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Gugushvili A, Azarova A, Irdam D, King L. Hazardous alcohol consumption in slow- and fast-privatized Russian industrial towns. Sci Rep 2024; 14:11737. [PMID: 38778062 PMCID: PMC11111452 DOI: 10.1038/s41598-024-62077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Hazardous drinking, defined as the consumption of homemade, unofficially made alcohol and non-beverages, is prevalent and accounts for a high proportion of alcohol-related deaths in Russia. Individual-level characteristics are important explanations of hazardous drinking, but they are unlikely to explain spatial variation in this type of alcohol consumption. Areas that attracted insufficient attention in the research of hazardous drinking are the legacy of industrialization and the speed of economic reforms, mainly through the privatization policy of major enterprises in the 1990s. Applying mixed-effects logistic regressions to a unique dataset from 30 industrial towns in the European part of Russia, we find that in addition to individual-level characteristics such as gender, age, marital status, education, social isolation, labor market status, and material deprivation, the types of towns where informants' relatives resided such as industrial structure and speed of privatization also accounted for the variance in hazardous alcohol consumption among both male and female populations of the analyzed towns.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo, Postboks 1096, Blindern, 0317, Oslo, Norway.
| | - Aytalina Azarova
- Department of Public Health and Primary Care, University of Cambridge, Worts Causeway, Cambridge, CB1 8RN, UK
| | - Darja Irdam
- Hall & Partners, Bankside 2, 90-100 Southwark Street, London, SE1 0SW, UK
| | - Lawrence King
- Department of Economics, University of Massachusetts, Crotty Hall, 412 North Pleasant Street, Amherst, MA, 01002, USA
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Gugushvili A, Präg P. Intergenerational social mobility and health in Russia: Mind over matter? ADVANCES IN LIFE COURSE RESEARCH 2021; 47:100390. [PMID: 36695147 DOI: 10.1016/j.alcr.2020.100390] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/11/2020] [Accepted: 11/23/2020] [Indexed: 06/17/2023]
Abstract
The consequences of changing one's socio-economic status over the life course-i.e. social mobility-for individual health are not well understood. Theories of the health implications of social mobility draw on the human perception of one's changing conditions, but empirical studies mostly examine the health implications of moving from objectively defined indicators of parental socio-economic position such as education, occupation, or income, to own socio-economic position in adult life. Little is known about the consequences of individuals' own assessment of changes in socio-economic position for health outcomes. In this study, we examine the association of social mobility and health in a unique sample of the Russian population after the transition to a market society. We take a broad perspective on social mobility, putting emphasis on subjectively perceived social mobility. Results show that individuals' objective characteristics only partially explain the variation in their subjective perceptions of intergenerational mobility. Net of social origin and destination variables, subjective social mobility is associated with individuals' health outcomes, as measured by the 12-Item Short Form Health Survey. Those who perceive being upwardly mobile report better health, and downward mobility is associated with poorer health. The association holds for mental and physical health, for perceived downward and upward social mobility, and for a general subjective measure of mobility and a subjective measure prompting respondents to only think of mobility in terms of occupation. These findings are robust to controlling for a rich set of socio-demographic predictors on childhood adversity, contemporaneous material wellbeing, and family-related circumstances. We conclude that a conventional focus on single socio-economic status dimensions such as occupation might be too narrow to capture the health consequences of social mobility.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo, Postboks 1096, Blindern, 0317, Oslo, Norway.
| | - Patrick Präg
- CREST/ENSAE Paris, 5 Avenue Le Chatelier, 91120, Palaiseau, France.
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Doniec K, Stefler D, Murphy M, Gugushvili A, McKee M, Marmot M, Bobak M, King L. Education and mortality in three Eastern European populations: findings from the PrivMort retrospective cohort study. Eur J Public Health 2020; 29:549-554. [PMID: 30520992 DOI: 10.1093/eurpub/cky254] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of the study is 2-fold. Firstly, it attempts to investigate the potential impact of major political and economic changes on inequalities in all-cause mortality among men and women with different levels of education in three Eastern European countries. Secondly, to identify changes in contribution of smoking and drinking to educational differences in all-cause mortality. Study covers the period from 1982 to 2013. METHODS Data were collected in 2013-14 as a part of the PrivMort retrospective cohort study. Participants in Russia, Belarus and Hungary provided information on their educational attainment, health-related behaviors and vital statistics of their close relatives (N = 179 691). Odds ratios for mortality and relative indices of inequality (RII) were estimated for individuals aged 20-65 years, stratifying by three levels of educational attainment: higher, secondary and less than secondary education. RESULTS Those in lower educational groups were significantly more likely to die, through most time periods and sub-groups. The RII increased over time in all countries and both genders, except for Hungarian men. Alcohol consumption and smoking have increasingly contributed to educational inequalities in mortality during this period. CONCLUSION Educational inequalities in mortality in these Eastern European countries have increased during recent decades. Smoking and alcohol consumption, two major health-related behaviors, made a significant contribution to these increases in inequality.
