Trends in alcohol-related mortality in Sweden 1969-2002: an age-period-cohort analysis.
ABSTRACT To study the effects of age, period and cohorts on alcohol-related mortality trends in Sweden.
The study comprises an age-period-cohort analysis.
The analysis was based on all deaths in the Swedish population between 1969 and 2002.
Data on alcohol-related deaths in Sweden from 1969 to 2002 excluding accidental injury and homicide were used. The analysis covered 43 021 deaths.
Time period and birth cohort both influenced alcohol-related mortality. Male cohorts born in the 1930-40s exhibited the highest alcohol-related mortality, while for females those born in the 1940-50s had the highest alcohol-related mortality. For both men and women, those born in the 1960-70s had the lowest age-adjusted alcohol-related mortality. High-risk cohorts were young or in early adulthood during the periods that alcohol became more available in Sweden. The low-risk cohorts of the 1960-70s were brought up during a period when society was concerned with increasing alcohol problems and more emphasis was placed on issuing alcohol awareness information in schools.
Cohort effects were found suggesting that the link between alcohol consumption and non-accident alcohol-related mortality at the population level is dependent on other factors that may change over time. One such factor may be that restrictive alcohol policies have a greater effect on drinking in those who are younger at the time they are put into effect.
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ABSTRACT: Since the mid 1970s, a striking reduction in alcohol-related problems has been observed in many Western countries. Liver cirrhosis mortality is considered to be a major indicator of alcohol-related problems in the general population. The aim of the present study is to describe liver cirrhosis mortality trends in European countries between 1970 and 1989. This is a descriptive study on liver cirrhosis mortality in 25 European countries, and in four grouped European regions. A Poisson log-linear age-period-cohort model is used to clarify whether the recent trend in mortality represents a short-term fluctuation or an emerging long-term trend. In addition, a descriptive comparison between trends in per capital alcohol consumption and liver cirrhosis mortality is conducted. In the whole European population and in that of Western and Southern Europe increasing period effects were observed until the second half of the 1970s followed by a decline in the next periods. In Eastern Europe the decline in period effects started in the first half of the 1980s, whereas in Northern Europe an increasing period effect was observed until the second half of the 1970s, followed by a stabilization. Similar trends were observed for per capita alcohol consumption. The age effect analysis showed a continuously rising effect in Eastern Europe, whereas an attenuation of the effect at around age 65 years was observed in Western Europe. Intermediate patterns were observed in Southern and Northern Europe. The birth cohort effect suggested that in the Western and Southern populations mortality could continue to decrease over the next decade, while in Eastern and Northern mortality is still rising and this will probably continue for the next decade. The age-period-cohort analysis allows targeting of health care and prevention programmes based on future trends. Aetiological and prognostic factors act differently in Europe. A better understanding of the trends would require more detailed information on alcoholism treatment rates, alcohol habits, viral hepatitic infections and other factors involved in the aetiopathogenesis of the disease.International Journal of Epidemiology 03/1997; 26(1):100-9. · 6.98 Impact Factor
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ABSTRACT: The relationship between self-reported frequency of drunkenness at 14-16 years of age and registered alcohol abuse at age 15-25 was studied in a large and representative group of Swedish men. The results showed that the proportion of boys who had experienced drunkenness more than 10 times increased rapidly between ages 14-16. Before the age of 25, 17% of the boys were registered in governmental records (police, social authorities or psychiatric services) because of alcohol abuse. A high frequency of self-reported drunkenness at age 14-16 was found to be significantly related to registered alcohol abuse at age 18-24. At the same time, however, it was found that 70-80% of the adolescent boys with the greatest frequency of drunkenness were not registered for alcohol abuse in early adult years. Using self-reported frequency of drunkenness at age 14-16 as a basis for predicting registered alcohol abuse at age 18-24 allowed correct classification of only 6% more boys than would have been expected by using a random procedure. The present study indicated that initial drinking habits per se are of limited importance in the development of alcohol abuse in early adulthood. However, the results showed that the combination of high self-reported frequency of drunkenness and appearance in government registers as early as age 15-17 constitutes a serious indication of continuing alcohol abuse.Journal of studies on alcohol 06/1988; 49(3):245-52.
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ABSTRACT: To estimate the separate influences of age, period and cohort on the consumption of beer wine and spirits in the United States. Linear age-period-cohort models controlling for demographic change with extensive specification testing. Setting US general population 1979-2000. Monthly average of past-year consumption of beer, wine and spirits in five National Alcohol Surveys. Findings The strongest cohort effects are found for spirits; cohorts born before 1940 are found to have significantly higher consumption than those born after 1946, with especially high spirits consumption for men in the pre-1930s cohorts. Significant cohort effects are also found for beer with elevated consumption in the 1946-65 cohorts for men but in the pre-1940 cohorts for women. Significant negative effects of age are found for beer and spirits consumption, although not for wine. Significant period effects are found for men's beer and wine consumption and for women's spirits consumption. Increased educational attainment in the population over time is associated with reduced beer consumption and increased wine consumption. Changing cohort demographics are found to have significant effects on beverage-specific consumption, indicating the importance of controlling for these effects in the evaluation of alcohol policy effectiveness and the potential for substantial improvement in the forecasting of future beverage-specific consumption trends, alcohol dependence treatment demand and morbidity and mortality outcomes.Addiction 10/2004; 99(9):1111-20. · 4.58 Impact Factor