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Letters
January 27, 1999

The Role of Alcohol and Social Stress in Russia's Mortality Rate—Reply

Author Affiliations
 

Margaret A.Winker, MDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor

JAMA. 1999;281(4):321-322. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-4-jbk0127

In Reply: We agree with Dr Vlassov that the conditions generated by the transition to a market economy have influenced the recent unfavorable mortality trends. However, it is important to identify what aspects of the transition were involved and how these broader social and economic forces were translated into mortality.

Mortality trends in Russia and other parts of the former Soviet Union are very different from those in other formerly communist countries. A comprehensive analysis1 showed that only moderate and short-lived decreases in male life expectancy (<1 year) occurred in Eastern Europe between 1988 and 1990. Subsequently, Poland and the Czech Republic have seen significant improvements in mortality. This contrasts with the sharp 6-year decrease in life expectancy in Russia and similar decreases in other former Soviet republics in the early 1990s.

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