BMJ  2003;327:751 (27 September), doi:10.1136/bmj.327.7417.751

Letter

Increase in mortality in Russia in the 1990s

Time of risk factor assessment is of special importance

The first 150 words of the full text of this article appear below.

EDITOR—Plavinski et al found that in two cohorts in St Petersburg mortality increased over the past decades in men without a university education but remained unchanged in those with one.1 In a subanalysis, mortality increased substantially over time in consumer groups with both high and low alcohol consumption while differences in mortality between the groups were much smaller. Therefore, the authors conclude, alcohol accounts only partly for the recent rise in Russian mortality.

I doubt that the study design is appropriate to detect differences in alcohol related mortality. Alcohol consumption was asked for only on recruitment, 1975-7 and 1986-8, respectively. This is of special importance for the later cohort since its recruitment coincided with Michail Gorbachev's anti-alcohol campaign, which caused a considerable decline in alcohol consumption in Russia.2 This decline, however, was shortlived, and alcohol consumption rose again quickly after the campaign's end. Therefore, many people classified as . . . [Full text of this article]

Ulrich Ronellenfitsch, doctoral student

University of Heidelberg, Department of Tropical Hygiene and Public Health, D-69120 Heidelberg, Germany Ulrich.ronellenfitsch@urz.uni-heidelberg.de


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Relevant Article

Social factors and increase in mortality in Russia in the 1990s: prospective cohort study
S L Plavinski, S I Plavinskaya, and A N Klimov
BMJ 2003 326: 1240-1242. [Abstract] [Full Text] [PDF]

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