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Affiliation
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Programme Manager, Alcohol and Illicit Drugs Programme & Prisons and Health Programme, Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office), Moscow, Russian Federation. |
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Copyright
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(Copyright © 2019, Alcohol Research Documentation, Inc., Rutgers, The State University of New Jersey) |
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Abstract
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Although parsimony is considered a virtue in science, simple interpretations are often simplistic, perhaps because they are only partially right and often because they are partially wrong. Complexity is a scientific challenge, not a reason for despair. There is a need for better models that describe the complexity of population-level health dynamics in ways that are not biased by individual-level assumptions about causality and individual-level mechanisms of action.
That need becomes apparent from a reading of the featured article in this issue of Journal of Studies on Alcohol and Drugs by Alexander Nemtsov, Maria Neufeld, and Jürgen Rehm (Nemtsov et al., 2019). These investigators provide a fascinating analysis of “long-wave” trends in mortality and life expectancy in the Russian Federation between 1990 and 2017. Their analysis, although not quite the definitive confirmation of a causal hypothesis in clinical medicine, does provide powerful circumstantial evidence of the impact of alcohol control measures on life expectancy. Trends in alcohol consumption were closely mirrored by trends in life expectancy, demonstrating the enormous effect that drinking patterns and per capita consumption can exert on the health of a population and on countries’ socioeconomic development. Of equal importance, the chronology of alcohol control policies, which were increasingly implemented over the 38-year observation period in Russia, makes it possible to “explain” a significant part of the variance in alcohol-related mortality, along with economic conditions, which may have also contributed.
Several factors are invoked to interpret these trends: the general economic situation, the availability and affordability of alcohol, and the changing patterns of alcohol consumption. Alcohol control measures seem to have had a positive impact on decreasing alcohol consumption and mortality insofar as they reinforced the existing economic trends. The power of the authors’ analysis of the trend data lies in their ability to disaggregate the broad categories of “mortality” and alcohol consumption according to gender, time period, beverage preferences, and disease incidence.
Alcohol science has been documenting the health and social consequences of alcohol consumption for more than a century, with improved attributable risk estimates ...
Language: en |