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The contribution of education, social class and economic activity to the income–mortality association in alcohol‐related and other mortality in Finland in 1988–2012
Author(s) -
Tarkiainen Lasse,
Martikainen Pekka,
Laaksonen Mikko
Publication year - 2016
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.13211
Subject(s) - demography , social class , medicine , socioeconomic status , household income , geography , population , economics , archaeology , sociology , market economy
Aims First, to quantify trends in the contribution of alcohol‐related mortality to mortality disparity in Finland by income quintiles. Secondly, to estimate the degree to which education, social class and economic activity explain the income–mortality association in alcohol‐related and other mortality in four periods within 1988–2012. Design Register‐based longitudinal study using an 11% random sample of Finnish residents linked to socio‐economic and mortality data in 1988–2012 augmented with an 80% sample of all deaths during 1988–2007. Mortality rates and discrete time survival regression models were used to assess the income–mortality association following adjustment for covariates in 6‐year periods after baseline years of 1988, 1994, 2001, and 2007. Setting Finland . Participants Individuals aged 35–64 years at baselines. For the four study periods for men/women, the final data set comprised, respectively, 26 360/12 825, 22 561/11 423, 20 342/11 319 and 2651/1514 deaths attributable to other causes and 7517/1217, 8199/1450, 9807/2116, 1431/318 deaths attributable to alcohol‐related causes. Measurements Alcohol‐related deaths were analysed with household income, education, social class and economic activity as covariates. Findings The income disparity in mortality originated increasingly from alcohol‐related causes of death, in the lowest quintile the contribution increasing from 28 to 49% among men and from 11 to 28% among women between periods 1988–93 and 2007–12. Among men, socio‐economic characteristics attenuated the excess mortality during each study period in the lowest income quintile by 51–62% in alcohol‐related and other causes. Among women, in the lowest quintile the attenuation was 47–76% in other causes, but there was a decreasing tendency in the proportion explained by the covariates in alcohol‐related mortality. Conclusions The income disparity in mortality among working‐age Finns originates increasingly from alcohol‐related causes of death. Roughly half the excess mortality in the lowest income quintile during 2007–12 is explained by the covariates of household income, education, social class and economic activity.