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The contribution of education, social class and economic activity to the income-mortality association in alcohol-related and other mortality in Finland in 1988-2012.
Addiction. 2016 Mar; 111(3):456-64.A

Abstract

AIMS

First, to quantify trends in the contribution of alcohol-related mortality to mortality disparity in Finland by income quintiles. Secondly, to estimate the degree to which education, social class and economic activity explain the income-mortality association in alcohol-related and other mortality in four periods within 1988-2012.

DESIGN

Register-based longitudinal study using an 11% random sample of Finnish residents linked to socio-economic and mortality data in 1988-2012 augmented with an 80% sample of all deaths during 1988-2007. Mortality rates and discrete time survival regression models were used to assess the income-mortality association following adjustment for covariates in 6-year periods after baseline years of 1988, 1994, 2001, and 2007.

SETTING

Finland.

PARTICIPANTS

Individuals aged 35-64 years at baselines. For the four study periods for men/women, the final data set comprised, respectively, 26,360/12,825, 22,561/11,423, 20,342/11,319 and 2651/1514 deaths attributable to other causes and 7517/1217, 8199/1450, 9807/2116, 1431/318 deaths attributable to alcohol-related causes.

MEASUREMENTS

Alcohol-related deaths were analysed with household income, education, social class and economic activity as covariates.

FINDINGS

The income disparity in mortality originated increasingly from alcohol-related causes of death, in the lowest quintile the contribution increasing from 28 to 49% among men and from 11 to 28% among women between periods 1988-93 and 2007-12. Among men, socio-economic characteristics attenuated the excess mortality during each study period in the lowest income quintile by 51-62% in alcohol-related and other causes. Among women, in the lowest quintile the attenuation was 47-76% in other causes, but there was a decreasing tendency in the proportion explained by the covariates in alcohol-related mortality.

CONCLUSIONS

The income disparity in mortality among working-age Finns originates increasingly from alcohol-related causes of death. Roughly half the excess mortality in the lowest income quintile during 2007-12 is explained by the covariates of household income, education, social class and economic activity.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Tarkiainen L
Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
Martikainen P
Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
Laaksonen M
Finnish Centre for Pensions, Research Department, Helsinki, Finland.

MeSH

AdultAlcohol-Related DisordersEducational StatusEmploymentFemaleFinlandHealth Status DisparitiesHumansIncomeLongitudinal StudiesMaleMiddle AgedRegistriesRegression AnalysisSocial Class

Pub Type(s)

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

Language

eng

PubMed ID

26477592

Citation

Tarkiainen, Lasse, et al. "The Contribution of Education, Social Class and Economic Activity to the Income-mortality Association in Alcohol-related and Other Mortality in Finland in 1988-2012." Addiction (Abingdon, England), vol. 111, no. 3, 2016, pp. 456-64.
Tarkiainen L, Martikainen P, Laaksonen M. The contribution of education, social class and economic activity to the income-mortality association in alcohol-related and other mortality in Finland in 1988-2012. Addiction. 2016;111(3):456-64.
Tarkiainen, L., Martikainen, P., & Laaksonen, M. (2016). The contribution of education, social class and economic activity to the income-mortality association in alcohol-related and other mortality in Finland in 1988-2012. Addiction (Abingdon, England), 111(3), 456-64. https://doi.org/10.1111/add.13211
Tarkiainen L, Martikainen P, Laaksonen M. The Contribution of Education, Social Class and Economic Activity to the Income-mortality Association in Alcohol-related and Other Mortality in Finland in 1988-2012. Addiction. 2016;111(3):456-64. PubMed PMID: 26477592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The contribution of education, social class and economic activity to the income-mortality association in alcohol-related and other mortality in Finland in 1988-2012. AU - Tarkiainen,Lasse, AU - Martikainen,Pekka, AU - Laaksonen,Mikko, Y1 - 2015/11/27/ PY - 2015/06/08/received PY - 2015/08/03/revised PY - 2015/10/09/accepted PY - 2015/10/20/entrez PY - 2015/10/20/pubmed PY - 2017/1/18/medline KW - Alcohol KW - disparity KW - income KW - mortality SP - 456 EP - 64 JF - Addiction (Abingdon, England) JO - Addiction VL - 111 IS - 3 N2 - AIMS: First, to quantify trends in the contribution of alcohol-related mortality to mortality disparity in Finland by income quintiles. Secondly, to estimate the degree to which education, social class and economic activity explain the income-mortality association in alcohol-related and other mortality in four periods within 1988-2012. DESIGN: Register-based longitudinal study using an 11% random sample of Finnish residents linked to socio-economic and mortality data in 1988-2012 augmented with an 80% sample of all deaths during 1988-2007. Mortality rates and discrete time survival regression models were used to assess the income-mortality association following adjustment for covariates in 6-year periods after baseline years of 1988, 1994, 2001, and 2007. SETTING: Finland. PARTICIPANTS: Individuals aged 35-64 years at baselines. For the four study periods for men/women, the final data set comprised, respectively, 26,360/12,825, 22,561/11,423, 20,342/11,319 and 2651/1514 deaths attributable to other causes and 7517/1217, 8199/1450, 9807/2116, 1431/318 deaths attributable to alcohol-related causes. MEASUREMENTS: Alcohol-related deaths were analysed with household income, education, social class and economic activity as covariates. FINDINGS: The income disparity in mortality originated increasingly from alcohol-related causes of death, in the lowest quintile the contribution increasing from 28 to 49% among men and from 11 to 28% among women between periods 1988-93 and 2007-12. Among men, socio-economic characteristics attenuated the excess mortality during each study period in the lowest income quintile by 51-62% in alcohol-related and other causes. Among women, in the lowest quintile the attenuation was 47-76% in other causes, but there was a decreasing tendency in the proportion explained by the covariates in alcohol-related mortality. CONCLUSIONS: The income disparity in mortality among working-age Finns originates increasingly from alcohol-related causes of death. Roughly half the excess mortality in the lowest income quintile during 2007-12 is explained by the covariates of household income, education, social class and economic activity. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/26477592/The_contribution_of_education_social_class_and_economic_activity_to_the_income_mortality_association_in_alcohol_related_and_other_mortality_in_Finland_in_1988_2012_ DB - PRIME DP - Unbound Medicine ER -