in results should certainly be ascribed to the different nature of the indicators, as the absolute death numbers depend strongly on mortality among the elderly and even on the proportion of the total population in older age groups. We can also mention here that in reality, not all the deviations of mortality rates from the expected or "natural" trend are related to the anti-alcohol campaign. For example, it is difficult to imagine that the substantial improvement among women aged 75+ is entirely attributable to either a direct or indirect impact of the anti-alcohol measures.

Variations in Male Mortality by Age and Cause of Death

In this and the next section, we consider the mortality trends and patterns for men. The phenomenon of alcohol-related mortality is certainly less important for Russian women than for men, and less dramatic. Moreover, most of the results obtained for males are similar for females, although at much lower levels for the latter.

The trends in age-specific death rates exhibit a wide variety of responses to the sharp variations in alcohol consumption since 1984, as shown in Figure 8-2. The trends in infancy and childhood do not show the same sharp fluctuations as those for adults (though perhaps with the exception of some acceleration in decline between 1985 and 1986). The long-term decline in the infant mortality rate continues with small fluctuations until 1990. Some increase occurs in the period 1991-1992 and a more significant increase in 1993.

In contrast, death rates at ages 20 to 55 exhibit very large variations. The maximum decrements of the age-specific death rates in the period 1985-1986 are about 30 to 40 percent of the basic levels of 1984. At older ages, the variation in mortality trends is gradually reduced from about 15 percent at ages between 45 and 54 to less than 7 to 8 percent among the elderly.

At working ages, death rates increase significantly starting in 1988, with an accelerated increase in 1992. By 1992, death rates have increased to just above the levels of 1984. This is not the case for ages above 55. Death rates for these ages grow rather slowly until 1992, when they rise substantially, though they remain slightly below the previous extreme point of 1984.

The similarities and dissimilarities in the age patterns of the mortality decrease in the period 1985-1987 and the increase in the period 1988-1992 are summarized in Figure 8-3. Certainly, the two age distributions of age-specific death rates have the same general shape. However, the age distribution of the mortality increase is slightly shifted to the left as compared with the age distribution of the mortality decrease. This means that for younger ages, the growth is higher than the previous decline, while, for older ages, the decrease in death rates is larger than the later increase.

Hence, some difference can be found between mortality trends for younger



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