Darja Irdam’s research while affiliated with University of Cambridge and other places

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Publications (28)


30 privatized industrial towns in the European part of Russia included in the PrivMort survey.
The proportion of individuals consuming hazardous alcohol in 30 privatized industrial towns of Russia among informants’ relatives. Notes: Bars represent 95% confidence intervals. Fa-Mo, fast mono towns; Sl-Mo, slow mono towns; Fa-Mu, fast multi towns; Sl-Mu, slow multi towns.
Predictive margins from multilevel binomial logistic regressions of hazardous drinking in four different types of privatized industrial towns of Russia among informants’ relatives, %. Notes: Bars represent 95% confidence intervals.
Hazardous alcohol consumption in slow- and fast-privatized Russian industrial towns
  • Article
  • Full-text available

May 2024

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29 Reads

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1 Citation

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Darja Irdam

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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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Deindustrialisation and the post-socialist mortality crisis

March 2023

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422 Reads

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12 Citations

Cambridge Journal of Economics

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Darja Irdam

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An unprecedented mortality crisis struck Eastern Europe during the 1990s, causing around seven million excess deaths. We enter the debate about the causes of this crisis by performing the first quantitative analysis of the association between de-industrialisation and mortality in Eastern Europe. We develop a theoretical framework identifying deindustrialisation as a process of social disintegration rooted in the lived experience of shock therapy. We test this theory relying on a novel multi-level dataset, fitting survival and panel models covering 52 towns and 42,800 people in 1989-95 in Hungary and 514 towns in European Russia in 1991-99. The results show that deindustrialisation was directly associated with male mortality and indirectly mediated by hazardous drinking as a stress-coping strategy. The association is not a spurious result of a legacy of dysfunctional working-class health culture aggravated by low alcohol prices during the early years of the transition. Both countries experienced deindustrialisation, but social and economic policies have offset Hungary's more immense industrial employment loss. The results are relevant to health crises in other regions, including the deaths of despair plaguing the American Rust Belt. Policies addressing the underlying causes of stress and despair are vital to save lives during painful economic transformations.


Deindustrialization and the Postsocialist Mortality Crisis

April 2021

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376 Reads

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3 Citations

An unprecedented mortality crisis struck Eastern Europe during the transition from socialism to capitalism. Working-class men without a college degree suffered the most. Some argue that economic dislocation caused stress and despair, leading to adverse health behavior and ill health (dislocation-despair approach). Others suggest that hazardous drinking inherited as part of a dysfunctional working-class culture and populist alcohol policy were the key determinants (supply-culture approach). We enter this debate by performing the first quantitative analysis of the association between economic dislocation in the form of industrial employment decline and mortality in postsocialist Eastern Europe. We rely on a novel multilevel dataset, fitting survival and panel models covering 52 towns and 42,800 people in 1989-1995 in Hungary and 514 medium-sized towns in the European part of Russia. The results show that deindustrialization was significantly associated with male mortality in both countries directly and indirectly mediated by adverse health behavior as a dysfunctional coping strategy. Both countries experienced severe deindustrialization, but social and economic policies seem to have offset Hungary’s more immense industrial employment loss. The policy implication is that social and economic policies addressing the underlying causes of stress and despair can improve health.


Figure 1. The national-level drop in fertility in Hungary, 1980-2009
Figure 2. The privatization-fertility mechanism
Figure 4. Privatization and fertility 1989-2012, annual country-level means
Figure 5. Privatization and fertility 1989-2012, country-level fixed effects models
Privatization and female to male employment rate ratio, town-level
Privatization and the Postsocialist Fertility Decline

December 2020

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711 Reads

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1 Citation

The ten countries with the fastest shrinking population are all located in Eastern Europe, with low fertility as one of the leading causes. In this article, we analyze the privatization of companies as a potential but so far neglected factor behind the postsocialist fertility decline. We argue that privatization is linked to lower fertility by catalyzing uncertainty, shifting the cost of care work onto families, and reducing the resources available to support social reproduction. We test this hypothesis using a novel database comprising information on the demographic and enterprise trajectories of 52 Hungarian towns between 1989-2006 and a cross-country dataset of 28 countries in Eastern Europe. We fit fixed and random-effects models adjusting for potential confounding factors and control for time-variant factors and common trends. We find that company privatization is significantly associated with the postsocialist fertility decline. The observed level of privatization among Hungarian towns corresponds to 0.37 fewer childbirths per woman on average, i.e., approximately 54.3% of the overall fertility decline. Cross-country fixed effects models covering 28 former socialist-bloc countries for the 1989-2012 period confirm the town-level findings. The observed level of privatization among postsocialist countries might explain approximately 49.75% of the overall fertility decline.




