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Social factors and increase in mortality in Russia in the 1990s: prospective cohort study

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7401.1240 (Published 05 June 2003) Cite this as: BMJ 2003;326:1240
  1. S L Plavinski (splavinskij{at}mail.ru), dean1,
  2. S I Plavinskaya, leading researcher2,
  3. A N Klimov, principal researcher2
  1. 1 College of Public Health, Medical Academy for Postgraduate Studies, Saint Petersburg, Russia,
  2. 2 Department of Biochemistry, Institute for Experimental Medicine, Saint Petersburg, Russia
  1. Correspondence to: S L Plavinski
  • Accepted 7 April 2003

Abstract

Objective To determine the association between social factors and the increase in mortality in Russia in the 1990s.

Design Prospective population cohort study.

Setting Saint Petersburg, Russia.

Participants Two cohorts of men aged 40–59 years randomly selected from district voting list: 3907 screened in 1975–7 and 1467 in 1986-8.

Main outcome measures Education, various health related measures, alcohol intake. Mortality in subsequent 10 years.

Results There was no recorded increase in mortality in men with university degrees. The relative risk in the second cohort compared with the first was 0.92 (95% confidence interval 0.67 to 1.24). For participants with only high school education it was significantly higher in the second cohort (1.32, 1.02 to 1.71). The most pronounced differences were found among participants with the lowest level of education, in which the relative risk was 1.75 (1.44 to 2.12). The same pattern held for coronary vascular disease and cancer mortality.

Conclusion In Russia men in the lower socioeconomic groups were most affected by the sharp increases in mortality in the 1990s.

Footnotes

  • Embedded ImageA figure showing details of recruitment and follow up and a table showing alcohol intake can be found on bmj.com

    We thank all those who participated in data collection and follow up of participants: G Ilyina, A Katrushenko, V Khoptiar, I Klenina, V Konstantinov, B Lipovetsky, E Magracheva, T Maslova, G Mirer, N Muchina, N Nikulcheva, N Parfenova, D Shestov, Y Slepenkov, V Tryufanov, L Vassilieva, N Zhukovskaya.

  • Contributors SLP proposed the initial hypotheses, analysed the data. and wrote the paper. SIP participated in data collection and analysis, provided expert knowledge of the mortality classification and determinants of mortality, and provided ideas for study execution and analysis. ANK conceived the study, supervised and directed data collection, and is guarantor. All authors commented on the paper. ANK was the principal investigator in the larger project of which this study is part.

  • Funding Cohort study was funded partially by NIH grants NO-1HR12243-L/HR/NHLBI, NO-1HV08112/HV/NHLBI and by the Soviet (then Russian) Academy of Medical Sciences. The guarantor accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.

  • Competing interests None declared.

  • Ethical approval The USSR Lipid Research Clinics cohort study has been carried out under a government-to-government agreement between the United States and the Union of Soviet Socialist Republics on a joint programme in cardiovascular diseases, signed in 1972.

  • Accepted 7 April 2003
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