Increasing adult mortality in Ukraine, 1965-1994: The contributions of alcohol and tobacco abuse.

Abstract

The premature loss of life experienced particularly by adult males in Ukraine and more generally in Eastern Europe during the last three decades is a social problem with far-reaching implications for individuals, families, and the society as a whole. This dissertation seeks to better understand and explain the ways in which Ukrainian mortality conditions are distinctive from those experienced in the West. What is unique about the mortality situation in Ukraine is the degree to which negative individual health behaviors, precisely the excessive consumption of alcohol and tobacco, result in the premature loss of life. This dissertation assesses the overall impact of these individual behaviors on a societal level by looking not only at the resultant mortality to the subpopulation groups engaged in these behaviors, but also by attempting to link these behaviors to the negative mortality experience of others. The implications of abusive alcohol and tobacco consumption for the individual are many. Based on mortality patterns uncovered in this dissertation, alcohol and tobacco abuse are responsible for very high proportions of premature mortality befalling Ukrainian males. Males who fatally abuse these substances cannot expect to survive to the official retirement age of 59. For Ukrainian females, alcohol and tobacco abuse are far less prevalent behaviors. Direct mortality befalling the individual female abuser remains at a much lower level than that for males--absolutely, relatively, and proportionately. The consequences of these abuses extend beyond the individual to affect negatively the family and society as a whole. This dissertation found strong and consistent evidence that abusive alcohol consumption by Ukrainian males is associated with female homicide victimization. These results hold true after controlling for alcohol abuse among the female population, patterns of societal alcohol consumption, age, and period effects. Such results provide inceptive indication that the issue of violence against intimates in Ukraine is linked to abuse of alcohol. The confirmation that alcohol abuse has large negative effects on the well-being of Ukrainian males is not a new finding. However, that male alcohol abuse threatens directly female well-being is a new finding with grave implications for both the affected women and their families.