The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis
Abstract Background Taxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis. Methods Census-linked mortality data between 2011 and 2019 were used to calcu...
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| Format: | Article |
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BMC
2023-01-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-022-02721-6 |
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| author | Jakob Manthey Domantas Jasilionis Huan Jiang Olga Meščeriakova Janina Petkevičienė Ričardas Radišauskas Mindaugas Štelemėkas Jürgen Rehm |
| author_facet | Jakob Manthey Domantas Jasilionis Huan Jiang Olga Meščeriakova Janina Petkevičienė Ričardas Radišauskas Mindaugas Štelemėkas Jürgen Rehm |
| author_sort | Jakob Manthey |
| collection | DOAJ |
| description | Abstract Background Taxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis. Methods Census-linked mortality data between 2011 and 2019 were used to calculate monthly sex- and education-stratified age-standardized mortality rates for the population aged 40 to 70 years. As primary outcome, we analysed the difference in age-standardized all-cause mortality rates between the population of lowest versus highest educational achievement. The impact of the 2017 taxation increase was evaluated using interrupted time series analyses. To identify whether changes in alcohol use can explain the observed effects on all-cause mortality, the education-based mortality differences were then decomposed into n = 16 cause-of-death groupings. Results Between 2012 and 2019, education-based all-cause mortality inequalities in Lithuania declined by 18% among men and by 14% among women. Following the alcohol taxation increase, we found a pronounced yet temporary reduction of mortality inequalities among Lithuanian men (− 13%). Subsequent decomposition analyses suggest that the reduction in mortality inequalities between lower and higher educated men was mainly driven by narrowing mortality differences in injuries and infectious diseases. Conclusions A marked increase in alcohol excise taxation was associated with a decrease in mortality inequalities among Lithuanian men. More pronounced reductions in deaths from injuries and infectious diseases among lower as compared to higher educated groups could be the result of differential changes in alcohol use in these populations. |
| first_indexed | 2024-04-10T21:01:53Z |
| format | Article |
| id | doaj.art-33eda5ba092d4300bab5de7044734678 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-10T21:01:53Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-33eda5ba092d4300bab5de70447346782023-01-22T12:16:12ZengBMCBMC Medicine1741-70152023-01-0121111010.1186/s12916-022-02721-6The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysisJakob Manthey0Domantas Jasilionis1Huan Jiang2Olga Meščeriakova3Janina Petkevičienė4Ričardas Radišauskas5Mindaugas Štelemėkas6Jürgen Rehm7Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE)Laboratory of Demographic Data, Max Planck Institute for Demographic ResearchInstitute for Mental Health Policy Research, Centre for Addiction and Mental HealthDepartment of Health Management, Faculty of Public Health, Lithuanian University of Health SciencesHealth Research Institute, Faculty of Public Health, Lithuanian University of Health SciencesDepartment of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health SciencesHealth Research Institute, Faculty of Public Health, Lithuanian University of Health SciencesCenter for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE)Abstract Background Taxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis. Methods Census-linked mortality data between 2011 and 2019 were used to calculate monthly sex- and education-stratified age-standardized mortality rates for the population aged 40 to 70 years. As primary outcome, we analysed the difference in age-standardized all-cause mortality rates between the population of lowest versus highest educational achievement. The impact of the 2017 taxation increase was evaluated using interrupted time series analyses. To identify whether changes in alcohol use can explain the observed effects on all-cause mortality, the education-based mortality differences were then decomposed into n = 16 cause-of-death groupings. Results Between 2012 and 2019, education-based all-cause mortality inequalities in Lithuania declined by 18% among men and by 14% among women. Following the alcohol taxation increase, we found a pronounced yet temporary reduction of mortality inequalities among Lithuanian men (− 13%). Subsequent decomposition analyses suggest that the reduction in mortality inequalities between lower and higher educated men was mainly driven by narrowing mortality differences in injuries and infectious diseases. Conclusions A marked increase in alcohol excise taxation was associated with a decrease in mortality inequalities among Lithuanian men. More pronounced reductions in deaths from injuries and infectious diseases among lower as compared to higher educated groups could be the result of differential changes in alcohol use in these populations.https://doi.org/10.1186/s12916-022-02721-6Mortality inequalityHealth inequalityAlcohol control policyAlcohol taxationLithuania |
| spellingShingle | Jakob Manthey Domantas Jasilionis Huan Jiang Olga Meščeriakova Janina Petkevičienė Ričardas Radišauskas Mindaugas Štelemėkas Jürgen Rehm The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis BMC Medicine Mortality inequality Health inequality Alcohol control policy Alcohol taxation Lithuania |
| title | The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis |
| title_full | The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis |
| title_fullStr | The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis |
| title_full_unstemmed | The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis |
| title_short | The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis |
| title_sort | impact of alcohol taxation increase on all cause mortality inequalities in lithuania an interrupted time series analysis |
| topic | Mortality inequality Health inequality Alcohol control policy Alcohol taxation Lithuania |
| url | https://doi.org/10.1186/s12916-022-02721-6 |
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