Alcohol and Alcoholism Advance Access originally published online on February 3, 2007
Alcohol and Alcoholism 2007 42(5):456-464; doi:10.1093/alcalc/agl099
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Differential trends in alcohol-related mortality: a register-based follow-up study in Finland in 1987–2003
1 Population Research Unit, Department of Sociology, University of Helsinki, Finland
2 National Research and Development Centre for Welfare and Health (Stakes), Helsinki, Finland
3 Helsinki Collegium for Advanced Studies, Helsinki, Finland
* Author to whom correspondence should be addressed at: Department of Sociology, University of Helsinki, FIN-00014, Finland. Tel: +358 9 19125401; Fax: +358 9 19123967; E-mail: kimmo.herttua{at}helsinki.fi
Received 26 September 2006; ; accepted 8 October 2006
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Abstract |
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Aims: To assess to what extent alcohol-related mortality has changed by age, sex and education in Finland in 1987–2003, a period which saw two periods of economic growth, separated by a severe depression (1991–1995). Methods: A register-based follow-up study of all over 15-year-old Finnish men and women. Age, sex and education of the participants were measured at the time of the 1985, 1990, 1995 and 2000 censuses. Follow-up for mortality was for 1987--2003. The outcome measure was alcohol-related mortality, which was defined using information on the underlying and contributory causes of death. Results: Among men and women aged 45 years and over, the trends in alcohol-related mortality were associated with economic cycles. Among those aged less than 45 years, alcohol-related mortality decreased from the early 1990s, but intoxication-related accidents and violence still contributed largely to premature mortality. The unfavourable trend for older men resulted from an increase in mortality due to directly alcohol-attributable diseases, alcohol-related diseases of the circulatory system and accidents and violence, and for older women from an increase due to intoxication-related accidents and violence, and alcohol-attributable diseases. Alcohol-related mortality was higher in lower educational groups, and among women the educational gap widened towards the end of the study period. Conclusions: This study shows that trends in both economic conditions and per capita consumption of alcohol are not associated with trends in alcohol-related mortality in all population subgroups. In health policy more attention should be paid to divergent trends in gender, age and education specific alcohol-related mortality.
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