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PubMed1979

Relations between demographic parameters.

The mean life-expectancy e describes the average prospective life-time of an individual aged zero. This parameter can be explicitly described in terms of the survivorship distribution of the population. The Malthusian parameter r represents the asymptotic growth rate of a population. This parameter can be implicitly expressed in terms of the net-maternity distribution. The parameters e and r incompletely incorporate the age-specific fertility and mortality pattern of a population; distinct populations may have the same growth rate but different net-maternity functions; distinct populations may be characterized by the same mean life expectation but may have different survivorship distributions. This article analyzes a class of parameters called the entropy of a population (Demetrius, 1974a) which distinguishes between net-maternity functions with the same growth rate and also mortality distributions with the same mean life expectation. This class of parameters measures the convexity of the fertility and mortality distributions. This paper analyzes the relations between the entropy parameter and the standard demographic parameters.

Demography↗
PubMed1984

A result-oriented medical information system. An alternative to the conventional approach.

A result-oriented medical information system at the Gulf Oil Corporation is described. Mortality data acquired mostly from routine company operations have been used to calculate standardized mortality ratios (SMRs) and life expectancy. Results show that male employees at the age of 20 have a life expectancy of 74.8 years. Compared with the U.S. general population at age 20 with a life expectancy of 71.8 years, Gulf employees have an advantage of exactly three years. Such an advantage may seem small, but it is equivalent to the gain that could be achieved if all deaths from cancer were eliminated in the United States, a hypothetical and impossible situation. These life expectancy data have the potential for use by the company to influence insurance premiums traditionally set by life insurance companies as well as to aid in the management of the company's pension fund. The SMR for all causes for the male employees is 0.82, significantly decreased in comparison with that of the U.S. general population. This favorable experience has been referred to as "the healthy worker effect." Cause-specific SMRs show a generalized pattern of deficits, some of which are statistically significant. None showed a significant increase. Seventy-six percent of the male deaths occurred among employees aged 65 years or older. If these annuitants (those alive at the beginning of the study) were not included and only the active workers were studied, an SMR of only 0.54 would be obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMed2005

Comparing risks and benefits of colorectal cancer screening in elderly patients.

BACKGROUND & AIMS: In patients with limited life expectancy, the risks of colorectal cancer screening may outweigh the benefits. The aim of this study was to quantify risks and benefits of different screening strategies in elderly patients with varying life expectancies. METHODS: We examined risks and benefits of screening in patients aged 70-94 years with differing health status using 3 strategies: annual fecal occult blood tests, flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years. We compared the number needed to screen to prevent one cancer-related death and the number needed to encounter one screening-related complication for different strategies. RESULTS: The potential benefit from screening varied widely with age, life expectancy, and screening modality. One cancer-related death would be prevented by screening 42 healthy men aged 70-74 years with colonoscopy, 178 healthy women aged 70-74 years with fecal occult blood tests, 431 women aged 75-79 years in poor health with colonoscopy, or 945 men aged 80-84 years in average health with fecal occult blood tests. Colonoscopy screening had the greatest benefit but the highest risk of complications. The potential for screening-related complications was greater than estimated benefit in some population subgroups aged 70 years and older. At all ages and life expectancies, the potential reduction in mortality from screening outweighed the risk of colonoscopy-related death. CONCLUSIONS: The potential benefits and risks of screening vary in elderly patients of different life expectancies. For any individual patient, the potential for harm from screening must be weighed against the likelihood of benefit, especially with shorter life expectancy.

Aged↗
PubMed2001

Cancer screening in elderly patients: a framework for individualized decision making.

