any value observed elsewhere. In the early 1970s, male mortality from injury and poisoning was much higher in Russia than in other European countries. Violent deaths have diminished almost everywhere, except in Russia. The particularly sharp jump of the most recent years has widened the gap between Russia and other countries. Male mortality from violence is more than twice as high in Russia as in Hungary (where it is the highest in Central Europe), but four times as high as in France and ten times as high as in England.

It is necessary to note here, however, that coding practices introduce some biases in comparing Russia with Western countries. In Russia, deaths due to acute alcoholism are coded as "accidental poisoning by alcohol," while in Western countries this item is devoted exclusively to true accidental poisoning resulting, for example, from the use of alcohol for industrial purposes (Blum and Monnier, 1989a). That is the reason why, despite Russia's high levels of alcohol consumption, few deaths are registered as "alcoholic psychosis" or "alcohol dependence syndrome." While total mortality for alcohol-related causes was similar in France and Russia in 1991 (42 per 100,000 in Russia and 37 per 100,000 in France), one-half of this total was registered as accidental poisoning in Russia, while nearly all of it was classified as digestive diseases (cirrhosis) or mental disease (psychoses or acute alcoholism) in France. Therefore, to compare violent deaths in France and Russia more precisely, we should reduce the Russian standardized mortality rate by about 20 points. However, even after this correction, the rate in Russia would be more than twice that in France in 1991 (230 per 100,000 against 100) and would probably remain approximately four times higher in 1993, as mentioned above.

Conversely, the French/Russian comparison for another component of violent deaths, accidental falls, is biased by a Russian underestimation. In France, this component includes broken hips; in Russia, these cases are often classified with cardiovascular or respiratory diseases, which often follow this type of injury, and cases classified as accidental falls are those related to alcohol or work. Correcting for this difference, for 1991 we would compare an adjusted Russian rate of 230 per 100,000 with a French rate of about 90 per 100,000. The ratio of Russia to France would then reach 2.5, just as before. These two successive corrections compensate each other.

The Russian Components of Injury and Poisoning

Figure 2-8 divides Russian violent deaths into their four main components: traffic accidents, poisoning, suicide, and homicide. In 1985-1986, after Gorbachev's anti-alcohol campaign, these four components sharply declined, although to a lesser extent for traffic accidents.

The upward trends observed before and after this period are more specific to the four components. The rise of the 1970s is associated with only three causes



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