Introduction and Aims.Eastern Europe is known to suffer from a large burden of alcohol-related mortality. However,persisting unfavourable conditions at the national level mask variation at the sub-national level. We aim to explore spatialpatterns of cause-specific mortality across four post-communist countries: Belarus, Lithuania, Poland and Russia (Europeanpart).Design and Methods.We use official mortality data routinely collected over 1179 districts and cities. The analysisrefers to males aged 20–64 years and covers the period 2006–2014. Mortality variation is mainly assessed by means of thestandardised mortality ratio.Getis-Ord Gi*statisticis employed to detect hot and cold spots of alcohol-related mortality.Results.Alcohol-related mortality exhibits a gradient from very high levels in northwestern Russia to low levels in southernPoland. Spatial transitions from higher to lower mortality are not explicitly demarcated by national boundaries. Within thesecountries, hot spots of alcohol-related mortality dominate the territories of northwestern and western Russia, eastern and north-western Belarus, southeastern Lithuania, and eastern and central Poland.Discussion and Conclusions.The observedmortality gradient is likely associated with the spread of alcohol epidemics from the European part of Russia to the other coun-tries, which appears to have started more than a century ago. Contemporary socioeconomic and demographic factors should betaken into account when developing anti-alcohol policies. The same is true for the peculiarities of culture, norms, traditionsand behavioural patterns observed in specific geographical areas of the four countries. Reducing alcohol-related harm in theareas identified as hot spots should be prioritised.
Introduction and Aims
In the 1990s, a strong inverse relationship between life expectancy (LE) in Russia and mortality from alcohol poisoning was observed. This association is remarkable as this cause accounts for less than 2% of deaths each year. It can be explained by treating the alcohol poisoning mortality as the best available measure in Russia of the population prevalence of harmful drinking in any year which in turn associated with mortality from a wide range of causes. This study analyses the evolving relationship of LE with this mortality‐based measure of harmful drinking since 1965, and places it in a policy context.
Design and Methods
We examine three periods: 1965–1984, a period of gradual LE decline; 1984–2003, a period of massive LE fluctuations; and 2003–2017, a period of LE improvement. Pearson's correlation coefficients and a linear relationship between annual changes in LE and alcohol poisoning were estimated for each period.
The strongest negative correlation between changes in LE and alcohol poisonings was found in 1984–2003. Over the period 2003–2017 a consistent positive LE trend emerged that was statistically independent of alcohol poisoning.
Discussion and Conclusions
These results suggest that in the period from the mid‐2000s a growth of LE in Russia was to a large extent independent of changes in the population prevalence of harmful drinking. While there has been a reduction in mortality at ages 15–64, at older ages mortality reduction unrelated to alcohol has become an increasingly important driver of overall mortality improvements.