Health and socio-economic impact of alcohol in a typical Russian City: Identifying dimensions of alcohol use among Russian men and their effects upon health and employment

Male life expectancy in Russia is extremely low for an industrialised country. Alcohol is an important contributory factor to low life expectancy and an important health determinant in Russian men. Conventional methods of measuring alcohol consumption may not fully capture distinctive aspects of Russian drinking. The aim of this PhD was to identify latent dimensions of alcohol use and to investigate their socio-demographic correlates and their effects on health and employment among working-age men (aged 25-60) in Izhevsk, Russia. The data used were from the Izhevsk Family Studies (IFS -1 and IFS-2). IFS-1 included a cross-sectional survey of 1941 working-age men resident in Izhevsk (2003-6). Controls were followed up at IFS-2 (2008-10).Three latent dimensions of beverage alcohol intake (beer, wine and spirit intake) were constructed from questionnaire responses on frequency, usual volume and maximum volume of each beverage and one latent dimension of acute alcohol-related dysfunction from responses on frequency of hangover, excessive drunkenness, sleeping in clothes because of drunkenness and failing family or personal obligations because of drinking. The relationship between these latent dimensions of alcohol use, socio-demographic factors, employment and cardiovascular risk factors were investigated using structural equation modelling. The latent factors of beverage alcohol intake were strong predictors of alcohol-related dysfunction, with spirit intake being the most influential. Alcohol-related dysfunction showed a strong association with education which was only partly explained by beverage alcohol intake and other observed aspects of alcohol consumption. Alcohol-related dysfunction was a strong predictor of employment status and an important mediator of the relationship between alcohol intake and employment. All four latent variables showed similar associations with serum lipids. Beer intake, spirit intake and alcohol-related dysfunction were strongly associated with hypertension. Hazardous alcohol consumption in Russian men strongly influenced employment status and cardiovascular risk factors. A latent variable approach to measuring alcohol use particularly acute alcohol-related dysfunction provided information of the relationship between alcohol, health and socio-economic circumstances in Russian men beyond that obtained using more conventional observed measures such as total volume of ethanol.