Theoretical model linking intergenerational mobility and individuals’ health.
Source: Authors’ interpretation
Comparing absolute and relative intergenerational educational mobility in Belarus, Hungary and Russia, %.
Source: Authors’ calculations based on the PrivMort data set
Predicted probabilities of a binge drinking and b smoking among men. Notes Error bars represent 95% CIs. qX → qX represent intergenerational trajectories from parental educational tertile to respondents educational tertile.
Source: Authors’ calculations based on the PrivMort data set
Intergenerational Mobility in Relative Educational Attainment and Health-Related Behaviours

January 2019

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350 Reads

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33 Citations

Social Indicators Research

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.


Cross‐country evidence on the social determinants of the post‐socialist mortality crisis in Europe: a review and performance‐based hierarchy of variables

December 2018

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214 Reads

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30 Citations

Sociology of Health & Illness

An unprecedented mortality crisis befell the former socialist countries between 1989 and 1995, representing one of the greatest demographic shocks of the period after the Second World War. While it is likely that country‐level variation in the post‐socialist mortality crisis in Eastern Europe can be explained by a constellation of political and socio‐economic factors, no comprehensive review of the existing scholarly attempts at explaining these factors exists. We review 39 cross‐national multi‐variable peer reviewed studies of social determinants of mortality in post‐socialist Europe in order to assess the social factors behind the post‐socialist mortality crisis, determine the gaps in the existing literature and to make suggestions for future research. We propose a novel methodology to determine the relative importance of variables based on the ratio of significant to insignificant findings for each variable. The literature identifies inequality, welfare payments, religious composition, democracy, economic performance and unemployment as the leading factors that have a significant influence on mortality outcomes. Existing cross‐country studies fail to establish a definitive connection between mortality and diets, drinking patterns, liberalisation, trust, health expenditure and war. We also point out that the level of analysis is not a neutral methodological choice but might influence the results themselves.


Correlates of frequent alcohol consumption among middle-aged and older men and women in Russia: A multilevel analysis of the PrivMort Retrospective Cohort Study*

May 2018

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95 Reads

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8 Citations

Drug and Alcohol Dependence

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.


Figure 1. Age-standardized cancer death rates among males in the Hungarian, Russian and Belarusian PrivMort sample compared to data from the WHO Health for All database 10 (Figures are plotted using moving averages. Actual values are shown in Table S1 in Supplementary material.). 
Table 1 . Population attributable risk fractions (PARFs) of cancer mortality due to alcohol, smoking, joint consumption and overall in Russian, Belarusian and Hungarian males
Smoking, alcohol and cancer mortality in Eastern European men: Findings from the PrivMort retrospective cohort study: Smoking, alcohol and cancer mortality in Eastern European men

March 2018

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101 Reads

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9 Citations

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 this 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 was 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 to 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% (‐1‐6), 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. This article is protected by copyright. All rights reserved.


Citations (21)


... This type of alcohol includes industrial surrogates such as medical alcohol, aftershaves, antifreeze, tooth powders, glues, kerosene[emphasis added], and brake fluid. It was easily accessible and widely consumed" [56]. In fact, most vodka and liquor has been purchased through legally functioning retail stores and supermarkets [57]. ...

Reference:

Quality and Toxicity of Alcoholic Beverages in Russia: Interdisciplinary Approach
Hazardous alcohol consumption in slow- and fast-privatized Russian industrial towns

... disproportionally increases among U.S. white men and women without college degrees. According to Anne Case and Angus Deaton (2020), the overwhelming surge in deaths of despair coincides with deindustrialization, social fragmentation, labor's weakening position, and the rapacious practices of the health industry (Scheiring et al. 2023). Whereas the U.S. college-educated become healthier and wealthier, the "deplorables 11 " succumb to pain. ...

