Russia has made tremendous progress in reducing mortality in recent years, but it will all be crossed decrease in prices for vodka and other measures to ensure a sharp increase in the availability of alcohol. The main consequence of this – the tragic senseless death of hundreds of thousands of Russians already in the next few years, says a group of sociologists led by Andrew Korotaeva in a lecture at “Gazeta.ru».
D.i.n., Professor, Director, Center for Anthropology of East State Humanitarian University; Ph.D., associate professor of RAGS Ph.D., researcher Oriental Studies
Andrew Korotaev, Daria Halturina
The fight for life – struggle with alcohol
Since 2005, Russia has made significant progress in reducing mortality. From 2005 to 2013 it was reduced to 2 million 304 thousand. up to 1 million 872 thousand. Deaths per year – ie was less than 432 thousand. deaths per year.
Especially strongly reduced the death rate from alcohol poisoning – 36 th. in 2005 to 9 th. 700 in 2013.
In this case, the overall mortality rate fell from 16,1 ‰ (1 ‰ – 1 ppm: 1/10 percent 1000th share anything in general) to 13,0 ‰ – t .e. to 3,1 ‰ – in recent years is the best indicator of the dynamics not only in all of Europe, but also among all high and moderately developed countries around the world as a whole. Achieved this reduction was almost entirely due to an increase in life expectancy of Russians. In 2005-2012 years it has grown to five years – from 65.5 to 70.5 years; is again the best result among all the countries of Europe, America and Asia. It is particularly strong (about 6 years), it increased in men. Especially strongly (from 467 to 334 – that is almost 30%) decreased standardized mortality rate among working-age men. And again – it’s the best speaker among all high and moderately developed countries of the world.
These impressive results Russia achieved mainly due to the decrease in mortality is alcohol. The fact is that in the mid-2000s – at the start of reduction in mortality in Russia, caused by the introduction in 2006 of the complex anti-alcohol measures – Alcoholic mortality in our country has contributed quite a huge contribution to the overall mortality rate.
We emphasize that only a small proportion of alcohol mortality associated with fatal alcohol poisoning. The main contribution of alcohol contributes to the Russian supermortality other ways.
In Russia the mid-2000s were associated with alcohol 19% of deaths from cardiovascular disease (including heart attacks and strokes), 61% of deaths from external causes, including 67% of murders, 50% of suicides, 68% of deaths from cirrhosis of the liver and 60% of the pancreatitis. Since alcohol is also associated a significant portion of deaths from pneumonia and tuberculosis, as alcohol abuse more likely to develop infectious diseases, and rarely committed to treatment. In Izhevsk in 1998-1999 among the dead men 20-55 years of high blood alcohol content had 62%. The large-scale study in Barnaul for 1990-2004 years (it was told “Times”) showed , that among the dead elevated blood alcohol levels were 68% men and 61% of women 15-34 years old, 60 % of men and 53% of women 35-69 years.
It is noteworthy that the decrease in mortality in Russia after 2005 is very similar in structure to the decline, which was observed in our country during Gorbachev’s anti-alcohol campaign of the 1980s .
In general, studies show that in Russia there is a very close relationship between the production of ethyl alcohol from food raw materials and mortality. A significant increase in production (and consumption) of alcohol in our country leads to an immediate significant increase in mortality – and vice versa (see. Fig. 1 and 2):
For the latter, schedule makes sense to bring the formal statistical characteristics of the corresponding dependence. As a standard measure, the coupling force in such cases, generally use the Pearson correlation coefficient ®. So, the value in this case is greater than 0.9. Any mathematically literate reader will understand that we are talking about an extremely close relationship. In order to understand the extent of the close relationship in question in such cases it makes sense to build a 0.9 squared. 0.81 obtain (or – in other words – 81 per hundred, i.e. 81%). This is called the coefficient of determination (R2).
In fact, its value suggests that in recent years the dynamics of mortality in Russia was highly due to alcohol is a factor.
Thus, there is reason to believe that the observed since 2005, a record decline in mortality in our country were more than 80% due to a reduction in alcohol consumption, ie, serious measures to restrict the availability of alcohol use in our country.
Death will be more
The success of public policies to combat the harmful use of alcohol is associated with the implementation of the whole complex of anti-alcohol measures recommended by the World Health Organization on the basis of international research practices, including higher prices and excise taxes on alcoholic beverages, limit the spatial and temporal availability of alcohol. In addition, significant progress has been made in reducing the volume of alcohol consumption unregistered, judging by the sharp decrease in fatal and non-fatal alcohol poisoning.
