000 and December 31, 2012. We used life table methods to calculate mortality rates and life expectancies for this cohort by sex and 5-year age group. We similarly generated population comparison rates using publicly available data for the general population of Ontario in 2006 as the midpoint of the follow up period. We compared these mortality indices between the 2000 Ontario prison cohort and the general population by age group and sex. Results The difference in all-cause mortality rates between the 2000 Ontario prison cohort and the general population was greatest for younger adults, with the prison cohort experiencing rates of death that would be expected for persons at least 15 years older at ages 20 to 44 for men and ages 20 to 59 for women. Life expectancy in the 2000 Ontario prison cohort was most similar to life expectancy of persons five years older in the general population at age intervals 20 to 45 in men and 20 to 30 in women. Conclusions For most of adulthood, life expectancy and mortality rates are worse for adults with a history of incarceration than for the general population in Ontario, Canada. However, the association between mortality and incarceration status is modified by age, with the greatest relative burden of mortality experienced by younger persons with a history of incarceration and modified by sex, with worse relative mortality in women. Future research should explore the association between incarceration status and markers of aging including mortality, morbidity and physical appearance.

High Life Expectancy of Muscovites Over Age 80: Reality or a Statistical Artifact?

The mortality of advanced-age residents of Russia has remained stable and high for several decades. However, the steady increase in life expectancy that started in the mid-2000s is largely due to decreased mortality among the elderly. The decrease in mortality among Moscow residents over age 80 was especially large during this period. We found evidence of a systematic deviation of these dynamics from the patterns observed in countries with reliable mortality statistics. Assuming that the patterns observed in these countries are applicable to Russia, we took the possible underestimation of mortality into account and corrected the life expectancy estimates for the residents of Moscow, Russia, and the Central Federal District at age 80, at retirement age, and at birth.

Decomposing Current Mortality Differences Into Initial Differences and Differences in Trends: The Contour Decomposition Method

This study proposes a new decomposition method that permits a difference in an aggregate measure at a final time point to be split into additive components corresponding to the initial differences in the event rates of the measure and differences in trends in these underlying event rates. For instance, when studying divergence in life expectancy, this method allows researchers to more easily contrast age-specific mortality trends between populations by controlling for initial age-specific mortality differences. Two approaches are assessed: (1) an additive change method that uses logic similar to cause-of-death decomposition, and (2) a contour decomposition method that extends the stepwise replacement algorithm along an age-period demographic contour. The two approaches produce similar results, but the contour method is more widely applicable. We provide a full description of the contour replacement method and examples of its application to life expectancy and lifetime disparity differences between the United States and England and Wales in the period 1980–2010.