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Affiliation(s)
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics and Political Science, London, UK
| | - Alexi Gugushvili
- Department of Social Policy and Intervention and Nuffield College, University of Oxford, Oxford, UK
| | - Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
| | - Michael Marmot
- Institute of Health Equity, University College London, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Lawrence King
- Department of Economics, University of Massachusetts, Amherst, USA
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Gugushvili A, Jarosz E. Inequality, validity of self-reported height, and its implications for BMI estimates: An analysis of randomly selected primary sampling units' data. Prev Med Rep 2019; 16:100974. [PMID: 31485392 PMCID: PMC6715954 DOI: 10.1016/j.pmedr.2019.100974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/14/2019] [Accepted: 08/15/2019] [Indexed: 11/30/2022] Open
Abstract
Any systematic errors in self-reported height, a measure commonly used in health research, may produce biased BMI estimates and reduce the effectiveness of public health interventions. To our knowledge, none of the studies evaluating the validity of self-reported height explore this issue in cross-national settings. This study analyses data on a sub-set of 750 individuals with information on self-reported and measured height from the Life in Transition Survey (LITS) conducted in 34 European and Central Asian countries in 2016. We make use of the unique design of LITS in which all respondents reported their height, but in one randomly selected primary sampling unit in each country the actual height was also measured, using a portable stadiometer. In addition to analysing individual-level characteristics, using a multiply imputed dataset for missing data and multilevel mixed-effects regressions, we test if macro-level factors are associated with respondents under- or over-reporting their height. We find that on the aggregate level self-reported and measured height estimates are not statistically different, but some socio-demographic groups such as women and those who live in rural areas are likely to overestimate their height. Adjusting for this bias would lead to the higher estimates of the proportion of individuals who are overweight and obese. The results from multilevel analysis also show that macro-level factors do not per se explain the likelihood of misreporting height, but rather some of the effects of individual characteristics are moderated by income inequality. Systematic errors in self-reported height may produce biased BMI estimates. On the aggregate level self-reported and measured height are indistinguishable. Women and those who live in rural areas are likely to overestimate their height. This bias can increase the estimated population BMI level by 2.1%. Some of the effects of individual variables are moderated by income inequality.
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Affiliation(s)
- Alexi Gugushvili
- Department of Social Policy and Intervention, Nuffield College, University of Oxford, Barnett House, 32 Wellington Square, Oxford OX1 2ER, United Kingdom
| | - Ewa Jarosz
- Department of Sociology, Centre for Time Use Research, University of Oxford, Institute of Philosophy and Sociology, Polish Academy of Sciences, 74 Woodstock Road Oxford, OX2 6HP, United Kingdom
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Stefler D, Azarova A, Irdam D, Scheiring G, Murphy M, McKee M, King L, Bobak M. Smoking, alcohol and cancer mortality in Eastern European men: Findings from the PrivMort retrospective cohort study. Int J Cancer 2018; 143:1128-1133. [PMID: 29582432 DOI: 10.1002/ijc.31406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/14/2018] [Accepted: 03/16/2018] [Indexed: 01/29/2023]
Abstract
Eastern European men have among the highest cancer mortality rates globally. Prevalence of smoking and alcohol intake in this region is also high. The aim of our study was to calculate population attributable risk fraction (PARF) of cancer deaths from smoking and alcohol in Russia, Belarus and Hungary, and to examine the contribution of these lifestyle factors to differences in male cancer mortality in the three countries. Data were collected as part of the PrivMort retrospective cohort study. Randomly selected participants living in mid-size towns in Russia, Belarus and Hungary provided information on smoking habits, alcohol consumption, vital status and cause of death (if applicable) of male relatives (fathers, siblings and partners). PARF of cancer deaths (age 35-79) due to smoking, alcohol consumption and both combined was estimated between 2001 and 2013. Among 72,190 men, 4,702 died of cancer. Age standardized cancer mortality rates were similar to official data in all three countries. The estimated PARF (95% CI) associated with measures of smoking, alcohol consumption, both combined, and overall smoking or drinking were 25% (19-30), 2% (0-4), 29% (19-39), 43% (32-53) in Russia, 18% (8-28), 2% (-1 to 6), 28% (20-35), 38% (25-50) in Belarus and 17% (13-20), 1% (0-3), 25% (20-30), 35% (28-42) in Hungary, respectively. These results suggest that in Eastern Europe, at least one third of cancer deaths in males may have been attributable to smoking and/or alcohol consumption in recent years. Health policies targeting these lifestyle factors can have a major impact on population health.
