Economic change, crime, and mortality crisis in Russia: regional analysis.
OBJECTIVE
To identify which aspects of socioeconomic change were associated with the steep decline in life expectancy in Russia between 1990 and 1994.


METHODS
Regression analysis of regional data, with percentage fall in male life expectancy as dependent variable and a range of socioeconomic measures reflecting transition, change in income, inequity, and social cohesion as independent variables. Determination of contribution of deaths from major causes and in each age group to changes in both male and female life expectancy at birth in regions with the smallest and largest declines.


METHODS
Regions (oblasts) of European Russia (excluding Siberia and those in the Caucasus affected by the Chechen war).


METHODS
The population of European Russia.


RESULTS
The fall in life expectancy at birth varied widely between regions, with declines for men and women highly correlated. The regions with the largest falls were predominantly urban, with high rates of labour turnover, large increases in recorded crime, and a higher average but unequal distribution of household income. For both men and women increasing rates of death between the ages of 30 and 60 years accounted for most of the fall in life expectancy, with the greatest contributions being from conditions directly or indirectly associated with heavy alcohol consumption.


CONCLUSIONS
The decline in life expectancy in Russia in the 1990s cannot be attributed simply to impoverishment. Instead, the impact of social and economic transition, exacerbated by a lack of social cohesion, seems to have played a major part. The evidence that alcohol is an important proximate cause of premature death in Russia is strengthened.
Department of Public Health and Caring Sciences, University of Uppsala, S-751 85 Uppsala, Sweden.
P
P
Walberg
M
M
McKee
V
V
Shkolnikov
L
L
Chenet
D A
DA
Leon
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002675:Child, Preschool; D003415:Crime / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010563:Personnel Turnover; D012044:Regression Analysis; D012426:Russia / Q000453:epidemiology; D017678:Sex Distribution; D012922:Social Change; D012959:Socioeconomic Factors