Alcohol-related mortality in Ukraine

Introduction and Aims. To substantiate public health policies aimed at diminishing alcohol-related harm, the level of alcohol-related deaths needs to be documented on a national level. The aim of this study was to explore the opportunities provided by the 1985-1988 anti-alcohol campaign related data for estimation of alcohol-related mortality in Ukraine. Design and Methods. Ecological study design based on the aggregate-level data analysis regarding the natural experiment in Ukraine. All-cause and cause-specific observed mortality levels in 1986-88 compared to the extrapolated 1980-84 trends. The number and proportion of 'prevented' deaths were calculated for those causes, for which were observed: (1) reduction of mortality levels during the campaign and (2) increase after 1988. Alcohol-attributable fractions of mortality per one litre of per capita consumption were calculated for each death cause based on prevented deaths and consumption decrease estimates. The total number of alcohol-related deaths for a specific year was also calculated. Results. Ukraine experienced a large mortality reduction during the campaign. The estimates of prevented deaths revealed that at least 76% of the mortality reduction was attributable to alcohol. Alcohol-related mortality due to injuries is much higher for men, while coronary heart disease (CHD) alcohol-attributable fractions were about 0.5 in middle age both for men and women. Discussion and Conclusions. While in Western countries alcohol is considered as a protective factor for CHD, in Ukraine alcohol-related cardiovascular mortality is rather high. In 2004 in Ukraine total number of alcohol-related deaths was about 119,000 or 251 per 100,000 of population. [Krasovsky K. Alcohol-related mortality in Ukraine. Drug Alcohol Rev 2009;28:396-405].