Explaining trends in alcohol-related harms in Scotland, 1991-2011 (I): the role of incomes, effects of socio-economic and political adversity and demographic change

被引：22

作者：

McCartney, G. ^{[1
]}

Bouttell, J. ^{[2
]}

Craig, N. ^{[1
]}

Craig, P. ^{[3
]}

Graham, L. ^{[4
]}

Lakha, F. ^{[5
]}

Lewsey, J. ^{[2
]}

McAdams, R. ^{[1
]}

MacPherson, M. ^{[1
]}

Minton, J. ^{[6
]}

Parkinson, J. ^{[1
]}

Robinson, M. ^{[1
]}

Shipton, D. ^{[1
]}

Taulbut, M. ^{[1
]}

Walsh, D. ^{[7
]}

Beeston, C. ^{[1
]}

机构：

[1] NHS Hlth Scotland, Meridian Court, 5 Cadogan St, Glasgow G2 6QE, Lanark, Scotland

[2] Univ Glasgow, Hlth Econ & Hlth Technol Assessment, 1 Lilybank Gardens, Glasgow G12 8RZ, Lanark, Scotland

[3] Univ Glasgow, MRC CSO Social & Publ Hlth Sci Unit, Top Floor, 200 Renfield St, Glasgow G2 3QB, Lanark, Scotland

[4] NHS Natl Serv Scotland, Publ Hlth & Intelligence, Gyle Sq,1 South Gyle Crescent, Edinburgh EH12 9EB, Midlothian, Scotland

[5] NHS Lothian, Waverley Gate, 2-4 Waterloo Pl, Edinburgh EH1 3EG, Midlothian, Scotland

[6] Univ Glasgow, Sch Social & Polit Sci, Urban Studies, 25 Bute Gardens, Glasgow, Lanark, Scotland

[7] Glasgow Ctr Populat Hlth, Bridgeton Cross, Olympia Bldg, Glasgow G40 2QH, Lanark, Scotland

来源：

PUBLIC HEALTH | 2016年 / 132卷

基金：

英国医学研究理事会;

关键词：

Alcohol; Scotland; England; Evaluation; Excess mortality; Scottish effect; Age period cohort; CONTROL POLICIES; MORTALITY-RATES; HEALTH; CONSUMPTION; ADVOCACY; DRINKING; ENGLAND; UK;

D O I：

10.1016/j.puhe.2015.12.013

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objective: This paper tests the extent to which differing trends in income, demographic change and the consequences of an earlier period of social, economic and political change might explain differences in the magnitude and trends in alcohol-related mortality between 1991 and 2011 in Scotland compared to England & Wales (E&W). Study design: Comparative time trend analyses and arithmetic modelling. Methods: Three approaches were utilised to compare Scotland with E&W: 1. We modelled the impact of changes in income on alcohol-related deaths between 1991-2001 and 2001-2011 by applying plausible assumptions of the effect size through an arithmetic model. 2. We used contour plots, graphical exploration of age-period-cohort interactions and calculation of Intrinsic Estimator coefficients to investigate the effect of earlier exposure to social, economic and political adversity on alcohol-related mortality. 3. We recalculated the trends in alcohol-related deaths using the white population only to make a crude approximation of the maximal impact of changes in ethnic diversity. Results: Real incomes increased during the 1990s but declined from around 2004 in the poorest 30% of the population of Great Britain. The decline in incomes for the poorest decile, the proportion of the population in the most deprived decile, and the inequality in alcohol-related deaths, were all greater in Scotland than in E&W. The model predicted less of the observed rise in Scotland (18% of the rise in men and 29% of the rise in women) than that in E&W (where 60% and 68% of the rise in men and women respectively was explained). One-third of the decline observed in alcohol-related mortality in Scottish men between 2001 and 2011 was predicted by the model, and the model was broadly consistent with the observed trends in E&W and amongst women in Scotland. An age-period interaction in alcohol-related mortality was evident for men and women during the 1990s and 2000s who were aged 40-70 years and who experienced rapidly increasing alcohol-related mortality rates. Ethnicity is unlikely to be important in explaining the trends or differences between Scotland and E&W. Conclusions: The decline in alcohol-related mortality in Scotland since the early 2000s and the differing trend to E&W were partly described by a model predicting the impact of declining incomes. Lagged effects from historical social, economic and political change remain plausible from the available data. (C) 2016 The Authors. Published by Elsevier Ltd.

引用

页码：13 / 23

页数：11

共 1 条

[1] Explaining trends in alcohol-related harms in Scotland 1991-2011 (II): policy, social norms, the alcohol market, clinical changes and a synthesis
McCartney, G.
Bouttell, J.
Craig, N.
Craig, P.
Graham, L.
Lakha, F.
Lewsey, J.
McAdams, R.
MacPherson, M.
Minton, J.
Parkinson, J.
Robinson, M.
Shipton, D.
Taulbut, M.
Walsh, D.
Beeston, C.
PUBLIC HEALTH, 2016, 132 : 24 - 32

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