But in the near future, Russia may lose these achievements, if not taken serious steps against impending catastrophic threats created by the last “outstanding” successes alcohol lobby that threaten our country, hundreds of thousands of unjustified deaths (and in this case especially among men of working age).
It is regrettable to note that in recent Russian history has repeatedly been occasions when after some growth fertility collapses to a level even lower than that observed in the years preceding the rise, and for a significant reduction in mortality followed a wave of her catastrophic growth (see. Fig. 4):
We regret to note that in the next few months we will (if not take drastic measures) risk to face a new demographic repetition of tragedies beginning and end of the 1990s, a new wave of growth catastrophic mortality and fertility decline. We have to admit that the tragic history repeats itself until a remarkably precise detail. Once again, we are dealing with an acute financial and economic crisis, the government again employed Superfund issues such as the dollar and the outflow of capital, again to demographics. Against this background, it is planned to dramatically increase the availability of alcohol. This is very reminiscent of the events of the late 1990s.
As we all remember, in 1998, Russia experienced an acute financial crisis, which was accompanied by a jump in inflation. However, the excise duty on spirits was not increased in line with inflation.
If the inflation rate in 1998 was 84%, the excise tax on vodka were increased only by 20%. As a result, in one year the real value of the excise tax declined by a third. In 2000, the excise tax was increased slightly above the rate of inflation, but it does not compensate for the decline of the previous year. In the years that followed the fall of the real value of the excise tax (adjusted for inflation) has not been compensated, and excise taxes on vodka is often increased again slightly lower inflation.
This is what the fall of the excise tax on vodka (if subsequent growth of income and purchasing power of the population) and was due to a huge increase in mortality in 1998-2005, which cost more than a million Russian lives.
But the crisis of 2008-2009, held against the backdrop of strong alcohol policy measures and is accompanied by a decrease in the availability of alcohol, did not lead to any increase in mortality. We also note that in the early 1990s, an acute financial and economic crisis in the former Soviet Union led to a catastrophic increase in mortality (as well as all kinds of negative social phenomena – homicide, suicide, divorce, abandoned children) only where it is accompanied by a sharp increase in alcohol consumption (due to a sharp increase in its availability) – in the same countries where financial and economic crisis marked increase in alcohol consumption was not followed, there has been no catastrophic increase in mortality (as well as the number of murders, suicides, divorces, abandoned children and etc.) (see. Appendix 2).
More details taken or planned government measures that will lead to a sharp increase in the availability of alcohol and the tragic senseless deaths of hundreds of thousands of our compatriots have in the next few years are listed in crashing.
Evaluation of the consequences of weakening the state’s alcohol policy
The proposed changes could lead to an increase in alcohol consumption, alcohol-related increase in mortality, morbidity and social problems and to prevent the implementation of the Presidential Decree number 606 dated May 7, 2012 “On measures for implementation of demographic policy of the Russian Federation”, providing software to increase by 2018 life expectancy in the Russian Federation to 74 years.
The calculations carried out by an expert group of the Institute of Scientific and public examination (Inoue), Russian Academy of National Economy and Public Administration under the President of the Russian Federation (RANHiGS) and the National Research University “Higher School of Economics” (HSE) have shown that the cancellation of the whole complex system of alcohol public policies may result in the period up to 2030 to unjustified death of five and a half million of our fellow citizens (see. Fig. 5 and Table. 1):
In a message to the Federal Assembly in 2014, Russian President Vladimir Putin once again stressed the need to solve the problem “in the near future to increase the average life expectancy to 74 years.” However, if the health authorities will not be able to fight off an extremely successful unfolding in recent months, an offensive alcohol lobby, the issue should be put more on how we would keep the life expectancy of Russians from the fall of 2018 to a level of 66-67 years (which is quite confidently projected experts in the event of initiatives described proalkogolnyh). Yes, Putin proposed Ads 2015 “National Year of combating cardiovascular disease” may somewhat slow down the process. Yes, in the case of the materialization of this initiative (in the face of flooding the country cheaply available alcohol) we can get and not 66-67, and 68 years, but about all sorts of dreams of 74 years by 2018 we will have to forget most definitely.
