Advertisement

Trends in Alcohol-Related Mortality by Educational Attainment in the U.S., 2000–2017

  • Yana C. VierboomEmail author
Article

Abstract

Alcohol-related mortality rates in the U.S. have risen since 2000, though how trends vary across socio-economic status is unclear. This analysis combines data from vital statistics and the National Health Interview Survey (NHIS) to estimate alcohol-related mortality rates at four levels of educational attainment (less than high school, high school/GED, some college/associate’s degree, 4-year degree, or more) over the period 2000–2017. The analysis includes a comprehensive set of 48 alcohol-related causes of death, including causes which are indirectly influenced by alcohol use. I consider period and cohort patterns in inequality using the relative index of inequality (RII). Results indicate that alcohol-related mortality rates increased over the study period, at all levels of educational attainment. Relative increases were larger for females than males at nearly all ages and levels of educational attainment, and were largest among 45–59-year-old women. Male and female members of the 1950–1959 birth cohort exhibited elevated rates of alcohol-related mortality relative to neighboring cohorts. Despite widespread increases in alcohol-related mortality, educational inequalities present at the beginning of the analysis persisted and exceeded those in all-cause mortality. Disparities were typically greatest among younger adults aged 30–44, though inequality in this age group declined over time. Inequality increased among females aged 60–74, as well as among males aged 45–74. While interventions targeting these groups may reduce educational disparities, care should also be taken to stem the increasing prevalence of alcohol-related deaths at all levels of educational attainment.

Keywords

Mortality Socio-economic status Alcohol United States 

Notes

Acknowledgements

I am grateful to Samuel Preston, Irma Elo, Michel Guillot, Jessica Ho, and three anonymous reviewers for invaluable feedback on this paper. This research received support from the Population Research Training Grant (NIH T32 HD007242) awarded to the Population Studies Center at the University of Pennsylvania by the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Supplementary material

11113_2019_9527_MOESM1_ESM.docx (33 kb)
Supplementary material 1 (DOCX 33 kb)

