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Alcohol‐related morbidity and mortality within siblings
Author(s) -
Søndergaard Grethe,
Osler Merete,
Andersen AnneMarie Nybo,
Andersen Per Kragh,
Dalton Susanne Oksbjerg,
Mortensen Laust H.
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12823
Subject(s) - hazard ratio , medicine , demography , sibling , proportional hazards model , cohort , confidence interval , cohort study , alcohol , psychology , biology , developmental psychology , biochemistry , sociology
Aims To estimate the association between educational status and alcohol‐related somatic and non‐somatic morbidity and mortality among full siblings in comparison with non‐related individuals. Design Cohort study. Setting Denmark. Participants Approximately 1.4 million full siblings born in Denmark between 1950 and 1979 were followed from age 28–58 years or censoring due to alcohol‐related hospitalization and mortality. Measurements Cox regression analyses were used to estimate associations of educational status with alcohol‐related outcomes. Results from cohort analyses based on non‐related individuals and inter‐sibling analyses were compared. Findings A lower educational status was associated with a higher rate of alcohol‐related outcomes, especially among the youngest (aged 28–37 years) and individuals born 1970–79. Compared with the cohort analyses, the associations attenuated slightly in the inter‐sibling analysis. For example, in the cohort analysis, females with a basic school education born 1970–79 had an increased rate of alcohol‐related non‐somatic morbidity and mortality [hazard rate ratio (HR) = 4.05, 95% confidence interval (CI) = 3.27–5.02] compared to those with a vocational education. In the inter‐sibling analysis, the HR attenuated (HR = 2.66, 95% CI = 1.95–3.63). For alcohol‐related somatic outcomes the corresponding figures were HR = 3.47 (95% CI = 2.63–4.58) and HR = 3.36 (95% CI = 2.10–5.38), respectively. In general, the associations were stronger among females than males (aged 28–37) in the analyses of alcohol‐related non‐somatic outcomes. Health conditions earlier in life explained only a minor part of the associations. Conclusions The association between educational status and alcohol‐related somatic and non‐somatic morbidity and mortality is only driven by familial factors to a small degree.