Alcohol-related mortality, drinking behavior, and business cycles: are slumps really dry seasons?

This paper explores the connection between alcohol-related mortality, drinking behavior, and macroeconomic conditions in Finland using both aggregate and microlevel data from recent decades. The aggregate data reveal that an improvement in economic conditions produces a decrease in alcohol-related mortality. Microlevel data show that alcohol consumption increases during economic expansion while the probability of being a drinker remains unchanged. This demonstrates that alcohol-related mortality and self-reported alcohol consumption may be delinked in the short-run business cycle context. One explanation for this paradox is that most harmful forms of drinking are not captured in survey-based data used to study the effect of macroeconomic conditions on alcohol consumption. Our evidence does not overwhelmingly support the conclusions reported for the United States that temporary economic downturns are good for health.     

Alcohol-related mortality in Italy

This study evaluated the impact of alcohol drinking habits on mortality in Italy during the 1980–1990 period. Alcohol Attributable Fractions for a list of Alcohol-Related Diseases were assessed from national and international medical literature and then applied to national mortality data according to 5 y age groups, sex, and place of residence for each year of the 1980–1990 period. Mortality rates and 95% Confidence Intervals were standardized with the direct method. Years of potential life lost (YPLL) were calculated for 1990. 18 033 Italian residents died during 1990 from causes related to alcohol drinking, representing 3.3% of general mortality (males 4.6%; females 2.0%) which corresponded to over 200 000 YPLL up to age 70 y. Chronic diseases account for 65% of alcohol-related mortality. Age-adjusted death rates declined in both genders during 1980–1990. Geographic differences in death rates are well evident. Alcohol drinking is a strong determinant of mortality in Italy. The variability of alcohol-related death rates across the country and the comparison with the results from other populations suggest that health consequences, mainly liver damage, of alcohol intake in Italy may be affected by other factors than alcohol itself. The need for further methodological efforts to improve alcohol attributable fraction estimates is recommended.     

Alcohol-related mortality in California, 1980 to 1989.

OBJECTIVES. This study sought to examine the impact of alcohol use and misuse on mortality in California during the 1980s. METHODS. Alcohol-Related Disease Impact estimation software and California vital statistics data were used to calculate alcohol-related mortality, mortality rates, and years of potential life lost. Statistical tests were applied to detect significant differences in death rates by sex and race/ethnicity. Time trends in death rates for a subset of alcohol-defined diagnoses were examined using regression analysis. RESULTS. An estimated 6.2% of all deaths for California residents during 1989 were related to alcohol, making it one of the top 10 leading causes of death. Injury diagnoses were major contributors to the total estimated number of alcohol-related deaths and years of potential life lost before age 65. Alcohol-related mortality rates were significantly higher for men and for Blacks. However, age-adjusted death rates for alcohol-defined diagnoses declined significantly from 1980 to 1989. CONCLUSIONS. A structured data-base approach to analyzing mortality data represents an important advance for alcohol research that has implications for policy and program planning. Future refinements and enhancements to the disease impact estimation methodology will add precision to determining how alcohol use and misuse affect public health in California.     

Alcohol-related deaths contribute to socioeconomic differentials in mortality in Sweden

BACKGROUND: This study aims at estimating the contribution of alcohol to socioeconomic mortality differentials in Sweden. METHODS: Data were obtained from a Census-linked Deaths Registry. Participants in the 1980 and 1990 censuses were included with a follow-up of mortality 1990-1995. Socioeconomic status was assigned from occupation in 1990 or 1980. Alcohol-related deaths were defined from underlying or contributory causes. Poison regressions were applied to compute age-adjusted mortality rate ratios for all-causes, alcohol-related and other causes among 30-79-year-olds. The contribution of alcohol to mortality differentials was calculated from absolute differences. RESULTS: Around 5% (9,547) of all deaths were alcohol-related (30-79 years). For both sexes, manual workers, lower nonmanuals, entrepreneurs and unclassifiable groups had significantly higher alcohol-related mortality than did upper nonmanuals. Male farmers had significantly lower such mortality. The contribution of alcohol to excess mortality over that of upper nonmanuals was greatest among middle-aged (40-59 years) men who were manual workers or who belonged to a group of 'unclassifiable & others' (25-35%). It was of considerable size also for middle-aged lower nonmanuals (both sexes), male entrepreneurs, female manual workers and 'unclassifiable & others'. Among men, the total contribution of alcohol (30-79 years) was estimated at 16% for manual workers, 10% for lower nonmanuals and 7% for entrepreneurs; and among women, 6% (manual workers, lower nonmanuals) and 3% (entrepreneurs). CONCLUSION: Although deaths related to alcohol were probably underreported (e.g. accidents), alcohol clearly contributes to socioeconomic mortality differentials in Sweden. The size of this contribution depends strongly on age (peak among the middle-aged) and gender (greatest among men).     

