Abstract
Wide health inequalities remain between eastern and western Europe. In 2008 there was a 20 year difference in life expectancy between Dutch men (80.7 years) and Russian men (60.5 years). Premature mortality (before 65 years of age) in some countries of western Europe has fallen to a single digit, but among Russian males it has fluctuated widely in recent decades, and is still about 50%. From the early 1960s the health trends in eastern Europe started to degenerate. In the years 1960–1990 there was a dramatic increase in premature mortality, especially among adult men, with a substantial increase of recorded deaths from CVD, lung cancer, injury, liver cirrhosis, etc. The economic and political changes that occurred in eastern Europe in the early 1990s reversed this trend in the Czech Republic, Hungary, Poland, Slovakia and Slovenia. The cardiovascular mortality started to decline and for the first time since 30 years life expectancy increased and premature mortality levels fell (http://www.hem.waw.pl/). The opposite happened in Russia, the Ukraine, and many other countries of the former Soviet Union. Huge increase in mortality occurred, followed by wide fluctuations. Recent epidemiological analytical research points at vodka (and other strong alcoholic drinks) as the key reason for the observed changes. It seems that the misuse of alcohol in Russia led not only to the increase of the classical alcohol-induced health problems (liver cirrhosis and particularly accidents, suicides, homicides, and unassigned external causes), but also to a large absolute increase in the mortality attributed to “non-MI acute IHD” (ICD-10 124), a cause commonly assigned in Russia, but almost never assigned in western Europe. (Lancet 27 June 2009).
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