References

  1. Alcohol-Related Disease Impact (ARDI) database. cdc.gov/ardi.Google Scholar
  2. Anonymous. (2017). Details omitted for blind review.Google Scholar
  3. Baan, R., Straif, K., Grosse, Y., Secretan, B., El Ghissassi, F., Bouvard, V., et al. (2007). Carcinogenicity of alcoholic beverages. Lancet Oncology, 8(4), 292–293.CrossRefGoogle Scholar
  4. Bell, S., Daskalopoulou, M., Rapsomaniki, E., George, J., Britton, A., Bobak, M., et al. (2017). Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: Population based cohort study using linked health records. British Medical Journal, 356, j909.CrossRefGoogle Scholar
  5. Blewett, L., Rivera Drew, J. A., Griffin, R., King, M. L., & Williams, K. C. W. (2016). IPUMS Health Surveys: National Health Interview Survey, Version 6.2. Minneapolis: University of Minnesota.  https://doi.org/10.18128/D070.V6.2.Google Scholar
  6. Breslow, R. A., & Graubard, B. I. (2008). Prospective study of alcohol consumption in the United States: Quantity, frequency, and cause-specific mortality. Alcoholism, Clinical and Experimental Research, 32(3), 513–521.CrossRefGoogle Scholar
  7. Breslow, R. A., Guenther, P. M., Juan, W., & Graubard, B. I. (2010). Alcoholic beverage consumption, nutrient intakes, and diet quality in the U.S. adult population, 1999-2006. Journal of the American Dietetic Association, 110(4), 551–562.CrossRefGoogle Scholar
  8. Caldwell, T. M., Rodgers, B., Clark, C., Jefferis, B. J. M. H., Stansfeld, S. A., & Power, C. (2008). Lifecourse socioeconomic predictors of midlife drinking patterns, problems and abstention: Findings from the 1958 British birth cohort study. Drug and Alcohol Dependence, 95(3), 269–278.CrossRefGoogle Scholar
  9. Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National academy of Sciences of the United States of America, 112(49), 15078–15083.CrossRefGoogle Scholar
  10. Case, A., & Deaton, A. (2017). Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity, 2017, 397–476.CrossRefGoogle Scholar
  11. Centers for Disease Control and Prevention (CDC). (2012). Vital signs: Binge drinking prevalence, frequency, and intensity among adults: United States, 2010. Morbidity and Mortality Weekly Report, 61(1), 14–19.Google Scholar
  12. Grant, B. F., Chou, S. P., Saha, T. D., Pickering, R. P., Kerridge, B. T., Ruan, W. J., et al. (2017). Prevalence of 12-month alcohol use, high-risk drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013 results from the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry, 74(9), 911–923.CrossRefGoogle Scholar
  13. Hendi, A. S. (2017). Trends in education-specific life expectancy, data quality, and shifting education distributions: A note on recent research. Demography, 54(3), 1203–1213.CrossRefGoogle Scholar
  14. Herttua, K., Mäkelä, P., & Martikainen, P. (2011). An evaluation of the impact of a large reduction in alcohol prices on alcohol-related and all-cause mortality: Time series analysis of a population-based natural experiment. International Journal of Epidemiology, 40(2), 441–454.CrossRefGoogle Scholar
  15. Herttua, K., Ostergren, O., Lundberg, O., & Martikainen, P. (2017). Influence of affordability of alcohol on educational disparities in alcohol-related mortality in Finland and Sweden: A time series analysis. Journal of Epidemiology and Community Health, 71(12), 1168–1176.Google Scholar
  16. Ho, J. Y. (2017). The contribution of drug overdose to educational gradients in life expectancy in the United States, 1992-2011. Demography, 54(3), 1175–1202.CrossRefGoogle Scholar
  17. Jamal, A., Homa, D. M., O’Connor, E., Babb, S. D., Caraballo, R. S., Singh, T., et al. (2015). Current cigarette smoking among adults: United States 2005-2014. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, 64(44), 1233–1240.CrossRefGoogle Scholar
  18. Kanny, D., Naimi, T. S., Liu, Y., Lu, H., & Brewer, R. D. (2018). Annual total binge drinks consumed by U.S. adults, 2015. American Journal of Preventive Medicine, 54(4), 486–496.CrossRefGoogle Scholar
  19. Keyes, K. M., Hatzenbuehler, M. L., McLaughlin, K. A., Link, B., Olfson, M., Grant, B. F., et al. (2010). Stigma and treatment for alcohol disorders in the United States. American Journal of Epidemiology, 172(12), 1364–1372.CrossRefGoogle Scholar
  20. Kuh, D., Ben-Shlomo, Y., Lynch, J., Hallqvist, J., & Power, C. (2003). Life course epidemiology. Journal of Epidemiology and Community Health, 57(10), 778–783.CrossRefGoogle Scholar
  21. Lieber, C. (2003). Relationships between nutrition, alcohol use, and liver disease. Alcohol Research & Health, 27(3), 220–231.Google Scholar
  22. Lui, C. K., Kerr, W. C., Mulia, N., & Ye, Y. (2018). Educational differences in alcohol consumption and heavy drinking: An age-period-cohort perspective. Drug and Alcohol Dependence, 186, 36–43.CrossRefGoogle Scholar
  23. Mackenbach, J. P., Kulhanova, I., Bopp, M., Borrell, C., Deboosere, P., Kovacs, K., et al. (2015). Inequalities in alcohol-related mortality in 17 European countries: A retrospective analysis of mortality registers. PLOS Medicine, 12(12), e1001909.CrossRefGoogle Scholar