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Affiliation(s)
- Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Aytalina Azarova
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom
| | - Gabor Scheiring
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Larry King
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom.,Department of Economics, University of Massachusetts, Amherst, MA, United States
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Horvat P, Stefler D, Murphy M, King L, McKee M, Bobak M. Alcohol, pattern of drinking and all-cause mortality in Russia, Belarus and Hungary: a retrospective indirect cohort study based on mortality of relatives. Addiction 2018; 113:1252-1263. [PMID: 29446502 DOI: 10.1111/add.14189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/26/2017] [Accepted: 02/05/2018] [Indexed: 01/28/2023]
Abstract
AIMS To assess the relationship between alcohol intake frequency and mortality among males and females in three Eastern European populations, and to estimate the additional mortality risk posed by a combination of frequent drinking, binge drinking and other hazardous drinking habits. DESIGN Retrospective cohort study; the cohort consisted of close relatives of survey participants. SETTING Middle-sized settlements in Russia, Belarus and Hungary. PARTICIPANTS A total of 124 150 subjects aged 35-69 years in 1998 and followed-up until 2013. MEASUREMENTS Survey respondents provided information on their mothers, fathers, siblings and partners of female respondents. This information, including current vital status and dates of birth and death, was used to construct the cohort of relatives. Alcohol consumption indices, reported by survey participants, included drinking frequency, binge drinking and hazardous drinking [consuming non-beverage and/or illicitly-produced alcohol and/or heavy drinking over several days (zapoi in Russian)]. FINDINGS Drinking frequency was associated positively with mortality in all three countries and both genders. At each drinking frequency level, mortality risk increased among those who also engaged in binge and/or hazardous drinking. Regular male drinkers who were also binge drinkers and hazardous drinkers had the highest risk of death; their hazard ratios (HR), compared with non-binge-non-hazardous occasional drinkers, were 2.56 [95% confidence interval (CI) = 2.27-2.88], 2.14 (95% CI = 1.84-2.48) and 2.11 (95% CI = 1.90-2.35) in Russia, Belarus and Hungary, respectively. In women, the corresponding HRs (using a lower frequency cut-off) were 2.86 (95% CI = 1.99-4.12) in Russia, 3.44 (95% CI = 2.17-5.44) in Belarus and 3.01 (95% CI = 2.26-4.01) in Hungary. CONCLUSIONS Drinking frequency is associated positively with mortality among men and women in Russia, Belarus and Hungary. The mortality risk is higher among frequent drinkers who exhibit binge and hazardous drinking patterns.
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Affiliation(s)
- Pia Horvat
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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Gugushvili A, Azarova A, Irdam D, Crenna-Jennings W, Murphy M, McKee M, King L. Correlates of frequent alcohol consumption among middle-aged and older men and women in Russia: A multilevel analysis of the PrivMort retrospective cohort study. Drug Alcohol Depend 2018; 188:39-44. [PMID: 29730584 DOI: 10.1016/j.drugalcdep.2018.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND A large proportion of premature deaths in Russia since the early 1990s, following the transition from communism, have been attributed to hazardous drinking. Little is known about the correlates of alcohol consumption. We present new data on the consumption of alcoholic beverages among middle-aged and older Russians and identify socio-demographic, socio-economic, and life-course correlates of frequent drinking. METHODS Within the framework of the PrivMort project, conducted in 30 industrial towns in the European part of Russia, we acquired information on the frequency of drinking among 22,796 respondents and 57,907 of their surviving and deceased relatives. We fit three-level mixed-effects logistic regression models of frequent drinking in which respondents' relatives, aged 40 and over, are nested in their families and towns. RESULTS Deceased male relatives consumed alcohol significantly more often, while deceased female relatives consumed alcohol significantly less often than the respondents of corresponding gender. In a multivariable analysis, we found that individuals' education, communication with family members, labour market status, history of unemployment, and occupational attainment are all significant correlates of frequent drinking in Russia. These associations are stronger among men rather than among women. CONCLUSION There are significant differences between frequency of drinking among surviving and deceased individuals and frequent drinking is associated with a wide array of individual socio-demographic, socio-economic, and life course factors that can partially explain high alcohol consumption in post-communist Russia.
