HEALTH CRISIS IN RUSSIA .2. CHANGES IN CA USES OF DEATHS - A COMPARISON WITH FRANCE AND ENGLAND AND WALES FROM 1970 TO 1993

In order to increase our understanding of the unfavourable trend in Ru ssian mortality after the 1960s, we compare it with the trends in two Western countries, France and England and Wales, for which continuous series of deaths by cause are available for the same period. The incre asing gap between Russia and the other two countries is largely due to diverging trends in mortality from cardio-vascular diseases. After 19 70, mortality from this group of causes decreased in France and Britai n, but increased in Russia. Deaths from violence also contributed to t his difference. In Russia mortality from this cause is linked to trend s in alcohol consumption. The number of violent deaths decreased signi ficantly following the anti-alcohol campaign introduced by Gorbachev, but increased again after 1987, as the effects of the campaign wore of f. In 1993 deaths from violence, specially homicide, increased again a t an even more rapid pace. However, some causes of death are less unfa vourable in Russia. Except in 1993, deaths from infectious diseases an d from diseases of the respiratory system have declined. Mortality fro m neoplasms is equal to that in France and England for men, and is low er for women. However, unfavourable trends observed for cancers of par ticular sites (lung, breast, intestins) suggest that deaths from these causes will become soon an important determinant of degradation.