Associations Between the Mortality Trends by Cause of Death and Hazardous Alcohol Consumption in Russia. The "Conveyor Belt Effect" in Action?

Relevance. Alcohol consumption is detrimental to the Russian population health and contributes significantly to mortality. The aim of the study is to determine the associations between alcohol consumption and mortality by cause of death in Russia. Data and methods. Data from the Russian Fertility and Mortality Database (RusFMD) were used. Correlation analysis of time series was used to estimate the statistical association with indicators of hazardous alcohol consumption for 80 causes of death. Findings and Discussion. Associations were found for 30 causes of death in classes such as diseases of the circulatory system, neoplasms, diseases of the digestive system, external and unspecified causes of death, infectious diseases, diseases of the respiratory system, and diseases of the nervous system. After pre-testing, the analyses were performed with a zero lag. Correlations have been found for a number of chronic diseases for which it is difficult to explain a direct response to variations in alcohol consumption. We suggest a ‘conveyor belt effect'; there is a vulnerable group in the population (at-risk population) whose health is compromised by high alcohol consumption. Mortality in this group will respond immediately to variations in current consumption. At normal levels of consumption, the ‘lethal conveyor belt' carries these individuals to the fatal line at a certain speed, which may accelerate or decelerate as consumption increases or decreases. The frequency of binge drinking or other hazardous drinking patterns, combined with changes in behaviour, including disruption of treatment, can have a particularly strong effect on the speed of the conveyor belt. The study was carried out as part of the basic research programme of the National Research University Higher School of Economics.