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The effects of regional characteristics on alcohol-related mortality-a register-based multilevel analysis of 1.1 million men.
Soc Sci Med. 2004 Jun; 58(12):2523-35.SS

Abstract

The aim of this study is to assess to what extent selected characteristics of functional regions affect alcohol-related mortality among men in Finland after adjusting for individual-level characteristics. The study was conducted as a multilevel Poisson regression analysis, with individuals (n = 1.1 million) as the first level and functional regions of Finland (n = 84) as the second level. The analysis covered men aged 25-64. The data are based on the 1990 census records, which were linked to death records in 1991-1996. The outcome measure was alcohol-related mortality, which was defined using information on the underlying and contributory causes of death. The individual-level covariates included age, education, socioeconomic status, marital status and mother tongue. The area-level variables considered were the proportion of manual workers, unemployment level, median household income, Gini coefficient of income, family cohesion, voting turnout, level of urbanisation and proportion of Swedish-speaking inhabitants. A high proportion of manual workers and of unemployed and low social cohesion (family cohesion and voting turnout) were found to produce adverse effects on alcohol-related mortality, and the independent effects of these variables remained after adjustment for all individual-level and area-level characteristics. The protective effect of high level of urbanisation was revealed after adjustment for other individual- and area-level characteristics. Neither mean income nor income inequality were related to alcohol-related mortality. Adjusting for individual-level variables diminished the average relative deviation of alcohol-related mortality among the functional regions by 41%. The inclusion of area-level characteristics in the model resulted in a total diminution of variation of 79%. The area characteristics considered in this study had a notable effect on alcohol-related mortality, although these effects were smaller than those of the individual-level characteristics. Fuller understanding of the mechanisms underlying the effects of area measures of social structure and cohesion on risky alcohol consumption and alcohol-related mortality is needed.

Authors+Show Affiliations

Blomgren J
Department of Sociology, University of Helsinki, Finland. jenni.blomgren@helsinki.fi
Martikainen P
No affiliation info available
Mäkelä P
No affiliation info available
Valkonen T
No affiliation info available

MeSH

AdultAge DistributionAlcoholismCause of DeathCohort StudiesEducational StatusFinlandHumansMaleMarital StatusMiddle AgedMultivariate AnalysisPoisson DistributionRegistriesRisk AssessmentSeverity of Illness IndexSocioeconomic Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15081202

Citation

Blomgren, Jenni, et al. "The Effects of Regional Characteristics On Alcohol-related Mortality-a Register-based Multilevel Analysis of 1.1 Million Men." Social Science & Medicine (1982), vol. 58, no. 12, 2004, pp. 2523-35.
Blomgren J, Martikainen P, Mäkelä P, et al. The effects of regional characteristics on alcohol-related mortality-a register-based multilevel analysis of 1.1 million men. Soc Sci Med. 2004;58(12):2523-35.
Blomgren, J., Martikainen, P., Mäkelä, P., & Valkonen, T. (2004). The effects of regional characteristics on alcohol-related mortality-a register-based multilevel analysis of 1.1 million men. Social Science & Medicine (1982), 58(12), 2523-35.
Blomgren J, et al. The Effects of Regional Characteristics On Alcohol-related Mortality-a Register-based Multilevel Analysis of 1.1 Million Men. Soc Sci Med. 2004;58(12):2523-35. PubMed PMID: 15081202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of regional characteristics on alcohol-related mortality-a register-based multilevel analysis of 1.1 million men. AU - Blomgren,Jenni, AU - Martikainen,Pekka, AU - Mäkelä,Pia, AU - Valkonen,Tapani, PY - 2004/4/15/pubmed PY - 2004/8/4/medline PY - 2004/4/15/entrez SP - 2523 EP - 35 JF - Social science & medicine (1982) JO - Soc Sci Med VL - 58 IS - 12 N2 - The aim of this study is to assess to what extent selected characteristics of functional regions affect alcohol-related mortality among men in Finland after adjusting for individual-level characteristics. The study was conducted as a multilevel Poisson regression analysis, with individuals (n = 1.1 million) as the first level and functional regions of Finland (n = 84) as the second level. The analysis covered men aged 25-64. The data are based on the 1990 census records, which were linked to death records in 1991-1996. The outcome measure was alcohol-related mortality, which was defined using information on the underlying and contributory causes of death. The individual-level covariates included age, education, socioeconomic status, marital status and mother tongue. The area-level variables considered were the proportion of manual workers, unemployment level, median household income, Gini coefficient of income, family cohesion, voting turnout, level of urbanisation and proportion of Swedish-speaking inhabitants. A high proportion of manual workers and of unemployed and low social cohesion (family cohesion and voting turnout) were found to produce adverse effects on alcohol-related mortality, and the independent effects of these variables remained after adjustment for all individual-level and area-level characteristics. The protective effect of high level of urbanisation was revealed after adjustment for other individual- and area-level characteristics. Neither mean income nor income inequality were related to alcohol-related mortality. Adjusting for individual-level variables diminished the average relative deviation of alcohol-related mortality among the functional regions by 41%. The inclusion of area-level characteristics in the model resulted in a total diminution of variation of 79%. The area characteristics considered in this study had a notable effect on alcohol-related mortality, although these effects were smaller than those of the individual-level characteristics. Fuller understanding of the mechanisms underlying the effects of area measures of social structure and cohesion on risky alcohol consumption and alcohol-related mortality is needed. SN - 0277-9536 UR - https://www.unboundmedicine.com/medline/citation/15081202/The_effects_of_regional_characteristics_on_alcohol_related_mortality_a_register_based_multilevel_analysis_of_1_1_million_men_ DB - PRIME DP - Unbound Medicine ER -