Deindustrialisation and the post-socialist mortality crisis

Cambridge Journal of Economics

... Another study shows that deindustrialization could have been another crucial determinant. Scheiring et al. (2021) fit survival and two-way fixed effects panel models covering 52 towns and 42,800 people in 1989-1995 in Hungary and 514 medium-sized towns in the European part of Russia. The results show that deindustrialization was significantly associated with male mortality in both countries, directly and indirectly mediated by adverse health behavior (alcohol abuse). ...

Deindustrialization and the Postsocialist Mortality Crisis

... Although substantial improvements in mortality emerged across all surveyed countries following regime change, the timing of the shift from mortality crises to a period of increasing life expectancy varied among them (Scheiring, Irdam, and King 2019). Most navigated regime change without experiencing significant mortality losses, and increases in life expectancy began shortly afterwards in Czechia, Slovakia, Poland, Hungary, and Slovenia, while in Romania and Bulgaria these gains emerged somewhat later, in the late 1990s (Cornia and Paniccià 2000;Parr, Li, and Tickle 2016). ...

Cross‐country evidence on the social determinants of the post‐socialist mortality crisis in Europe: a review and performance‐based hierarchy of variables

Sociology of Health & Illness

... Poisonings with metabolically toxic alcohols occur for many reasons: accidental ingestion (particularly in children), as a result of a suicide attempt or work accidents [2,3]. In Eastern Europe/Russia, it is frequently encountered due to climatic conditions and due to the increased consumption of ethanol and possibly the low economic level that requires self-cleaning [4][5][6][7][8]. According to data from the literature, the mortality risk is higher with 30% in methanol poisoning cases that associate severe acidemia and with 20% in ethylene glycol poisoning [9]. ...

Correlates of frequent alcohol consumption among middle-aged and older men and women in Russia: A multilevel analysis of the PrivMort Retrospective Cohort Study*
  • Citing Article
  • May 2018

Drug and Alcohol Dependence

... Age is an independent risk factor of CVD in old people and the proportion of CVD incidence linearly increased with aging among both men and women [29,30]. The highest risk of CVD mortality in the EEU region and Russia could be attributed to poor diet quality, higher prevalence of smoking and alcohol use, and high-level use of illicit drugs [20,31,32]. ...

Smoking, alcohol and cancer mortality in Eastern European men: Findings from the PrivMort retrospective cohort study: Smoking, alcohol and cancer mortality in Eastern European men

... Using the Hungarian leg of the PrivMort study, Scheiring et al. (2018) reported results from multilevel data related to Hungary between 1995 and 2004. Using population surveys conducted in 52 towns to collect data on vital status and other characteristics of survey respondents' relatives, they found that women living in towns with prolonged state ownership had significantly lower odds of dying than women living in towns dominated by privatized companies -either foreignowned (8-31 percent lower odds of dying) or domestically owned (10-39 percent lower). ...

The gendered effects of foreign investment and prolonged state ownership on mortality in Hungary: an indirect demographic, retrospective cohort study

... The mental health knowledge gap among PCPs may be even more pronounced in countries like Hungary, where a post-socialist transition [12] and economic adversities may have hindered growth in mental health care and training [12,13]. Hungarians are more likely to have negative attitudes and less openness toward depression relative to other countries in Europe [14], and people with mental illness are among the most rejected groups in Hungarian society [15]. ...

The wounds of post-socialism: a systematic review of the social determinants of mortality in Hungary

... Although some studies have used multi-component measures to estimate intergenerational social mobility 15 , studies which focused on health tended to use single measures of mobility 16 . For instance, previous studies have explored the association of intergenerational educational mobility with depressive symptoms, tobacco smoking, binge drinking, physical activity, self-rated health and health satisfaction; the association of intergenerational occupational mobility with oral health and physical activity; the links between intergenerational income mobility and self-rated health and physical activity; or the association between subjective social mobility and self-rated health [17][18][19][20] . Results, however, have been inconclusive perhaps because of the different measures of intergenerational mobility 21 . ...

Intergenerational Mobility in Relative Educational Attainment and Health-Related Behaviours

Social Indicators Research