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Gran variación en las tasas de mortalidad rusas 1984-94: ¿artefacto, alcohol o qué?
D A Leon1, L Chenet, V M Shkolnikov
1European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, UK.
Lancet (London, England)
|August 9, 1997
Resumen
Las tasas de mortalidad rusas fluctuaron significativamente entre 1984 y 1994. El aumento del consumo de alcohol es la explicación más plausible para estos cambios dramáticos en la esperanza de vida.
Área de la Ciencia:
- Salud Pública La salud pública.
- Demografía La demografía es la demografía.
- Epidemiología La epidemiología.
Sus antecedentes:
- Rusia experimentó importantes fluctuaciones en la tasa de mortalidad entre 1984 y 1994, con una notable disminución en la esperanza de vida masculina.
- Se plantearon preocupaciones sobre los posibles artefactos en los datos de mortalidad, aunque el consumo de alcohol se implicó como un factor contribuyente.
Objetivo del estudio:
- Analizar los patrones de mortalidad por edad y causa específica en Rusia.
- Examinar la plausibilidad de varias explicaciones para las tendencias de mortalidad observadas utilizando una serie de mortalidad reconstruida.
Principales métodos:
- Análisis de los datos de mortalidad por edad específica para Rusia (1984-1994).
- Análisis de la mortalidad por causas específicas, centrándose en las tendencias en varias categorías de enfermedades y causas externas.
- Reconstrucción de las series de datos de mortalidad para garantizar la precisión de los datos.
Principales resultados:
- Se observaron disminuciones de la mortalidad (1984-1987) seguidas de aumentos (1987-1994) por la mayoría de las causas, excluyendo las neoplasias.
- Los mayores cambios proporcionales en la mortalidad se observaron en el grupo de edad de 40 a 50 años, afectando a hombres y mujeres por igual.
- Las muertes, accidentes, violencia, infecciones, enfermedades circulatorias y respiratorias relacionadas con el alcohol mostraron fluctuaciones significativas; las neoplasias se mantuvieron estables.
Conclusiones:
- La estabilidad de la mortalidad por cáncer (neoplasmas) sugiere que los cambios observados en la esperanza de vida no son principalmente artefactos.
- Los cambios significativos en el consumo de alcohol explican plausiblemente las principales características de las fluctuaciones de la mortalidad rusa durante 1984-1994.
- Los hallazgos desafían las estrategias de salud pública en Rusia y la comprensión del papel del alcohol en los patrones mundiales de mortalidad.
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