Considerable uncertainty exists about the use of cancer screening tests in older people, as illustrated by the different age cutoffs recommended by various guideline panels. We suggest that a framework to guide individualized cancer screening decisions in older patients may be more useful to the practicing clinician than age guidelines. Like many medical decisions, cancer screening decisions require weighing quantitative information, such as risk of cancer death and likelihood of beneficial and adverse screening outcomes, as well as qualitative factors, such as individual patients' values and preferences. Our framework first anchors decisions through quantitative estimates of life expectancy, risk of cancer death, and screening outcomes based on published data. Potential benefits of screening are presented as the number needed to screen to prevent 1 cancer-specific death, based on the estimated life expectancy during which a patient will be screened. Estimates reveal substantial variability in the likelihood of benefit for patients of similar ages with varying life expectancies. In fact, patients with life expectancies of less than 5 years are unlikely to derive any survival benefit from cancer screening. We also consider the likelihood of potential harm from screening according to patient factors and test characteristics. Some of the greatest harms of screening occur by detecting cancers that would never have become clinically significant. This becomes more likely as life expectancy decreases. Finally, since many cancer screening decisions in older adults cannot be answered solely by quantitative estimates of benefits and harms, considering the estimated outcomes according to the patient's own values and preferences is the final step for making informed screening decisions.

Aged↗
PubMed2005

Does socio-economic advantage lead to a longer, healthier old age?

The effect of socio-economic disadvantage on mortality is well documented and differences exist even at older ages. However, whether this translates into differences in the quality of life lived at older ages is less well studied, and in particular in the proportion of remaining life spent without ill health (healthy life expectancy), a key UK Government target. Although there have been studies exploring socio-economic differences in disability-free life expectancy (DFLE) worldwide, these have tended to focus on a single measure of socio-economic advantage, for example, education, race, social class or income, with the majority based on cross-sectional data from younger populations. In this prospective study we examine differences in DFLE and total life expectancy (TLE) at older ages using a range of measures of socio-economic advantage. We use a longitudinal study of 1480 participants aged 75 years or over in 1988 registered with a UK primary care practice, who were followed up until 2003 with measurements at up to seven time points. Disability was defined as difficulty with any one of five activities of daily living. The largest differences in DFLE for both men and women were found for housing tenure. Women aged 75 years living in owned or mortgaged property could expect to live 1 year extra without disability compared with those living in rented accommodation, while for men the difference was almost 1.5 years. The effect of socio-economic advantage on disability-free and total life expectancies appeared to be larger for men than women. In women, socio-economic advantage had more effect on DFLE than total life expectancy for all indicators considered, thus the socio-economically advantaged experienced a compression of disability.

Aged↗
PubMed1992

[Cardiovascular pathology related to aging. Role of prevention].

During the last 50 years the increase of life expectancy has been dramatic in all Western countries. In France, the life expectancy in 1988 was 80.6 years for women and 72.3 years for men. In 1980, the life expectancy at the age of 60 was more than 20 years in women and 16 years in men. Side by side with this increase of life expectancy there has been a change in the structure of the causes of death. Cardiovascular diseases accounted for 15.6 percent of all causes in 1930, 31 percent in 1950 and 37.4 percent in 1980. Cardiovascular diseases therefore rank very high among the causes of mortality, and one of the principal reasons for this is ageing of the population. Studying the epidemiology of cardiovascular ageing is tantamount to determining the part played by prevention in these diseases. There are wide fluctuations in cardiovascular mortality rate according to some demographic variables: men are more affected than women, the poorer subjects more than the richer subjects, and people living in the North of France more than those living in the South. These disparities are real, irrespective of age, and they can be explained, at least partly, by differences in the prevalence of well-known risk factors. Cardiovascular ageing plays a role, probably important, in the genesis of physical and mental disabilities, but markers that would measure them precisely are lacking. The development of such indicators is a major line of research which should make it possible to evaluate the prospective results of a policy of prevention in a segment of the population where people aged 60 or more accounted for 19.1 percent in 1990 and will account for 25 percent in the year 2020.

Adult↗
PubMed2006

Paleodemography of a medieval population in Japan: analysis of human skeletal remains from the Yuigahama-minami site.