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Affiliation(s)
- Alexi Gugushvili
- Department of Social Policy and Intervention and Nuffield College, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
| | - Aytalina Azarova
- Department of Sociology, University of Cambridge, 16 Mill Lane, Cambridge, CB2 1SB, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, 16 Mill Lane, Cambridge, CB2 1SB, UK
| | | | - Michael Murphy
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Lawrence King
- University of Massachusetts, 300 Massachusetts Ave, Amherst, MA, 01003, USA
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Gugushvili A, McKee M, Azarova A, Murphy M, Irdam D, King L. Parental transmission of smoking among middle-aged and older populations in Russia and Belarus. Int J Public Health 2018; 63:349-358. [PMID: 29302722 PMCID: PMC5978922 DOI: 10.1007/s00038-017-1068-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 06/12/2017] [Accepted: 12/14/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The very high rates of smoking among men and the rapid changes among women in the Post-Soviet countries mean that this region offers an opportunity to understand better the intergenerational role of parental influences on smoking. METHODS In this study, we exploit a unique data set, the PrivMort cohort study conducted in 30 Russian and 20 Belarusian towns in 2014-2015, which collects information on behaviours of middle-aged and older individuals and their parents, including smoking. We explored the associations between smoking by parents and their offspring using multiply imputed data sets and multilevel mixed-effect Poisson regressions. RESULTS Adjusting for a wide array of social origin, socio-demographic, and socio-economic variables, our analysis suggests that sons of regularly smoking fathers have prevalence ratios of 1.35 [95% confidence intervals (CI) 1.21-1.50] and 1.39 (CI 1.23-1.58) of smoking, while the figures for daughters of regularly smoking mothers are 1.91 (CI 1.40-2.61) and 2.30 (CI 1.61-3.28), respectively, in Russia and Belarus. CONCLUSIONS Intergenerational paternal and maternal influences on smoking should be taken into account in studies seeking to monitor the rates of smoking and the impact of tobacco control programmes.
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Affiliation(s)
- Alexi Gugushvili
- Department of Social Policy and Intervention and Nuffield College, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
- Department of Sociology, University of Cambridge, Cambridge, UK.
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Michael Murphy
- London School of Economics and Political Science, London, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
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Gugushvili A, McKee M, Murphy M, Azarova A, Irdam D, Doniec K, King L. Intergenerational Mobility in Relative Educational Attainment and Health-Related Behaviours. SOCIAL INDICATORS RESEARCH 2018; 141:413-441. [PMID: 31467460 PMCID: PMC6694039 DOI: 10.1007/s11205-017-1834-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/28/2017] [Indexed: 06/07/2023]
Abstract
Research on intergenerational social mobility and health-related behaviours yields mixed findings. Depending on the direction of mobility and the type of mechanisms involved, we can expect positive or negative association between intergenerational mobility and health-related behaviours. Using data from a retrospective cohort study, conducted in more than 100 towns across Belarus, Hungary and Russia, we fit multilevel mixed-effects Poisson regressions with two measures of health-related behaviours: binge drinking and smoking. The main explanatory variable, intergenerational educational mobility is operationalised in terms of relative intergenerational educational trajectories based on the prevalence of specified qualifications in parental and offspring generations. In each country the associations between intergenerational educational mobility, binge drinking and smoking was examined with incidence rate ratios and predicted probabilities, using multiply imputed dataset for missing data and controlling for important confounders of health-related behaviours. We find that intergenerational mobility in relative educational attainment has varying association with binge drinking and smoking and the strength and direction of these effects depend on the country of analysis, the mode of mobility, the gender of respondents and the type of health-related behaviour. Along with accumulation and Falling from Grace hypotheses of the consequences of intergenerational mobility, our findings suggest that upward educational mobility in certain instances might be linked to improved health-related behaviours.