Work experience and drinking behavior: alienation, occupational status, workplace drinking subculture and problem drinking

This study explored the association between alienating job conditions and problem drinking within the context of occupational status and workplace drinking subculture. From December 1994 to March 1995, a questionnaire survey was implemented in the manufactory sector in southern Taiwan. Within the questionnaire, any perceived self-estrangement, powerlessness and social isolation that the individual experienced in his work were measured as the alienating job conditions, and any negative physical, psychological and social consequences the individual experienced during the previous month were considered as affecting problem drinking. Of the 1117 subjects, 668 (61.8%) reported imbibing one or more drinks during the preceding month; the average daily alcohol consumption being 0.2+/-0.9 drinks. In addition, 188 (16.8%) subjects reported having experienced drinking-related problems in the preceding month. Workers with low occupational status were more likely to become problem drinkers when they felt comparatively self-estranged in their work. Further, those with a family history including any habitual drinker or those under more encouraging workplace drinking subculture were more likely to have drinking-related problems. For the prevention of problem-related drinking behavior, the workplace should be considered as the focus of our future intervention and management program.     

One-year drinking history and mortality

The one-year drinking history of 94 men was recorded by recurrent interviews (mean: 20 per person). The cohort was followed for 18.3 years; during that time, 13 men died. Cox's proportional hazards survival models including age and social class as confounders, indicated that mortality was significantly associated with total annual alcohol consumption, frequency of drinking, and frequency of intoxicating drinking. Estimates of risk of death for various consumption levels are presented: For having 10 drinks (each containing 12 grams of pure ethanol) a week vs one drink a week, the estimated relative risk of death (95% confidence limits in parentheses) was 2.3 (1.6-3.3). For being intoxicated once a week vs no intoxications at all during one year the respective risk was 2.1 (1.3-3.1). The risk estimates for the frequency of intoxication were found to be higher than those in an earlier study using single interview data on drinking. This suggests that more accurate measurement of alcohol consumption may yield higher risk of death estimates than found in studies based on single interview data on alcohol.     

Alcohol-related birth defects in long- and short-sleep mice: postnatal litter mortality

Alcohol sensitivity may influence the severity of alcohol-related birth defects (ARBD). To examine this hypothesis, pregnancy outcome and offspring development were examined in alcohol-sensitive Long-Sleep (LS) mice and alcohol-resistant Short-Sleep (SS) mice following prenatal ethanol exposure. Dams were intragastrically intubated twice per day (6 hr apart) with either 4.5 g/kg (20% w/v) ethanol (E) or an isocaloric amount of sucrose (S) on days 7 through 18 of pregnancy. An untreated control group (C) was maintained for each line. Results showed litter mortality at 10 days of age was greater for LS-E litters compared to both LS-S and LS-C litters. Litter mortality for SS-E litters did not differ from either SS-S or SS-C litters. Maternal weight gain, blood ethanol levels, and birth weight deficits were similar for ethanol-exposed LS and SS groups. These results suggest genetically based alcohol sensitivity influences the severity of ARBD.     

Symmetric mortality and asymmetric suicide cycles

In this investigation, tests were performed to determine whether mortality cycles are asymmetric. Results from an asymmetry test of U.S. time-series data from 1951 to 2005 provide no evidence that all-cause mortality or mortality caused by disease causes asymmetric cycles. However, the rate of fatalities from suicide exhibits the pattern of an asymmetric cycle. The evidence for asymmetric suicide cycles is statistically significant for men and working-age groups but not for women and non-working-age groups.     

Alcohol-related deaths in Wisconsin: the impact of alcohol on mortality.

Analysis of the impact of alcohol as an underlying and non-underlying cause of death in Wisconsin showed a marked increase between 1963 and 1977 in the frequency of deaths reported with mention of alcohol. The rate of deaths for which alcohol was a non-underlying cause rose more sharply during this period (2.4 per 100,000 to 9.3) than that of alcohol-related causes (4.6/100,000 to 9.0). Nearly 90 per cent of alcohol-related deaths at ages 15-24 reported alcohol as a non-underlying cause, compared to 40.7 per cent at ages 45-54 and 57 per cent at ages 75+. This proportion was higher (50.8 per cent) among males than among females (32.8 per cent). Deaths related to alcohol are attributed to a number of underlying causes in addition to alcohol. In 1975-77, nearly half of the reported alcohol-related deaths were attributed to other causes, including accidents (14.8 per cent), heart disease (14.3 per cent), respiratory diseases (4.9 per cent), suicide (3.7 per cent), and cancer (31 per cent). These percentages may reflect substantial underreporting. Comparison of motor vehicle driver death certificates with blood alcohol test reports for these drivers shows 90 per cent underreporting of alcohol on death certificates. This fact, along with other information on underreporting, shows that the approximately 650 deaths now being reported with mention of alcohol annually in Wisconsin, represent only a portion of such deaths.     