The purpose of this study is to obtain demographic data regarding the medieval population buried at the Yuigahama-minami site in Kamakura, Japan, and to detect a secular trend in the life expectancy of Japanese population over the last several thousand years. The Yuigahama-minami skeletal sample consists of 260 individuals, including 98 subadults (under 20 years old) and 162 adults. A Yuigahama-minami abridged life-table analysis yielded a life expectancy at birth (e0) of 24.0 years for both sexes, a life expectancy at age 15 years (e15) of 15.8 years for males, and an e15 of 18.0 years for females. The reliability of the estimated e0 was confirmed by analysis of the juvenility index. Demographic profiles comparing the Yuigahama-minami series with other skeletal series indicated that both the survivorship curve and life expectancy of the Yuigahama-minami sample are similar to those of the Mesolithic-Neolithic Jomon population, but are far lower than those of the early modern Edo population. These comparisons strongly suggest that life expectancy changed little over the thousands of years between the Mesolithic-Neolithic Jomon and medieval periods, but then improved remarkably during the few hundred years between the medieval period and early modern Edo period. The short-lived tendency of the Yuigahama-minami sample does not contradict the archaeological hypothesis of unsanitary living conditions in medieval Kamakura. This is the first investigation to address the demographic features of a medieval population in Japan, and will help refine our understanding of long-term trends in the demographic profiles of inhabitants of Japan.

Adult↗
PubMed2005

Management of influenza symptoms in healthy children: cost-effectiveness of rapid testing and antiviral therapy.

OBJECTIVE: To determine the cost-effectiveness of rapid testing and antiviral therapy for children of different ages with symptoms of influenza. DESIGN: Cost-effectiveness analysis from the societal perspective using a decision model based on published data. SETTING: Physician's office during an influenza A epidemic. PARTICIPANTS: Hypothetical children aged 2, 7, and 15 years. INTERVENTIONS: Rapid testing or clinical diagnosis followed by treatment with amantadine hydrochloride or oseltamivir phosphate compared with no antiviral therapy. OUTCOME MEASURES: Costs and quality-adjusted life expectancy. RESULTS: Empirical therapy with antiviral medication resulted in the greatest quality-adjusted life expectancy in all age groups. Compared with not treating, antiviral therapy improved quality-adjusted life expectancy by 0.003 quality-adjusted life-year by shortening the duration of illness and preventing otitis media. In young children it saved up to USD 121 per child mostly by avoiding parental work loss. Excluding work loss, antiviral therapy improved quality-adjusted life expectancy at a cost of USD 800 to 1800 per quality-adjusted life-year saved. Compared with amantadine, oseltamivir was not cost-effective when influenza A predominated. The incremental cost-effectiveness of oseltamivir fell below USD 50 000 per quality-adjusted life-year saved when the proportion of influenza B exceeded 14% for a 2-year-old, 27% for a 7-year-old, or 43% for a 15-year-old. Rapid testing was cost-effective only when the probability of influenza was 60% or less. CONCLUSIONS: For children presenting with influenza symptoms during a local influenza outbreak, treatment with antiviral therapy appears to offer the best outcome and often saves money. The choice of antiviral drug should be based on the prevalence of influenza B.

Adolescent↗
PubMedDate not supplied

Estimation of expectation of life at advanced ages.

Comments are presented on a formula developed by Enzo Lombardo "for the relation between the death rate above age a and the growth rate above age a (where a is an advanced age, above 55 or 60) on the one hand, and the expectation of life at age a on the other." Estimates obtained by this method are compared with results obtained by the method of S. Horiuchi and A. J. Coale. It is concluded that "the formula proposed by Horiuchi and [Coale] produces much more accurate estimates, with a maximum error of 0.03 years." The author describes a way in which Lombardo's method "can be modified to give estimates of precision comparable to the Horiuchi and Coale estimates." (summary in FRE, ITA)

Adult↗
PubMed2004

Race/ethnicity and the receipt of watchful waiting for the initial management of prostate cancer.