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Affiliation(s)
- Alexi Gugushvili
- 1Department of Social Policy and Intervention and Nuffield College, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Martin McKee
- 2European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
| | - Michael Murphy
- 3Department of Social Policy, London School of Economics and Political Science, London, UK
| | - Aytalina Azarova
- 4Department of Sociology, University of Cambridge, Cambridge, UK
| | - Darja Irdam
- 4Department of Sociology, University of Cambridge, Cambridge, UK
| | - Katarzyna Doniec
- 4Department of Sociology, University of Cambridge, Cambridge, UK
| | - Lawrence King
- 4Department of Sociology, University of Cambridge, Cambridge, UK
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Scheiring G, Stefler D, Irdam D, Fazekas M, Azarova A, Kolesnikova I, Köllő J, Popov V, Szelenyi I, Marmot M, Murphy M, McKee M, Bobak M, King L. The gendered effects of foreign investment and prolonged state ownership on mortality in Hungary: an indirect demographic, retrospective cohort study. LANCET GLOBAL HEALTH 2017; 6:e95-e102. [PMID: 29191434 DOI: 10.1016/s2214-109x(17)30391-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 09/07/2017] [Accepted: 09/19/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research on the health outcomes of globalisation and economic transition has yielded conflicting results, partly due to methodological and data limitations. Specifically, the outcomes of changes in foreign investment and state ownership need to be examined using multilevel data, linking macro-effects and micro-effects. We exploited the natural experiment offered by the Hungarian economic transition by means of a multilevel study designed to address these gaps in the scientific literature. METHODS For this indirect demographic, retrospective cohort study, we collected multilevel data related to Hungary between 1995 and 2004 from the PrivMort database and other sources at the town, company, and individual level to assess the relation between the dominant company ownership of a town and mortality. We grouped towns into three ownership categories: dominant state, domestic private, and foreign ownership. We did population surveys in these towns to collect data on vital status and other characteristics of survey respondents' relatives. We assessed the relation between dominant ownership and mortality at the individual level. We used discrete-time survival modelling, adjusting for town-level and individual-level confounders, with clustered SEs. FINDINGS Of 83 eligible towns identified, we randomly selected 52 for inclusion in the analysis and analysed ownership data from 262 companies within these towns. Additionally, between June 16, 2014, and Dec 22, 2014, we collected data on 78 622 individuals from the 52 towns, of whom 27 694 were considered eligible. After multivariable adjustment, we found that women living in towns with prolonged state ownership had significantly lower odds of dying than women living in towns dominated by domestic private ownership (odds ratio [OR] 0·74, 95% CI 0·61-0·90) or by foreign investment (OR 0·80, 0·69-0·92). INTERPRETATION Prolonged state ownership was associated with protection of life chances during the post-socialist transformation for women. The indirect economic benefits of foreign investment do not translate automatically into better health without appropriate industrial and social policies. FUNDING The European Research Council.
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Affiliation(s)
- Gábor Scheiring
- Department of Sociology, University of Cambridge, Cambridge, UK.
| | - Dénes Stefler
- Department of Epidemiology, University College London, London, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Mihaly Fazekas
- Department of Sociology, University of Cambridge, Cambridge, UK
| | | | - Irina Kolesnikova
- Institute of Economics, National Academy of Sciences of Belarus, Minsk, Belarus
| | - János Köllő
- Institute of Economics, Hungarian Academy of Sciences, Budapest, Hungary
| | | | - Ivan Szelenyi
- Department of Sociology, Yale University, New Haven, CT, USA
| | - Michael Marmot
- Department of Epidemiology, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Martin Bobak
- Department of Epidemiology, University College London, London, UK
| | - Lawrence King
- Department of Economics, University of Massachusetts, Amherst, MA, USA
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Gugushvili A. Political democracy, economic liberalization, and macro-sociological models of intergenerational mobility. SOCIAL SCIENCE RESEARCH 2017; 66:58-81. [PMID: 28705364 DOI: 10.1016/j.ssresearch.2017.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 05/11/2017] [Accepted: 06/17/2017] [Indexed: 06/07/2023]
Abstract
Building on the previously investigated macro-sociological models which analyze the consequences of economic development, income inequality, and international migration on social mobility, this article studies the specific contextual covariates of intergenerational reproduction of occupational status in post-communist societies. It is theorized that social mobility is higher in societies with democratic political regimes and less liberalized economies. The outlined hypotheses are tested by using micro- and macro-level datasets for 21 post-communist societies which are fitted into multilevel mixed-effects linear regressions. The derived findings suggest that factors specific to transition societies, conventional macro-level variables, and the legacy of the Soviet Union explain variation in intergenerational social mobility, but the results vary depending which birth cohorts survey participants belong to and whether or not they stem from advantaged or disadvantaged social origins. These findings are robust to various alternative data, sample, and method specifications.
