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Citation
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Donat M, Regidor E, Barrio G, Ambrosio E, Sordo L, Guerras JM, Politi J, Belza MJ. Addiction 2023; ePub(ePub): ePub. |
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Abstract
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BACKGROUND AND AIMS: Alcohol-related mortality risk is almost always greater in lower than higher socioeconomic positions (SEPs). There is little information on the evolution of this SEP gradient and its relationship with the economic cycle. Some results suggest that during economic expansions there is a hypersensitivity of low-SEP people to harmful drinking. The main objective was to measure the evolution of educational inequality in alcohol-related and non-alcohol related mortality by sex and age group in Spain during 2012-2019.
DESIGN: Repeated cross-sectional study. Setting and participants All residents in Spain aged 25 and over from 2012 to 2019. MEASUREMENTS: 1) Age-standardized mortality rates (ASMRs) from strongly/moderately alcohol-related causes (directly alcohol-attributable, unspecified liver cirrhosis, liver and upper aerodigestive tract cancers, and moderately alcohol-related), weakly alcohol-related causes and other causes by education level. 2) Age-adjusted relative Index of Inequality (RII), and Slope Index of Inequality (SII) to measure relative and absolute educational inequality in mortality, respectively. 3) Age-adjusted annual percent change (APC) to measure linear trends in mortality by education level. RII, SII and APC were obtained from negative binomial regression.
FINDINGS: Between 2012-2015 and 2016-2019, economic growth accelerated, the RII in mortality from strongly/moderately alcohol-related causes increased from 2.0 to 2.2 among men and from 1.1 to 1.3 among women, and the SII in deaths/100,000 person-years from 181.4 to 190.9 among men and from 18.9 to 46.5 among women. It also increased relative and absolute inequality in mortality from weakly alcohol-related and other causes of death in both men and women. These increases in inequality were primarily due to a flattening or even reversal of the downward mortality trend among low-and medium-educated people.
CONCLUSIONS: In Spain during the economic expansion of 2012-2019, changes in mortality risk from strongly/moderately alcohol-related causes were especially unfavourable among low- and medium-educated people.
Language: en |