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

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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.

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References

  • Alcohol-Related Disease Impact (ARDI) database. cdc.gov/ardi.

  • Anonymous. (2017). Details omitted for blind review.

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Book  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Case, A., & Deaton, A. (2017). Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity,2017, 397–476.

    Article  Google Scholar 

  • 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 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Lieber, C. (2003). Relationships between nutrition, alcohol use, and liver disease. Alcohol Research & Health,27(3), 220–231.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • 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.

    Article  Google Scholar 

  • 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.

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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 

  • Watzl, B., & Watson, R. (1992). Role of alcohol-abuse in nutritional immunosuppression. Journal of Nutrition,122(3), 733–737.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

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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.

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  1. Population Studies Center, University of Pennsylvania, McNeil Building, 3718 Locust Walk, Philadelphia, PA, USA

    Yana C. Vierboom

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Vierboom, Y.C. Trends in Alcohol-Related Mortality by Educational Attainment in the U.S., 2000–2017. Popul Res Policy Rev 39, 77–97 (2020). https://doi.org/10.1007/s11113-019-09527-0

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