INTRODUCTION: Several recent studies have noted that African Americans disproportionately receive "watchful waiting" for the initial management of their prostate cancer. To determine whether racial/ethnic differences in the receipt of watchful waiting are explained by differences in clinical presentation and life expectancy at the time of diagnosis, we examined Surveillance, Epidemiology, and End Results (SEER)-Medicare data for men diagnosed with prostate cancer in 1994 to 1996. METHODS: Race/ethnicity, comorbidity, stage, grade, age, and expected lifespan and their association with the receipt of watchful waiting were examined in multivariate logistic regression analyses. Race-stratified logistic regression analyses were also used to examine racial/ethnic variation in the association of clinical and demographic factors with the receipt of watchful waiting among African-American, Hispanic, and non-Hispanic white men. RESULTS: African-American (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.3 to 1.6) and Hispanic men (OR, 1.3; 95% CI, 1.1 to 1.5) were significantly more likely than non-Hispanic white men to receive watchful waiting in a multivariate model adjusted for age, comorbidity, stage, grade, and life expectancy. Advanced stage and grade, lower life expectancy, older age, and high comorbidity indices were also significantly associated with an increase in the odds of receipt of watchful waiting in multivariate analyses. In general, the association between the receipt of watchful waiting and the clinical characteristics (i.e., stage, grade, and age) were similar for the three racial/ethnic groups. In race-stratified logistic regression analyses, life expectancy was associated with an increase in the odds of receiving watchful waiting but results were statistically significant for whites only. There was also a statistically significant increase in the odds of receiving watchful waiting for African-American and white men with high comorbidity indices but not Hispanic men. The odds of receiving watchful waiting were also higher for African-American and Hispanic men who resided in census tracts where a large percentage of residents had not completed high school than for white men who resided in similar census tracts. CONCLUSION: The disproportionate receipt of watchful waiting among African Americans and Hispanics is not completely explained by racial/ethnic variation in clinical characteristics or life expectancy as measured in this study. These data suggest that there are other factors that contribute to racial/ethnic differences in receipt of watchful waiting that warrant investigation.

Black or African American↗
PubMed1993

[Regional and socioeconomic disparities in mortality in Latin America].

Differences in life expectancy between various countries of Latin America decreased considerably between 1960 and 1979. More recently, this decrease has slowed down in the 1980s. Disparities between Latin American countries remain considerable. Indeed, some countries are near European standards, others are more similar to some countries of sub-Saharan Africa with low life expectancy. Statistical analysis has demonstrated that after 1960, disparities are associated with economic factors, life expectancy is lower than 64 years; with cultural factors life expectancy is higher. According to the results of a factoral analysis, it is possible to classify countries into six groups with regard to life expectancy.

Adolescent↗
PubMed2005

A cost-effectiveness analysis of combination antiplatelet therapy for high-risk acute coronary syndromes: clopidogrel plus aspirin versus aspirin alone.

BACKGROUND: Although clopidogrel plus aspirin is more effective than aspirin alone in preventing subsequent vascular events in patients with unstable angina, the cost-effectiveness of this combination has yet to be examined in this high-risk population. OBJECTIVE: To determine the cost-effectiveness of clopidogrel plus aspirin compared with aspirin alone. DESIGN: Cost-utility analysis. DATA SOURCES: Published literature. TARGET POPULATION: Patients with unstable angina and electrocardiographic changes or non-Q-wave myocardial infarction. time horizon: Lifetime. PERSPECTIVE: Societal. INTERVENTIONS: Combination therapy with clopidogrel, 75 mg/d, plus aspirin, 325 mg/d, for 1 year, followed by aspirin monotherapy, was compared with lifelong aspirin therapy, 325 mg/d. OUTCOME MEASURES: Lifetime costs, life expectancy in quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio. RESULTS OF BASE-CASE ANALYSIS: Patients treated with aspirin alone lived 9.51 QALYs after their initial event and incurred expenses of 127,700 dollars; the addition of clopidogrel increased life expectancy to 9.61 QALYs and costs to 129,300 dollars. The incremental cost-effectiveness ratio for clopidogrel plus aspirin compared with aspirin alone was 15,400 dollars per QALY. RESULTS OF SENSITIVITY ANALYSES: The analysis of 1 year of therapy was robust to all sensitivity analyses. In the probabilistic sensitivity analysis, fewer than 3% of simulations resulted in cost-effectiveness ratios over 50,000 dollars per QALY. The cost-effectiveness of longer combination therapy depends critically on the balance of thrombotic event rates, durable efficacy, and the increased bleeding rate in patients taking clopidogrel. LIMITATIONS: This analysis may not apply to patients with severe heart failure, those undergoing long-term anticoagulant therapy, those recently managed with revascularization, or those undergoing short-term treatment with glycoprotein IIb/IIIa inhibitors. CONCLUSIONS: In patients with high-risk acute coronary syndromes, 1 year of therapy with clopidogrel plus aspirin results in greater life expectancy than aspirin alone, at a cost within the traditional limits of cost-effectiveness. The durable efficacy of clopidogrel relative to the risk for hemorrhage should be further explored before more protracted therapy can be recommended.

