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Educational inequalities in hospitalization attributable to alcohol: a population-based longitudinal study of changes during the period 2000-07.
Addiction. 2015 Jul; 110(7):1092-100.A

Abstract

AIMS

To estimate the relative risk of hospitalization from alcohol-related causes among men and women in Finland across different educational categories, and to determine whether these differentials changed following a large reduction in alcohol prices in 2004.

DESIGN AND MEASUREMENTS

A register-based longitudinal study of hospitalizations. We used repeated-measures analysis to estimate alcohol-attributable hospitalization rates and assessed effects of the reduction in alcohol prices by comparing two 4-year periods (2000-03 and 2004-07).

SETTING

Finland.

PARTICIPANTS

A representative sample of the residents of Finland aged 30-79 years in the period 2000-07 (n = 470,627).

FINDINGS

There was a clear gradient across educational levels in alcohol-attributable hospitalizations: the incidence rate ratios among men and women with basic education were 1.70 [95% confidence interval (CI) = 1.32, 2.20] and 1.96 (95% CI = 1.36, 2.84), respectively, compared with those with upper-tertiary education. After allowing for the long-term trend, there were no significant changes between the two follow-up periods either among men with an upper tertiary education or among women in any educational level, whereas the rate increased by 21% (95% CI = 5, 41), 16% (95% CI = 6, 27) and 10% (95% CI = 2, 18), respectively, among men with a lower tertiary, secondary and basic education. However, these differences in changes were not statistically significant.

CONCLUSIONS

Lower-level education is associated with a substantially increased risk of alcohol-related hospitalization among men and women in Finland, even when adjusted for age, economic activity and income. The results do not provide strong evidence that the 2004 price reduction had differential effects by education.

Authors+Show Affiliations

Department of Social Research, Population Research Unit, University of Helsinki, Finland. Department of Public Health, Centre of Maritime Health and Society, University of Southern Denmark, Esbjerg, Denmark.National Institute for Health and Welfare, Helsinki, Finland.Department of Social Research, Population Research Unit, University of Helsinki, Finland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25808691

Citation

Herttua, Kimmo, et al. "Educational Inequalities in Hospitalization Attributable to Alcohol: a Population-based Longitudinal Study of Changes During the Period 2000-07." Addiction (Abingdon, England), vol. 110, no. 7, 2015, pp. 1092-100.
Herttua K, Mäkelä P, Martikainen P. Educational inequalities in hospitalization attributable to alcohol: a population-based longitudinal study of changes during the period 2000-07. Addiction. 2015;110(7):1092-100.
Herttua, K., Mäkelä, P., & Martikainen, P. (2015). Educational inequalities in hospitalization attributable to alcohol: a population-based longitudinal study of changes during the period 2000-07. Addiction (Abingdon, England), 110(7), 1092-100. https://doi.org/10.1111/add.12933
Herttua K, Mäkelä P, Martikainen P. Educational Inequalities in Hospitalization Attributable to Alcohol: a Population-based Longitudinal Study of Changes During the Period 2000-07. Addiction. 2015;110(7):1092-100. PubMed PMID: 25808691.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Educational inequalities in hospitalization attributable to alcohol: a population-based longitudinal study of changes during the period 2000-07. AU - Herttua,Kimmo, AU - Mäkelä,Pia, AU - Martikainen,Pekka, Y1 - 2015/05/14/ PY - 2014/08/18/received PY - 2014/12/15/revised PY - 2015/03/17/accepted PY - 2015/3/27/entrez PY - 2015/3/27/pubmed PY - 2016/12/15/medline KW - Alcohol KW - alcohol prices KW - education KW - hospitalisation KW - inequalities KW - longitudinal study KW - morbidity KW - natural experiment KW - population based SP - 1092 EP - 100 JF - Addiction (Abingdon, England) JO - Addiction VL - 110 IS - 7 N2 - AIMS: To estimate the relative risk of hospitalization from alcohol-related causes among men and women in Finland across different educational categories, and to determine whether these differentials changed following a large reduction in alcohol prices in 2004. DESIGN AND MEASUREMENTS: A register-based longitudinal study of hospitalizations. We used repeated-measures analysis to estimate alcohol-attributable hospitalization rates and assessed effects of the reduction in alcohol prices by comparing two 4-year periods (2000-03 and 2004-07). SETTING: Finland. PARTICIPANTS: A representative sample of the residents of Finland aged 30-79 years in the period 2000-07 (n = 470,627). FINDINGS: There was a clear gradient across educational levels in alcohol-attributable hospitalizations: the incidence rate ratios among men and women with basic education were 1.70 [95% confidence interval (CI) = 1.32, 2.20] and 1.96 (95% CI = 1.36, 2.84), respectively, compared with those with upper-tertiary education. After allowing for the long-term trend, there were no significant changes between the two follow-up periods either among men with an upper tertiary education or among women in any educational level, whereas the rate increased by 21% (95% CI = 5, 41), 16% (95% CI = 6, 27) and 10% (95% CI = 2, 18), respectively, among men with a lower tertiary, secondary and basic education. However, these differences in changes were not statistically significant. CONCLUSIONS: Lower-level education is associated with a substantially increased risk of alcohol-related hospitalization among men and women in Finland, even when adjusted for age, economic activity and income. The results do not provide strong evidence that the 2004 price reduction had differential effects by education. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/25808691/Educational_inequalities_in_hospitalization_attributable_to_alcohol:_a_population_based_longitudinal_study_of_changes_during_the_period_2000_07_ DB - PRIME DP - Unbound Medicine ER -