Supplementary materials (to Bessudnov A., McKee, M. and Stuckler, D. “Inequalities in
male mortality by occupational class, perceived status, and education in Russia, 19942006"
1. Description of the RLMS and comparison of the RLMS estimates of mortality
rates versus official statistics
The Russian Longitudinal Monitoring Survey (RLMS) was undertaken in 38 centres across the
Russian Federation. St Petersburg and Moscow were selected automatically, and the remaining
primary sampling units (PSUs), were sampled by stratification , selecting from each stratum using
a probability proportional to size (PPS). Within the selected PSUs, urban and rural secondary
sampling units (SSUs), census enumeration districts and villages respectively, were selected.
From each SSU, 10 households were selected from housing lists developed by the investigators.
The first dwelling was chosen at random, and the remainder at regular intervals. Thus, the
sampling procedure was designed to achieve a study population that was broadly representative
of the national population, but also ensuring that the two principal cities, with their particular
characteristics, were included. The survey has a panel element, as the same households are visited
in successive waves, with replacement of losses to follow-up. Investigators attempted to followup people who moved to a new address if they remained within the same PSU. Our estimates of
mortality rates are lower than those previously reported for the RLMS [10]. This is because our
sample includes people who changed households during the follow-up. As these mobile
populations tend to be younger than the sample average, excluding them would artefactually
increase estimated mortality rates. Thus, between 1994 and 2006, we identified 1,557 deaths out
of 147,115 person-years (21,275 subjects, mean follow-up 6.9 years). The estimated mortality
rates in the RLMS are about 15% lower in men and 34% in women than the average official rate
for 1994-2006 reported by the Russian Statistical Office, almost certainly reflecting an element of
selection common to all surveys in Russia. In the RLMS deaths of individuals were reported by
other members of the household during the interviews in successive waves (‘the Brass method’
of indirect estimation). This observation likely explains the lower reported mortality ratios
observed among women, as many older women in Russia live on their own after their husbands
have died.
2. Class gap in mortality in Russia and Western Europe
Kunst et al. provided estimates of manual to non-manual mortality rate ratios for eleven Western
European countries based on census and survey data collected in the 1980s [40]. Rate ratios were
presented for men only in three age groups: 30-44, 45-59 and 60-64 and were adjusted for the
exclusion of economically inactive people. The adjusted manual/non-manual mortality rate ratios
for men aged 45-59 varied from 1.24 in Denmark to 1.65 in France, with the rate ratios in most
countries being under 1.5. We estimated the manual to non-manual mortality rate ratio in Russia
for men aged 45-59, using the same methodology as Kunst et al. The rate ratio was 2.29 (95%
CI: 1.51-3.48, adjusted for the exclusion of economically inactive people). This suggests that the
manual to non-manual mortality gap in Russia is considerably larger than in Western European
countries. When calculating the rate ratio, Kunst et al. used directly standardized mortality rates
and we had to use crude mortality rates, as direct standardization could generate misleading
results given the small numbers in our sample. However, this is unlikely to seriously bias the
results.
Table A1. Descriptive statistics for class (men aged 21 to 70, the analytic sample)
European Socio-Economic
Examples of main
No of men (%)
Classification (ESeC)
occupations included
1a/2a. Managers
Managers of small enterprises
185 (2.8%)
1b. Higher professionals
Engineers, architects, medical
424 (6.4%
doctors
2b. Lower professionals
Army officers, police
509 (7.7%)
inspectors, technicians
3.Intermediate (higher routine
Sales representatives,
138 (2.1%)
Managers in wholesale and
325 (4.9%)
non-manual)
4/5. Self-employed
retail trade
6. Lower supervisors and
Building caretakers, safety and
technicians (manual
quality inspectors, stock clerks
411 (6.2%)
supervisors)
7. Lower sales and service
Police officers, shop
(lower routine non-manual)
salespersons, stock clerks
8. Lower technical (skilled
Building electricians,
manual)
mechanics and fitters,
214 (3.2%)
1423 (21.6%)
plumbers and pipe fitters
9. Routine (non-skilled
Drivers, building caretakers,
manual)
freight handlers
Not in the labour force
Long-term ill, unemployed
Total
2198 (33.4%)
759 (11.5%)
6586 (100%)
Table A2. Descriptive statistics for other variables (men aged 21 to 70, the analytic
sample)
Variable
Age (at the last observation)
Marital status (at the last observation)
% or mean
43.8 (st.dev. 14.5)
Never married
14.6%
Married or cohabiting
79.6%
Divorced, widowed, married, but separated
5.8%
Ethnicity
Russian
83.0%
Non-Russian
14.6%
No answer
2.4%
Education (at the last observation)
Secondary incomplete or lower
15.3%
Secondary completed
28.4%
Lower vocational (PTU)
23.1%
Secondary specialized (technikum or uchilische)
15.0%
University degree
18.2%
Logged household income divided by the number of people in the
4.4 (st.dev. 1.3)
household
Perceived respect scale (1 to 9, 1 is the highest)
4.1 (st.dev. 1.8)
Perceived wealth scale (1 to 9, 1 is the highest)
6.3 (st.dev. 1.5)
Perceived power scale (1 to 9, 1 is the highest)
6.7 (st.dev. 1.7)