Background: Socioeconomic differences in alcohol-related mortality and hospitalisations, as based on register data, are larger than socioeconomic differences in various types of harmful drinking, as based on survey data.
Objective: The aim was to use a follow-up study to examine whether differential drinking patterns between socioeconomic groups explain the observed differences in alcohol-related mortality and hospitalisations, or whether similar drinking patterns predict higher mortality among lower socioeconomic groups.
Method: The study population included Finns who participated in cross-sectional surveys on drinking habits in 1969, 1976 or 1984 when aged 25–69 (n = 6406). They were followed up for alcohol-related mortality and hospitalisations (n = 180) for 16 years. Drinking patterns were measured by total consumption, frequency of subjective intoxication and of drinking different amounts of alcohol at a time, and by volume of consumption that was drunk in heavy drinking occasions and non-heavy drinking occasions.
Results: Compared with non-manual workers, manual workers had a 2.06-fold hazard of alcohol-related death or hospitalisation. Adjustment for drinking patterns explained only a small fraction of the excess hazard among manual workers. Additionally, in each category of total consumption and in each level of the volume drunk in heavy drinking occasions, the risk of alcohol-related death and hospitalisation was higher for manual than for non-manual workers.
Conclusions: Consequences of similar drinking patterns are more severe for those with lower socioeconomic status. Future studies are needed to explain how higher socioeconomic groups manage to escape the consequences of drinking that others have to face.
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Funding: The study has been funded by the Academy of Finland (grant 200852). Tapio Paljärvi has been supported by the Finnish Foundation for Alcohol Studies. The authors are indebted to three referees for their insightful comments.
Competing interests: None.