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Abstract

Background: Individual lifestyle risk factors have been linked to increased mortality globally; however, there is limited data on these associations in Russia. A secondary analysis of the Russia Longitudinal Monitoring Survey (RLMS) data was conducted to close this gap.

Methods: The secondary data have been obtained from a nationally-representative annual cohort survey conducted by the Higher School of Economics (HSE). In this original study, for the first time in Russia, we extracted RRs for researched risk factors. Of additional original value, we made a prospective-retrospective cohort based on a representative longitudinal survey and provided the deaths as outcomes for survival analysis. We included 56,559 respondents between 1994 and 2019 in the study. Self-reported questionnaires were used to collect data, and Cox proportional hazard models were used to compute the hazard ratios (HR).

Results: In total, 4,063 deaths were reported during the analyzing period. Overall, the risk of death was more than 2.2 times higher for males than for females (HR = 2.29, 95% CI: 2.14; 2.44). Individuals who used tobacco had 3.52 times (95% CI: 3.27; 3.79) higher risk of death. People with alcohol use had a 2.08 (95% CI: 1.92; 2.25), and responders with poor nutrition had a 2.16 (95% CI: 1.79; 2.60) higher mortality risk.

Conclusion: Poor lifestyle risk behaviors, including tobacco smoking, alcohol consumption, and poor nutrition, are associated with a significantly higher risk of death in the Russian population.

Keywords: Mortality, Non-communicable diseases, NCDs, Behavioural risk factors, RLMS

References

[1] World Health Organization [WHO]. Noncommunicable diseases country profiles 2018. Geneva : WHO; 2028. [cited 2022 Nov]. Available from: https://apps.who.int/iris/handle/10665/274512

[2] Rehm J, Ferreira-Borges C. Risk factor policies, morbidity, and mortality in Russia. Lancet. 2018 Sep 29;392(10153):1094-1095. doi: 10.1016/S0140-6736(18)32043-9. Epub 2018 Aug 30.

[3] World Health Organization [WHO]. Global status report on noncommunicable diseases 2014: attaining the nine global noncommunicable diseases targets, a shared responsibility. Geneva: WHO; 2014. [cited 2022 Nov]. Available from: https://apps.who.int/iris/handle/10665/148114 [4] Ford ES, Zhao G, Tsai J, Li C. Low-risk lifestyle behaviors and all-cause mortality: findings from the National Health and Nutrition Examination Survey III Mortality Study. Am J Public Health. 2011 Oct;101(10):1922-9. doi: 10.2105/AJPH.2011.300167.

[5] Siewchaisakul P, Sarakarn P, Vatanasapt P, Chen SL, Yen AM. Sex Differences in the Heterogeneous Dynamic Incidence of Oral Cancer: A Comparison between Taiwan and Thailand. Biomed Res Int. 2020 Sep 15;2020:9321246. doi: 10.1155/2020/9321246.

[6] Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004 Sep 22;292(12):1433-9. doi: 10.1001/jama.292.12.1433.

[7] Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, et al. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. Circulation. 2018 Jul 24;138(4):345-355. doi: 10.1161/CIRCULATIONAHA.117.032047. Erratum in: Circulation. 2018 Jul 24;138(4):e75.

[8] Ding D, Rogers K, van der Ploeg H, Stamatakis E, Bauman AE. Traditional and Emerging Lifestyle Risk Behaviors and All-Cause Mortality in Middle-Aged and Older Adults: Evidence from a Large Population-Based Australian Cohort. PLoS Med. 2015 Dec 8;12(12):e1001917. doi: 10.1371/journal.pmed.1001917.

[9] Russia Longitudinal Monitoring Survey of HSE [cited 2023 Apr 14]. Available from: https://rlms-hse.cpc.unc.edu

[10] GBD 2019 Tobacco Collaborators. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021 Jun 19;397(10292):2337-2360. doi: 10.1016/S0140-6736(21)01169-7. Epub 2021 May 27. Erratum in: Lancet. 2021 Jun 19;397(10292):2336.

