{"title":"Changes in socio-economic inequality in alcohol-attributable mortality in periods of increasing and decreasing alcohol affordability.","authors":"Pia Mäkelä, Elsi Lindell","doi":"10.1111/dar.13989","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Reducing alcohol affordability reduces alcohol-related harm but its impact on socio-economic inequalities requires further study. We examine changes in alcohol-attributable mortality inequalities in Finland during periods of sharply rising (2000-2007) and falling (2008-2017) alcohol affordability.</p><p><strong>Methods: </strong>Linking individual-level register data on causes of death and socio-demographics for the Finnish population aged ≥25 in 2000-2017 (68 million person-years), we analysed age-standardised monthly alcohol-attributable mortality rates by sex and income quintile (n = 32,699 alcohol-attributable deaths). Regression models were used to analyse mortality trends in the two periods, contrasting high- and low-income groups.</p><p><strong>Results: </strong>Inequalities in alcohol-attributable mortality between low- and high-income groups were large throughout the study period. During the period of rising alcohol affordability, mortality increased among high-income men with an average monthly increase of 0.17% (p = 0.046). This rate was even higher among low-income men, increasing by 0.55% per month, that is, +0.38 percentage points more than the rate for high-income men (p = 0.002). Among women, mortality increased at similar rates in both income groups. During the period of falling alcohol affordability, mortality decreased among high-income men with an average monthly decrease of -0.21% (p < 0.001), and it decreased even more among low-income men (-0.40%, i.e., -0.19 percentage points more, p = 0.030). Among women, the decreases were not statistically significant.</p><p><strong>Discussion and conclusions: </strong>The results indicate that increased alcohol affordability was associated with widening socio-economic inequalities while reduced affordability was linked with narrowing inequalities among men. Reducing alcohol affordability is thus a recommendable policy for reducing socio-economic inequality in alcohol-related harm.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug and alcohol review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dar.13989","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Reducing alcohol affordability reduces alcohol-related harm but its impact on socio-economic inequalities requires further study. We examine changes in alcohol-attributable mortality inequalities in Finland during periods of sharply rising (2000-2007) and falling (2008-2017) alcohol affordability.
Methods: Linking individual-level register data on causes of death and socio-demographics for the Finnish population aged ≥25 in 2000-2017 (68 million person-years), we analysed age-standardised monthly alcohol-attributable mortality rates by sex and income quintile (n = 32,699 alcohol-attributable deaths). Regression models were used to analyse mortality trends in the two periods, contrasting high- and low-income groups.
Results: Inequalities in alcohol-attributable mortality between low- and high-income groups were large throughout the study period. During the period of rising alcohol affordability, mortality increased among high-income men with an average monthly increase of 0.17% (p = 0.046). This rate was even higher among low-income men, increasing by 0.55% per month, that is, +0.38 percentage points more than the rate for high-income men (p = 0.002). Among women, mortality increased at similar rates in both income groups. During the period of falling alcohol affordability, mortality decreased among high-income men with an average monthly decrease of -0.21% (p < 0.001), and it decreased even more among low-income men (-0.40%, i.e., -0.19 percentage points more, p = 0.030). Among women, the decreases were not statistically significant.
Discussion and conclusions: The results indicate that increased alcohol affordability was associated with widening socio-economic inequalities while reduced affordability was linked with narrowing inequalities among men. Reducing alcohol affordability is thus a recommendable policy for reducing socio-economic inequality in alcohol-related harm.
期刊介绍：
Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.
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