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Editorial |

Social Stress and the Russian Mortality Crisis

David A. Leon, PhD; Vladimir M. Shkolnikov, PhD
JAMA. 1998;279(10):790-791. doi:10.1001/jama.279.10.790.
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The public health situation in Russia today is grave. Information on morbidity is fragmentary; however, an enormous burden of ill health must underlie the very high mortality rates reported for the 1990s. For instance, in 1994, a Russian man aged 20 years would have only a 1 in 2 chance of surviving to age 60 years, compared with a 9 in 10 chance for men born in the United States or Britain. Moreover, in 1994, life expectancy at birth for men was 13 years less than for women. These trends almost certainly are not a statistical artifact.1 Yet, despite its magnitude, this public health crisis has not received the attention it deserves from medical and public health specialists around the world. The article by Notzon and colleagues2 in this issue of JAMA helps to redress this situation by outlining the dimensions of the crisis and reviewing the findings and conclusions of other research groups.1,36

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