Alcohol-Related Conditions Play An Important Role In Inequalities In Total Mortality

Alcohol consumption patterns are linked to socioeconomic status (SES) and most studies find that mortality from alcohol-related conditions is higher in low-SES groups compared with high-SES groups. This study, based on national and regional mortality registries in 17 European countries, assessed the magnitude of SES inequalities in alcohol-related mortality.

  • Mortality from alcohol-related conditions was highest in Hungary where the age-standardized mortality rate per 100,000 person-years was 198 deaths among men and 51 among women. This was mostly due to alcohol-related liver cirrhosis. Alcohol use disorder mortality was highest in Denmark and alcohol poisoning mortality highest in Estonia.
  • Inequality in mortality from alcohol-related causes was found in all populations, and mortality rates were higher in low-SES groups compared with high-SES groups. Nevertheless, the gap between low and high education groups varied substantially between populations (from small in Southern Europe to large in Eastern Europe, Finland, and Denmark).
  • Over time there was a rise in inequalities in alcohol-related mortality due to a large increase in mortality among individuals with low education levels, while mortality was stable or only moderately increased among high-SES groups. This was mostly explained by the rapid rise in mortality in low-SES groups in Eastern Europe, Denmark, and Finland.

Comments:

This study demonstrates important inequalities in total mortality in many European countries due to alcohol-related conditions. The rise in inequalities is of great concern. Dealing with the impact of alcohol-related conditions in low-SES groups is crucial to reducing inequalities in mortality. Among other factors, these changes might be explained by the increased affordability of alcohol in some countries, or the liberalization of the alcohol market in Eastern countries since low-SES groups are more responsive to price changes.



Nicolas Bertholet, MD, MSc

Reference:

Mackenbach JP, Kulhánová I, Bopp M, et al. Inequalities in alcohol-related mortality in 17 European countries: a retrospective analysis of mortality registers. PLoS Med. 2015;12(12):e1001909.

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