The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
Abstract Background Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the a...
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| Format: | Article |
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BMC
2021-11-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-021-02132-z |
| _version_ | 1818724268715802624 |
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| author | Charlotte Probst Shannon Lange Carolin Kilian Celine Saul Jürgen Rehm |
| author_facet | Charlotte Probst Shannon Lange Carolin Kilian Celine Saul Jürgen Rehm |
| author_sort | Charlotte Probst |
| collection | DOAJ |
| description | Abstract Background Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. Methods We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). Results We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70–2.59], 50th: 3.43 [2.67–4.49], 75th: 4.43 [3.62–5.50], 100th: 4.50 [3.26–6.40]; men: 25th: 2.34 [1.98–2.76], 50th: 4.22 [3.38–5.24], 75th: 5.87 [4.75–7.10], 100th: 6.28 [4.89–8.07]. Conclusions The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives. |
| first_indexed | 2024-12-17T21:23:43Z |
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| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-17T21:23:43Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-78fefa8518ef4d388e8524c729cbd11a2022-12-21T21:32:05ZengBMCBMC Medicine1741-70152021-11-0119111310.1186/s12916-021-02132-zThe dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysisCharlotte Probst0Shannon Lange1Carolin Kilian2Celine Saul3Jürgen Rehm4Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)Institute of Clinical Psychology and Psychotherapy, Technische Universität DresdenHeidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg UniversityInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)Abstract Background Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. Methods We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). Results We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70–2.59], 50th: 3.43 [2.67–4.49], 75th: 4.43 [3.62–5.50], 100th: 4.50 [3.26–6.40]; men: 25th: 2.34 [1.98–2.76], 50th: 4.22 [3.38–5.24], 75th: 5.87 [4.75–7.10], 100th: 6.28 [4.89–8.07]. Conclusions The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.https://doi.org/10.1186/s12916-021-02132-zSocioeconomic statusInequalityDose-responseSocioeconomic deprivationAlcohol useMortality |
| spellingShingle | Charlotte Probst Shannon Lange Carolin Kilian Celine Saul Jürgen Rehm The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis BMC Medicine Socioeconomic status Inequality Dose-response Socioeconomic deprivation Alcohol use Mortality |
| title | The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis |
| title_full | The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis |
| title_fullStr | The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis |
| title_full_unstemmed | The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis |
| title_short | The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis |
| title_sort | dose response relationship between socioeconomic deprivation and alcohol attributable mortality risk a systematic review and meta analysis |
| topic | Socioeconomic status Inequality Dose-response Socioeconomic deprivation Alcohol use Mortality |
| url | https://doi.org/10.1186/s12916-021-02132-z |
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