  24. Mackenbach, J., & Kunst, A. (1997). Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe. Social Science and Medicine, 44(6), 757–771.CrossRefGoogle Scholar
  25. Mäkelä, P., Herttua, K., & Martikainen, P. (2015). The socioeconomic differences in alcohol-related harm and the effects of alcohol prices on them: A summary of evidence from Finland. Alcohol and Alcoholism, 50(6), 661–669.CrossRefGoogle Scholar
  26. Mäkelä, P., & Paljärvi, T. (2008). Do consequences of a given pattern of drinking vary by socioeconomic status? A mortality and hospitalisation follow-up for alcohol-related causes of the Finnish drinking habits surveys. Journal of Epidemiology and Community Health, 62(8), 728–733.CrossRefGoogle Scholar
  27. Mehta, N. K., House, J. S., & Elliott, M. R. (2015). Dynamics of health behaviours and socioeconomic differences in mortality in the USA. Journal of Epidemiology and Community Health, 69(5), 416–422.CrossRefGoogle Scholar
  28. Miniño, A.M., Arias, E., Kochanek, K.D., Murphy, S.L., Smith, B.L. (2002). Deaths: Final Data for 2000. National vital statistics reports (vol 50 no 15). Hyattsville, Maryland: National Center for Health Statistics.Google Scholar
  29. Mossakowski, K. N. (2008). Is the duration of poverty and unemployment a risk factor for heavy drinking? Social Science and Medicine, 67(6), 947–955.CrossRefGoogle Scholar
  30. National Bureau of Economic Research. (2019). Vital Statistics NCHS’ Multiple Cause of Death Data, 1959-2017. Cambridge, MA. Retrieved from https://www.nber.org/data/vital-statistics-mortality-data-multiple-cause-of-death.html.
  31. Probst, C., Roerecke, M., Behrendt, S., & Rehm, J. (2014). Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: A systematic review and meta-analysis. International Journal of Epidemiology, 43(4), 1314–1327.CrossRefGoogle Scholar
  32. Rehm, J., Baliunas, D., Borges, G. L. G., Graham, K., Irving, H., Kehoe, T., et al. (2010). The relation between different dimensions of alcohol consumption and burden of disease: An overview. Addiction, 105(5), 817–843.CrossRefGoogle Scholar
  33. Roerecke, M., & Rehm, J. (2010). Irregular heavy drinking occasions and risk of ischemic heart disease: A systematic review and meta-analysis. American Journal of Epidemiology, 171(6), 633–644.CrossRefGoogle Scholar
  34. Rogers, R. G., Boardman, J. D., Pendergast, P. M., & Lawrence, E. M. (2015). Drinking problems and mortality risk in the United States. Drug and Alcohol Dependence, 151, 38–46.CrossRefGoogle Scholar
  35. Rostron, B. L., Boies, J. L., & Arias, E. (2010). Education reporting and classification on death certificates in the United States. Vital and Health Statistics, 151(2), 1–21.Google Scholar
  36. Schalick, L., Hadden, W., Pamuk, E., Navarro, V., & Pappas, G. (2000). The widening gap in death rates among income groups in the United States from 1967 to 1986. International Journal of Health Services, 30(1), 13–26.CrossRefGoogle Scholar
  37. Stahre, M., Roeber, J., Kanny, D., Brewer, R. D., & Zhang, X. (2014). Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Preventing Chronic Disease, 11, 130293.CrossRefGoogle Scholar
  38. Taylor, B., & Rehm, J. (2006). When risk factors combine: The interaction between alcohol and smoking for aero-digestive cancer, coronary heart disease, and traffic and fire injury. Addictive Behaviors, 31(9), 1522–1535.CrossRefGoogle Scholar
  39. Virtanen, S., Kaprio, J., Viken, R., Rose, R., & Latvala, A. (2018). Birth cohort effects on the quantity and heritability of alcohol consumption in adulthood: A Finnish longitudinal twin study. Behavior Genetics, 48(6), 518–519.Google Scholar
  40. Watzl, B., & Watson, R. (1992). Role of alcohol-abuse in nutritional immunosuppression. Journal of Nutrition, 122(3), 733–737.CrossRefGoogle Scholar
  41. White, A. M., Slater, M. E., Ng, G., Hingson, R., & Breslow, R. (2018). Trends in alcohol-related emergency department visits in the United States: Results from the nationwide emergency department sample, 2006 to 2014. Alcoholism, Clinical and Experimental Research, 42(2), 352–359.CrossRefGoogle Scholar
  42. Xu, J.Q., Murphy, S.L., Kochanek, K.D., Bastian, B., Arias, E. (2018). Deaths: Final data for 2016. National Vital Statistics Reports (vol 67 no 5). Hyattsville, MD: National Center for Health Statistics.Google Scholar
  43. Zaridze, D., Brennan, P., Boreham, J., Boroda, A., Karpov, R., Lazarev, A., et al. (2009). Alcohol and cause-specific mortality in Russia: A retrospective case-control study of 48,557 adult deaths. Lancet, 373(9682), 2201–2214.CrossRefGoogle Scholar
  44. Zhao, J., Zhu, Y., Wang, P. P., West, R., Buehler, S., Sun, Z., et al. (2012). Interaction between alcohol drinking and obesity in relation to colorectal cancer risk: A case-control study in Newfoundland and Labrador. Canada. BMC Public Health, 12(1), 94.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Population Studies CenterUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations