Russia’s rising life expectancy is a reminder of alcohol's dangerous downsides

Russia is a famously hard-drinking nation, where, historically, the average person drank more than 14 liters of alcohol per year between 2000 and 2016. However, new research indicates that since 2003 there’s been a 43 percent drop in Russian alcohol consumption — and during the same period, mortality rates have also declined.

Analysis published Wednesday in the Journal of Studies on Alcohol and Drugs and again in a World Health Organization report reveals that life expectancy in Russia has increased by 6.1 years for men and 4.7 years for women since the 1980s alongside massive changes in the way that the country regulates and drinks alcohol.

As alcohol consumption spiked between 1991 and 1994, the team also found that mortality spiked concurrently. Between 1998 and 2002, they saw the same thing: more alcohol consumption and more deaths. Finally, starting in 2003, alcohol consumption in Russia began to plunge, and along with it so did the rates of alcohol-poisoning deaths, alcohol-related psychoses, deaths by traffic accidents, and deaths by suicide, amongst others conditions.

However, because of Russia’s (and the world’s) tumultuous history between 1980 and today, there are good reasons not to say a drop in drinking is entirely responsible for lower mortality rates. Over that period of time, the world has changed a lot, both politically and medically. The Soviet Union dissolved. The AIDS epidemic broke out. Swine flu happened, and more recently, measles was eliminated and has since resurged around the world.

With that cultural backdrop, it may seem incredulous that alcohol could be a major driver behind the increase in Russian lifespans. In an accompanying commentary titled “The World Is Complex But Alcohol Policy Matters,” William Pridemore, a professor at SUNY Albany’s School of Criminal Justice, makes that case that we can’t attribute too much of this strange mirroring effect to alcohol alone.

However, that doesn’t mean we should discount alcohol’s contribution to these numbers, as lead author Maria Neufeld, Ph.D., of the Moscow Research Institute of Psychiatry, argues.

“Alcohol use has been established as one of the main contributors, if not the main contributor, to Russian mortality,” Neufeld explained Thursday.

More broadly, those results connect back to what scientists are discovering about how alcohol impacts us in the long term.

Alcohol in the long run

Despite studies that once praised the value of moderate drinking, there is a growing amount of work pointing to some of the darker sides of constant alcohol use. A smattering of those effects include impacts on white matter in the brain, memory, and a strange relationship with binge-eating.

When it comes to general longevity and health, alcohol doesn’t have a great reputation. On that front, a few population-wide studies published in recent years add some color to Neufeld’s findings.

"Alcohol use has been established as one of the main contributors, if not the main contributor, to Russian mortality."

In August 2018, The Lancet released a study noting that there was no safe level of drinking. Based on data collected from 694 data sources and 594 studies on alcohol use between 1990 and 2016, that analysis found that alcohol was the seventh leading risk factor for death in 2016. They concluded that even one drink carried significant enough health risks to suggest that alcohol causes “substantial health loss.”

It’s important to note that this study was aimed at looking into alcohol’s role in bolstering other types of conditions that lead to sickness or death — like, say, liver disease or traffic accidents. They concluded that it played a significant enough role to “shatter” the myth that drinking is healthy, as the study’s senior study author Emmanuela Gakidou, Ph.D., noted in August.

“The myth that one or two drinks a day are good for you is just that — a myth,” she said. “This study shatters that myth.”

That study took a hard line, but there is other evidence that attacks the long-term risks of alcohol from the opposite direction: by looking into what happens when people quit, or at least curb their consumption. One study that took this approach was published in July 2019 and compared the alcohol habits and well-being of 10,385 Chinese people and 31,079 Americans.

"The myth that one or two drinks a day are good for you is just that — a myth."

There they found that, in both populations, the people who didn’t drink at all reported the highest levels of mental well-being than people who even drank casually. Women who decided to give up alcohol were able to increase their mental well-being over the course of four years, but those who kept on drinking moderately saw no changes.

Generally speaking, moderation is important when it comes to alcohol, but studies like these speak to the fact that it’s best to know exactly what you’re dealing with. In the long run, it’s not exactly a health booster. But neither are plenty of the things we’re exposed to every day, from sugar to sitting to air pollution.

But these massive county-level public health studies are concerned with getting the facts straight about just how much alcohol might contribute to risks down the line. In light of that, Neufeld’s Russian study provides a useful look.

It may not be enough to affect the way we drink on a day to day basis, but it does illuminate how a culture shaped by alcohol — as human culture has been since the very beginning — can come with a cost.

Partial Abstract:

Results: Corresponding trends of alcohol consumption and all-cause mortality and cause-specific mortality were observed for the analyzed period. Steep increases in consumption and mortality occurred in 1991–1994 and in 1998–2002, and a continuous decline was observed since 2003. Trends in alcohol consumption were also closely mirrored by trends in life expectancy. These dynamics seem to be affected by economic trends and alcohol control policies, which were increasingly implemented over the observation period, even though some measures remained vague.

Conclusions: A combination of several factors seems to be at play to explain alcohol consumption and mortality 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 have reinforced the existing economic trends.