Spatial Variation and Determinants of Alcohol-related Mortality in Belarus and Lithuania: an Ecological Study

Numerous population- and individual-level studies have confirmed a strong relationship between excessive alcohol consumption and striking excess male mortality in the countries of the former USSR. Yet the complex interplay between macro- and micro-level factors underlying this relationship has remained underexplored. Our analysis refers to the most recent period, and focuses on the male population aged 20-64. Using the detailed cause-specific mortality at the district level we first explore a spatial distribution of alcohol-related mortality in the two neighboring countries, Belarus and Lithuania. Then, using the simultaneous autoregressive models we assess the strength of association between mortality and its potential determinants. As independent explanatory macro-level variables we consider a set of indicators available from the adjacent population censuses such as unemployment, education, marital status, and ethnicity. The preliminary results show that the districts located at the Belarus-Lithuania border show similar patterns and form large cross-border areas with elevated alcohol-related mortality. Although mortality variation is likely to be largely explained by differences in the contemporary socioeconomic conditions, the observed spatial patterns suggest the relevance of the common socio-cultural context.