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Affiliation(s)
- Alexi Gugushvili
- Department of Social Policy and Intervention and Nuffield College, University of Oxford, Department of Sociology, University of Cambridge, Barnett House, 32 Wellington Square, Oxford OX1 2ER, United Kingdom.
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Stefler D, Murphy M, Irdam D, Horvat P, Jarvis M, King L, McKee M, Bobak M. Smoking and Mortality in Eastern Europe: Results From the PrivMort Retrospective Cohort Study of 177 376 Individuals. Nicotine Tob Res 2017; 20:749-754. [DOI: 10.1093/ntr/ntx122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/30/2017] [Indexed: 11/14/2022]
Affiliation(s)
- Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Pia Horvat
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Jarvis
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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Azarova A, Irdam D, Gugushvili A, Fazekas M, Scheiring G, Horvat P, Stefler D, Kolesnikova I, Popov V, Szelenyi I, Stuckler D, Marmot M, Murphy M, McKee M, Bobak M, King L. The effect of rapid privatisation on mortality in mono-industrial towns in post-Soviet Russia: a retrospective cohort study. LANCET PUBLIC HEALTH 2017. [PMID: 28626827 PMCID: PMC5459934 DOI: 10.1016/s2468-2667(17)30072-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Population-level data suggest that economic disruptions in the early 1990s increased working-age male mortality in post-Soviet countries. This study uses individual-level data, using an indirect estimation method, to test the hypothesis that fast privatisation increased mortality in Russia. METHODS In this retrospective cohort study, we surveyed surviving relatives of individuals who lived through the post-communist transition to retrieve demographic and socioeconomic characteristics of their parents, siblings, and male partners. The survey was done within the framework of the European Research Council (ERC) project PrivMort (The Impact of Privatization on the Mortality Crisis in Eastern Europe). We surveyed relatives in 20 mono-industrial towns in the European part of Russia (ie, the landmass to the west of the Urals). We compared ten fast-privatised and ten slow-privatised towns selected using propensity score matching. In the selected towns, population surveys were done in which respondents provided information about vital status, sociodemographic and socioeconomic characteristics and health-related behaviours of their parents, two eldest siblings (if eligible), and first husbands or long-term partners. We calculated indirect age-standardised mortality rates in fast and slow privatised towns and then, in multivariate analyses, calculated Poisson proportional incidence rate ratios to estimate the effect of rapid privatisation on all-cause mortality risk. FINDINGS Between November, 2014, and March, 2015, 21 494 households were identified in 20 towns. Overall, 13 932 valid interviews were done (with information collected for 38 339 relatives [21 634 men and 16 705 women]). Fast privatisation was strongly associated with higher working-age male mortality rates both between 1992 and 1998 (age-standardised mortality ratio in men aged 20-69 years in fast vs slow privatised towns: 1·13, SMR 0·83, 95% CI 0·77-0·88 vs 0·73, 0·69-0·77, respectively) and from 1999 to 2006 (1·15, 0·91, 0·86-0·97 vs 0·79, 0·75-0·84). After adjusting for age, marital status, material deprivation history, smoking, drinking and socioeconomic status, working-age men in fast-privatised towns experienced 13% higher mortality than in slow-privatised towns (95% CI 1-26). INTERPRETATION The rapid pace of privatisation was a significant factor in the marked increase in working-age male mortality in post-Soviet Russia. By providing compelling evidence in support of the health benefits of a slower pace of privatisation, this study can assist policy makers in making informed decisions about the speed and scope of government interventions. FUNDING The European Research Council.
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Affiliation(s)
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Alexi Gugushvili
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Mihaly Fazekas
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Gábor Scheiring
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Pia Horvat
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Irina Kolesnikova
- Institute of Economics of the National Academy of Sciences of Belarus, Minsk, Belarus
| | - Vladimir Popov
- Central Economics and Mathematics Institute, Russian Academy of Sciences, Moscow, Russia
| | - Ivan Szelenyi
- Sociology Department, Yale University, New Haven, CT, USA
| | - David Stuckler
- Faculty of Politics, Psychology, Sociology and International Studies, University of Oxford, Oxford, UK
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
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