Alcohol,drinking pattern and all-cause,cardiovascular and alcohol-related mortality in Eastern Europe

Alcohol has been implicated in the high mortality in Central and Eastern Europe but the magnitude of its effect, and whether it is due to regular high intake or episodic binge drinking remain unclear. The aim of this paper was to estimate the contribution of alcohol to mortality in four Central and Eastern European countries. We used data from the Health, Alcohol and Psychosocial factors in Eastern Europe is a prospective multi-centre cohort study in Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania) and six Czech towns. Random population samples of 34,304 men and women aged 45–69 years in 2002–2005 were followed up for a median 7 years. Drinking volume, frequency and pattern were estimated from the graduated frequency questionnaire. Deaths were ascertained using mortality registers. In 230,246 person-years of follow-up, 2895 participants died from all causes, 1222 from cardiovascular diseases (CVD), 672 from coronary heart disease (CHD) and 489 from pre-defined alcohol-related causes (ARD). In fully-adjusted models, abstainers had 30–50 % increased mortality risk compared to light-to-moderate drinkers. Adjusted hazard ratios (HR) in men drinking on average ≥60 g of ethanol/day (3 % of men) were 1.23 (95 % CI 0.95–1.59) for all-cause, 1.38 (0.95–2.02) for CVD, 1.64 (1.02–2.64) for CHD and 2.03 (1.28–3.23) for ARD mortality. Corresponding HRs in women drinking on average ≥20 g/day (2 % of women) were 1.92 (1.25–2.93), 1.74 (0.76–3.99), 1.39 (0.34–5.76) and 3.00 (1.26–7.10). Binge drinking increased ARD mortality in men only. Mortality was associated with high average alcohol intake but not binge drinking, except for ARD in men.     

青少年饮酒与自伤行为关系

目的 探讨青少年饮酒行为与自伤行为的关系,为相关部门预防青少年饮酒与自伤行为提供参考依据.方法 使用饮酒行为问卷及自伤行为问卷收集饮酒与自伤信息,对四川省凉山州整群抽取的4所中学9 247名中学生进行调查.采用单因素和多因素Logistic回归分析,对饮酒行为和自伤行为关系进行分析.结果 在9 247名初高中学生中,尝...     

Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence

Aim  

To assess how drinking patterns and delinquency are associated with self-reported experiences of alcohol-related violence in an adolescent population.     

Alcohol-related hospital utilization and mortality in different occupations in Sweden in 1991-1995.

OBJECTIVES: This study investigated alcohol-related hospital utilization and alcohol-related mortality according to occupation among men and women. Whether increased rates of alcoholism in some occupations result from circumstances within the occupation or from selective recruitment of persons prone to alcohol misuse was studied. METHODS: All Swedish residents were included who reported an occupation in the censuses of 1985 and 1990 and were born in 1926-1960. The relationships between occupation and hospitalization due to an alcoholism diagnosis in 1991-1994 and alcohol-related mortality in 1991-1995 were studied among stable workers (those who held the same occupation in both censuses) and newly recruited workers (those who held different occupations in the two censuses). Incidence and mortality rates were calculated for the different occupations using the person-year method, and standardized rate ratios were used as approximations of the relative risk of disease occurrence and mortality in different occupations as compared with the corresponding statistics of the entire study population. RESULTS: Several, mostly manual, occupations showed an increased relative risk of alcoholism diagnoses and alcohol-related mortality. Nonmanual occupations had low risks. Women in male-dominated high-risk occupations often showed increased relative risks. Stable and newly recruited employees in the same occupation showed very similar relative risks. CONCLUSIONS: New recruits into high-risk occupations often have increased relative risks of at least the same magnitude as persons employed long-term in the same occupations. This finding indicates that the increased relative risk of alcoholism found in some occupations can partly be explained by selective recruitment of heavy drinkers.     

Business cycles and mortality: results from Swedish microdata

We assess the relationship between business cycles and mortality risk using a large individual level data set on over 40,000 individuals in Sweden who were followed for 10-16 years (leading to over 500,000 person-year observations). We test the effect of six alternative business cycle indicators on the mortality risk: the unemployment rate, the notification rate, the deviation from the GDP trend, the GDP change, the industry capacity utilization, and the industry confidence indicator. For men we find a significant countercyclical relationship between the business cycle and the mortality risk for four of the indicators and a non-significant effect for the other two indicators. For women we cannot reject the null hypothesis of no effect for any of the business cycle indicators.     

Magnesium and calcium in drinking water and cardiovascular mortality

Data on the hardness of drinking water were collected from 27 municipalities in Sweden where the drinking water quality had remained unchanged for more than 20 years. Analyses were made of the levels of lead, cadmium, calcium, and magnesium. These water-quality data were compared with the age-adjusted mortality rate from ischemic heart and cerebrovascular disease for the period 1969-1978. Lead and cadmium were not present in detectable amounts except in one water sample. A statistically significant inverse relationship was present between hardness and mortality from cardiovascular disease for both sexes. Mortality caused by ischemic heart disease was inversely related to the magnesium content, particularly for the men (P less than 0.01). The rather small set of data supports results from previous studies suggesting that a high magnesium level in drinking water reduces the risk for death from ischemic heart disease, especially among men, although the possible importance of confounding factors needs further evaluation.