From the Soviet Union to Modern Russia: How Alcohol Shaped National Mortality Trends Over Half a Century

The period from 1965 to 2020 in Russia was marked by unprecedentedly high alcohol-related and overall mortality, making it unique in the country's demographic history. Despite the significance of this issue, alcohol-related causes of death and overall mortality trends have often been studied in isolation, without simultaneously considering their long-term dynamics. This study aims to comprehensively analyze alcohol-related and overall mortality trends over this period and identify key stages marked by changes in mortality patterns. Using Rosstat data, standardized mortality rates for men and women due to alcohol poisoning and all causes were calculated for 1965–2020. Correlation and regression analyses were performed to examine the relationship between overall and alcohol-related mortality. The dynamics of these indicators were compared over the entire period and across individual stages. The results revealed three complete cycles of synchronous fluctuations in alcohol and overall mortality in Russia: 1965–1988, 1988–1998, and 1998–2019, with peaks in 1980, 1994, and 2003, respectively. The historical maximum mortality rate occurred in 1994. Between 1965 and 1994, overall mortality increased by 47%, while alcohol poisoning mortality increased by 361%. By the early 2010s, both indicators had returned close to their 1965 levels. Analysis indicated that each shift in mortality trends was associated with the emergence of new, often multiple, factors affecting alcohol consumption and mortality, specific to periods of growth or decline. A strong synchronicity between overall and alcohol-related mortality was observed (R = 0.84; 95% CI: 0.73–0.91), despite alcohol poisoning accounting for only 1.4% of all deaths. Two exceptions were noted: 1965–1980 among women, and 2005–2019 among individuals with severe alcohol dependence, reflecting specific drinking behaviors. Four post-World War II anti-alcohol campaigns (1958, 1972, 1985, and 2000) were also analyzed. Only the 2000 campaign achieved a significant and sustained reduction in alcohol consumption and mortality. The synchronicity between alcohol-related and overall mortality in Russia indicates a substantial contribution of alcohol to excess mortality and population decline. Despite notable declines in alcohol consumption and overall mortality between 2005 and 2019, both indicators remain high. Russia continues to rank among the highest globally in alcohol-related mortality, showing disproportionately high mortality relative to alcohol consumption levels.