Figure 8-5

Annual alcohol consumption and the standardized death rate for ischemic heart disease (IHD) and external causes of death in Russia, males, 19841992. Note: The arrows indicate movement in time from 1984 to 1992.

than in 1984. The trace corresponding to ischemic heart disease finishes at the value of the standardized death rate, which is lower than in 1984.

Hence, the difference in mortality trends between the young adult and older adult ages in the period 1988-1992 could be explained by the difference in the structure of causes of death. At young adult ages, external causes, directly related to alcohol abuse, predominate and control the trend of the total age-specific death rate; at older ages, mortality from circulatory diseases predominates.

Alcohol Abuse and the Large Increase in Mortality in 1993

A sharp increase in death rates occurs at almost all ages in 1993, as shown in Figure 8-6. The highest increase is at ages 40-44. Within the range of ages 25 to 64, the increase in age-specific death rates is more than 20 percent. In contrast with 1992, mortality increases very substantially at ages other than working ages, among the elderly population in particular. The serious deterioration occurs for all leading classes of causes of death (Figure 8-3). For ages above 65, the rise in



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