The Contribution of Alcohol Consumption to Past Long-Term Trends in Socio-Economic Inequalities in Life Expectancy in Selected European Countries.

Jesús-Daniel Zazueta Borboa , Netherlands Interdisciplinary Demographic Institute (NIDI)
Wanda Van Hemelrijck , Netherlands Interdisciplinary Demographic Institute (NIDI)
Pekka Martikainen, University of Helsinki
Nicolás Zengarini, Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco(Turin)
Anton E Kunst, Department of Public Health, Amsterdam UMC, University of Amsterdam
Fanny Janssen , Netherlands Interdisciplinary Demographic Institute (NIDI) and University of Groningen

Socio-economic inequalities in life expectancy in Europe are large, and have been increasing over the past decades, albeit with important trend breaks. It is unknown how – for different European countries - the different levels and trends in alcohol-attributable mortality across socio-economic groups affected past trends in socio-economic inequalities in life expectancy. We therefore assess the contribution of alcohol consumption to past long-term trends in educational inequalities in remaining life expectancy at age 30 (e30) in England and Wales, Finland and Italy. We will use yearly, individually linked, all-cause and cause-specific mortality data by educational level (high, middle, low), sex and age from 1971 onwards. We will estimate alcohol-attributable mortality after comparing different estimation techniques, and determine the impact of alcohol on trends in educational inequalities in e30 (high minus low) by comparing trends in educational inequalities in e30 with and without alcohol-attributable mortality. Our preliminary results for Finland, using multiple cause of death data to estimate alcohol-attributable mortality, indicate that the increase in educational inequalities in e30 among females (1987-2017) diminished from 2.1 to 1.5 years when excluding alcohol-attributable mortality. For Finnish males, without alcohol-attributable mortality, the increase in inequalities up to 2008 diminished from 2.5 to 1.4 years, and the subsequent decline almost disappeared. Alcohol-attributable mortality contributed 45% among males (1987-2008) and 30% among females (1987-2017) to the increase in educational inequalities in e30. Alcohol-attributable mortality, thus, seems an important determinant of both levels and trends in educational inequalities, especially among Finnish males.

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 Presented in Session 36. Alcohol, smoking, and obesity attributable mortality