Physical assault in the previous year and total and cause-specific mortality in Russia: a case-control study of men aged 25-54 years

Background: Violence has important health effects. The results of exposure to physical violence include, but may not be limited to, death from suicide and homicide. The connection between the experience of assault and risk of death from causes other than homicide and suicide has rarely been examined.

Methods: We analysed data from the first Izhevsk Family Study (IFS-1), a population-based case-control study of premature mortality in Russian men. Structural equation models were used to obtain odds ratios (ORs) for the association between the proxy report of physical attack in the previous year and mortality.

Results: The estimate of the all-cause mortality OR for assault, after adjusting for alcohol use and socio-demographic confounders, was 1.96 (95% confidence interval: 1.71, 3.31). Strong cause-specific associations were found for external causes, but associations were also found for deaths from cardiovascular and alcohol-related deaths.

Conclusions: We found that, in our population of working-aged Russian men, there was a strong association between physical assault and mortality from a wide range of causes. Other than direct effects of physical assault on mortality, residual confounding is an important possibility. The association between assault and mortality, particularly from cardiovascular and alcohol-related causes requires replication and further investigation.