Angina, Unstable↗
PubMed2006

Increasing geographical inequalities in health in New Zealand, 1980-2001.

BACKGROUND: Recent studies have noted widening health inequalities between rich and poor areas in a number of OECD countries. This paper examines whether health in New Zealand has become more geographically polarized during the period 1980-2001, a time of rapid social and economic changes in New Zealand society. METHODS: Mortality records for each year between 1980 and 2001 were extracted for consistent geographical areas: the 21 District Health Boards operating in New Zealand in 2001 and used to calculate male and female life expectancies for each area. The geographical inequalities in life expectancy were measured by calculating the slope index of inequality for each year between 1980 and 2001. RESULTS: Although overall life expectancy has increased during the period of study, New Zealand has experienced increased spatial polarization in health, with a particularly sharp rise in inequality during the late 1980s and early 1990s. Since the mid-1990s regional inequality has remained at stable but high levels. The polarization in mortality was mirrored by a growth in income inequality during the 1980s and 1990s. CONCLUSIONS: Health inequalities as expressed geographically in New Zealand have reached historically high levels and show little sign of abating. In order to tackle health inequalities, a greater commitment by the New Zealand government to a more redistributive social and economic agenda is required. Furthermore, issues of differentiated and health selective migration, emigration, and immigration need to be addressed as if these are important they should matter more for New Zealand than for almost any other developed nation-state.

Aged↗
PubMedDate not supplied

Simulations model for predicting survival in women receiving adjuvant therapy for early breast cancer.

PURPOSE: In 1990, a worldwide overview of the randomized trials of all aspects of the systemic treatment of early breast cancer was undertaken by the Early Breast Cancer Trialists' Collaborative Group. We used the overview data to develop a simulations model to assess and compare the potential benefits of various adjuvant therapies. METHODS: The model consists of an expert system, a simulations module, a graphical user interface, and an output module. RESULTS: The model has shown that tamoxifen benefited all women regardless of age or estrogen-receptor status. However, absolute gains in disease-free survival and life expectancy compared with controls were higher in women younger than 50 years of age. Prolonged chemotherapy showed absolute benefits in disease-free survival and life expectancy for all age groups and all nodal states, but the magnitude of absolute benefit appeared smaller in older women. The magnitude of the absolute gain in disease-free survival and life expectancy achieved by ovarian ablation in patients younger than 50 years of age was equal to or better than that attained by tamoxifen or prolonged chemotherapy. Ovarian ablation added to chemotherapy in young patients has demonstrated an improvement in disease-free survival and life expectancy superior to that achieved by chemotherapy alone. On the other hand, particularly for women younger than 50 years, the magnitude of the survival gain accomplished by combining tamoxifen and chemotherapy versus each modality alone was greater for disease-free survival than for life expectancy. CONCLUSIONS: We illustrate the development process and outcome of a robust tool for reasoning and decision-making. The limitations of the model are discussed.

Adult↗
PubMed2001

Older female inpatients in Arkansas.