[11] World Health Organization [WHO]. Global status report on alcohol and health 2018. Geneva: WHO; 2018. [ cited 2022 Nov]. Available from: https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf

[12] Keenan K, Saburova L, Bobrova N, Elbourne D, Ashwin S, Leon DA. Social Factors Influencing Russian Male Alcohol Use over the Life Course: A Qualitative Study Investigating Age Based Social Norms, Masculinity, and Workplace Context. PLoS One. 2015 Nov 17;10(11):e0142993. doi: 10.1371/journal.pone.0142993.

[13] Lunze K, Yurasova E, Idrisov B, Gnatienko N, Migliorini L. Food security and nutrition in the Russian Federation - a health policy analysis. Glob Health Action. 2015 Jun 24;8:27537. doi: 10.3402/gha.v8.27537.

[14] GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 May 11;393(10184):1958-1972. doi: 10.1016/S0140-6736(19)30041-8. Epub 2019 Apr 4. Erratum in: Lancet. 2021 Jun 26;397(10293):2466.

[15] Soshnikov SS, Egorova AN, Idrisova AI, Grjibovski AM, Atoeva MA. Cohort profile: The longitudinal study on the risk factors of non-communicable diseases in Russia. Vestnik of Saint Petersburg University. Medicine. 2022; 17(3): 191-202. https://doi.org/10.21638/spbu11.2022.304.

[16] Leykin I. Dying Unneeded: The Cultural Context of the Russian Mortality Crisis by Michelle A. Parsons. Anthropological Quarterly. 2015;88(4):1131–5. DOI:10.1353/anq.2015.0048

[17] Bhattacharya J, Gathmann C, Miller G. The Gorbachev Anti-Alcohol Campaign and Russia's Mortality Crisis. Am Econ J Appl Econ. 2013;5(2):232-260. doi: 10.1257/app.5.2.232.

[18] Lunze K, Migliorini L. Tobacco control in the Russian Federation--a policy analysis. BMC Public Health. 2013 Jan 23;13:64. doi: 10.1186/1471-2458-13-64.

[19] Vlassov V. Russia needs to look beyond longevity. Lancet Public Health. 2019 Apr;4(4):e169-e170. doi: 10.1016/S2468-2667(19)30043-X.

[20] Krokstad S, Ding D, Grunseit AC, Sund ER, Holmen TL, Rangul V, et al. Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study. BMC Public Health. 2017 Jan 10;17(1):58. doi: 10.1186/s12889-016-3993-x.

[21] Zhu D, Zhao G, Wang X. Association of Smoking and Smoking Cessation With Overall and Cause-Specific Mortality. Am J Prev Med. 2021 Apr;60(4):504-512. doi: 10.1016/j.amepre.2020.11.003.

[22] Mannoh I, Hussien M, Commodore-Mensah Y, Michos ED. Impact of social determinants of health on cardiovascular disease prevention. Curr Opin Cardiol. 2021 Sep 1;36(5):572-579. doi: 10.1097/HCO.0000000000000893.

[23] Regitz-Zagrosek V. Sex and gender differences in health. Science & Society Series on Sex and Science. EMBO Rep. 2012 Jun 29;13(7):596-603. doi: 10.1038/embor.2012.87.

[24] World Health Organization [WHO]. Regional Office for Europe. Gender and noncommunicable diseases in Europe: analysis of STEPS data. Geneva: WHO; 2020. [cited 2023 Apr 14]. Available from: https://apps.who.int/iris/handle/10665/337471

[25] Saburova L, Keenan K, Bobrova N, Leon DA, Elbourne D. Alcohol and fatal life trajectories in Russia: understanding narrative accounts of premature male death in the family. BMC Public Health. 2011 Jun 20;11:481. doi: 10.1186/1471-2458-11-481.

[26] Marmot M, Bell R. Social determinants and non-communicable diseases: time for integrated action. BMJ. 2019 Jan 28;364:l251. doi: 10.1136/bmj.l251.

[27] Zaridze D, Lewington S, Boroda A, Scélo G, Karpov R, Lazarev A, et al. Alcohol and mortality in Russia: prospective observational study of 151,000 adults. Lancet. 2014 Apr 26;383(9927):1465-1473. doi: 10.1016/S0140-6736(13)62247-3. Epub 2014 Jan 31. Erratum in: Lancet. 2014 Apr 26;383(9927):1464.

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