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The effect of childhood socioeconomic position on alcohol-related disorders later in life: a Swedish national cohort study
  1. Karl Gauffin1,2,
  2. Tomas Hemmingsson3,4,
  3. Anders Hjern1,5
  1. 1Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
  2. 2Department of Public Health Sceinces, Karolinska Institutet, Stockholm, Sweden
  3. 3Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  4. 4Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
  5. 5Clinical Epidemiology/Department of Medicine, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Karl Gauffin, Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm SE-10691, Sweden, karl.gauffin{at}chess.su.se

Abstract

Background Alcohol use is the third most important global-health risk factor and a main contributor to health inequalities. Previous research on social determinants of alcohol-related disorders has delivered inconsistent results. We aimed to investigate whether socioeconomic position (SEP) in childhood predicts alcohol-related disorders in young adulthood in a Swedish national cohort.

Methods We studied a register-based national cohort of Swedish citizens born during 1973–1984 (N=948 518) and followed them up to 2009 from age 15. Childhood SEP was defined by a six-category socioeconomic index from the Censuses of 1985 and 1990. HRs of alcohol-related disorders, as indicated by register entries on alcohol-related death and alcohol-related medical care, were analysed in Cox regression models with adjustment for sociodemographic variables and indicators of parental morbidity and criminality.

Results Low childhood SEP was associated with alcohol-related disorders later in life among both men and women in a stepwise manner. Growing up in a household with the lowest SEP was associated with risk for alcohol-related disorders of HR: 2.24 (95% CI 2.08 to 2.42) after adjustment for sociodemographic variables, compared with the highest SEP group. Adjusting the analysis for parental psychosocial problems attenuated the association to HR 1.87 (95% CI 1.73 to 2.01).

Conclusions The study demonstrates that low SEP in childhood predicts alcohol-related disorders in young adulthood. Alcohol abuse needs to be addressed in policies to bridge the gap of health inequalities.

  • Alcohol
  • Social Inequalities
  • Longitudinal Studies
  • Social Class
  • Social Epidemiology

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