The purpose of this study was to examine age and Major Diagnostic Categories (MDCs) and compare the variables to mortality and length of stay among inpatient women age 50 and over. Archival statistical data were obtained for 2,238 inpatients in a private, nonprofit hospital in 1998. The ages ranged from 50 to 107 years old, with a mean age of 71.21 years. Quantitative analyses were conducted to examine the data from a private, nonprofit hospital and determine if there were significant relationships between age, major diagnostic category, length of stay, and mortality in older women. The MDC distribution indicated that the highest frequency of diseases and disorders were in the following three systems: circulatory system, musculoskeletal system and connective tissue, and the digestive system. The average length of stay was 8.01 days. The 30-day readmission percentage and the 365-day readmission percentage were 12.24% and 28.02%, respectively. The mortality rate was 6%. In addition, 63.97% went home after discharge, and 67.07% were Medicare recipients. The risk of musculoskeletal diseases and disorders increased with age (p = .0001). The conditional probability of death was nearly nine times higher for the diseases of the nervous system, myeloproliferative diseases and disorders, poorly differentiated neoplasms and respiratory diseases. As age increased, the probabilities of a long hospital stay decreased. The mortality analyses found that the lowest probabilities of survival were in categories of myeloproliferative diseases and disorders, poorly differentiated neoplasms, and infectious and parasitic diseases. According to current health statistics, our society is getting older. Not only are people living longer, they are accessing more health care (American Association for World Health, 1999). Overall, the average life expectancy at birth has been identified at 76.5 years. The female has a longer life expectancy than the male, averaging 5.8 years longer. The highest life expectancy has been identified in the white female, who can expect to live to 79. The black woman has the second-highest life expectancy, 74.7 years. Peters, Kochanek, and Murphy reported an all-time-low age-adjusted death rate for the United States and a continuing trend in the decline in mortality for all age groups. With a growing number of people living longer, there is a need to know about the most common health issues that affect quality of life. The top three national causes of death in older Americans were diseases of the heart, malignant neoplasms, and cerebrovascular diseases/stroke. Arkansas health statistics mirror the national statistics. In April 1999, the Arkansas Department of Health reported that 30.5% percent of all female deaths were caused by heart disease. Malignant neoplasms were responsible for 20.1%, followed by cerebrovascular diseases at 10.8%. Other than three Connecticut hospital studies that explored the relationship of diagnosis code, mortality, and readmission, research is meager in this area. There is a need for hospital-based research that addresses the diagnosis categories and the relationship to age and other variables.

Age Factors↗
PubMed2006

Eight Americas: investigating mortality disparities across races, counties, and race-counties in the United States.

BACKGROUND: The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the "eight Americas," to explore the causes of the disparities that can inform specific public health intervention policies and programs. METHODS AND FINDINGS: The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15-44 y) and middle-aged (45-59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. CONCLUSIONS: Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.

Adolescent↗
PubMed2002

Decision analysis tree for deciding whether to remove an undescended testis from a young dog.

A decision analysis tree was constructed to estimate the life span which might be expected for a dog presented with cryptorchidism at one year of age if it underwent a preventive orchidectomy or if it did not. The tree was constructed by using risk factors associated with cryptorchidism and data on the prevalence of complications after surgery from the literature. The expected life span without an orchidectomy was not significantly different from the expected life span after an orchidectomy.

Animals↗
PubMed2006

Alcoholism, tobacco, and drug use in the countries of Central and Eastern Europe and the former Soviet Union.

This note reviews recent literature relating to the use of alcohol, tobacco, and intravenous drugs in the countries of Central and Eastern Europe and the former Soviet Union. Trends in substance use among subpopulations are discussed in relation to changes in the major population health indicators since 1990. This article summarizes recent work into understanding the role of substance use and misuse in the region in explaining demographic developments in terms of life expectancy and population growth. In 1993, 80% of Russian males drank, and among these, alcohol intake averaged near 600 grams per day. Smoking is much more prevalent among Russian men (61.4%) than among women (10.3%). In 2003, 185.8 per 100 thousand Russian men were drug addicted. High rates of male alcohol abuse, suicide, accidents, violence, and cardiovascular disease appear to be major causes of the large falls in life expectancy and rising gender gaps in life expectancy in the region. Life expectancy at birth in Russia was estimated at 60.5 years for males and 74 years for females in 2005. Russia's population is now declining at a rate of 0.37% per annum, and with more than 1% of the population estimated to be HIV positive, it is likely that this population decline will accelerate further in the near future. Many of these population trends are mirrored across the former Soviet Union.

Alcoholism↗