Putin is not without reason glad penetration in Russia this year in the category of “safe countries” in the “global ranking of health».
But if you can not stop the attempts to fill in the country of cheap alcohol, the next year Russia will depart from this category.
What should I do?
Keep in mind that simply repealing the above legislative initiatives will help us just keep expectancy at the current level about 71 years. Note that in the current critical situation for the realization of the idea of increasing the life expectancy of Russians and 74 years must not only restore the status quo, to establish a moratorium on the abolition of the anti-alcohol measures, but also to make new and serious steps to limit the availability of alcohol in time, in space and economically. It seems that is no longer enough simply to return to the first ruling (and put vodka lobby downhill) law, assumes an increase January 1, 2015 the excise tax on spirits from 500 to 600 rubles per one liter of anhydrous ethanol. Given jumped dramatically since the adoption of this version of the law we have inflation should go about improving since the beginning of the year excise not 600, but somewhere 650 rubles.
We need to think and to increase the temporal ban on the sale from 23.00 – 8.00 and 20.00 – 11.00 (a ban on the sale of alcohol in the morning to 11.00 well proven in the Nordic countries, as it blocks the mood northerners “sober” before the start of the working day, which too often leads to the top most of these drinking bouts).
It is also advisable as soon as possible to prohibit the sale of alcoholic beverages containing more than 15% ethanol in department stores, not isolated from other departments and do not have a separate entrance from the street – in the case what if, “going to the store to buy bread, one sees on the shelves and alcohol, it often provokes him for the purchase of alcoholic beverages».
It should also start the discussion back to the state monopoly on retail sales strong drinks in Russia. Response to the severe epidemic of alcoholism in the Nordic countries it has become a state monopoly on the retail sale of alcohol.
This measure has proven to be an effective means of reducing alcohol problems and mortality in Sweden, Iceland, Norway , Finland, Canada, etc.
For example, in the United States in 19 states that have some form of monopoly on the sale of alcohol, compared to states without alcohol monopoly persons 14-18 years lower than 14.5%, the incidence of abuse of this group of alcohol (more than 70 g of ethanol at a time) is lower by 16.7%, and road deaths caused by drunk drivers below 9.3%. In the Scandinavian countries such monopoly involves the sale of alcoholic beverages (usually stronger than 4,7-5%) only in state stores, not including service in the bars. Prices in stores gosmonopolnyh high, especially on spirits, time limited daylight hours, the number of such points is limited. In addition, the state monopoly contributes to the completion of the state budget. Despite the high monopoly prices (and hence reduced consumption of hard liquor), in countries with a state monopoly total revenue from the sale of alcoholic beverages tend to be higher than in the same level of economic development without monopolies.
The advantage of the state monopoly on the retail sale of alcoholic beverages in that it minimizes the private interest, which in this area is often contrary to the public interest. Employees of the State Store no interest to sell alcohol to minors (because his salary at socially oriented state monopoly does not depend on revenue), while for the owner of the private booth behind this specific material gain.
Finally , experience shows that the regulation of alcohol policy of the state should be given into the hands of a social rather than economic bloc of the government (as in the Scandinavian countries) with a leading role and the Ministry of Health Rospotrebnadzor. Rosalkogolregulirovanie should serve as a struggle with the shadow of alcohol that it has successfully fulfilled the years. However, as the last few months, the agency is difficult to resist the attacks of alcoholic lobbyists on the population – it has no authority on the prevention of alcohol-related deaths and diseases, there is no corresponding department and specialists. Besides, Rosalkogolregulirovaniya a conflict of interest between the functions of public policy and monitoring its implementation. In this situation, the agency often must choose between protecting the market and the protection of citizens’ health.
As a result, we see the massive violations of the Concept of state policy to reduce the abuse of alcohol and alcohol prevention among the population of the Russian Federation for the period up to 2020, adopted Government in 2009.
We hope that this situation will overcome this and we can keep the population in the new, tough economic times the country.
The annexes, telling about the scenario forecasting methodology and opportunities alkopolitiki in alleviating the social consequences of the financial and economic crisis in modern Russia can be found link .
Authors lecture: AV Korotaev, DA Halturina, Y. Zinkina, VA Zykov (National Research University “Higher School of Economics”, NGO “Council on public health and demography» )
A detailed description of the method of calculation cm. In: Bozhevolnov Yu Ed.
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