American Journal of Epidemiology Advance Access originally published online on August 20, 2008
American Journal of Epidemiology 2008 168(10):1110-1118; doi:10.1093/aje/kwn216
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ORIGINAL CONTRIBUTIONS |
Changes in Alcohol-Related Mortality and its Socioeconomic Differences After a Large Reduction in Alcohol Prices: A Natural Experiment Based on Register Data
Correspondence to Kimmo Herttua, Population Research Unit, Department of Sociology, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland (e-mail: kimmo.herttua{at}helsinki.fi).
Received for publication October 1, 2007. Accepted for publication February 25, 2008.
The authors examined the effect of a large reduction in the price of alcohol in Finland in 2004 on alcohol-related mortality by age and socioeconomic group. For this register-based study of Finns aged 
15 years, data on independent variables were extracted from the employment statistics of Statistics Finland. Mortality follow-up was carried out for 2001–2003 (before the price reduction) and 2004–2005 (after). Alcohol-related causes were defined using both underlying and contributory causes of death. Alcohol-related mortality increased by 16% among men and by 31% among women; 82% of the increase was due to chronic causes, particularly liver diseases. The increase in absolute terms was largest among men aged 55–59 years and women aged 50–54 years. Among persons aged 30–59 years, it was biggest among the unemployed or early-age pensioners and those with low education, social class, or income. The relative differences in change between the education and social class subgroups were small. The employed and persons aged <35 years did not suffer from increased alcohol-related mortality during the 2 years after the change. These results imply that a large reduction in the price of alcohol led to substantial increases in alcohol-related mortality, particularly among the less privileged, and in chronic diseases associated with heavy drinking.
alcohol drinking; alcohol-related disorders; commerce; economics; education; income; social class; socioeconomic factors
Abbreviations: ICD-10, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision
Editor's note: An invited commentary on this article appears on page 1126.
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