Health inequality in many European countries may owe much to alcohol-related conditions, researchers have reported.
Dr Johan Mackenbach at Erasmus University Medical Centre, Rotterdam, The Netherlands, and colleagues say: "Socioeconomic inequalities in alcohol-related mortality have been documented in several European countries, but it is unknown whether the magnitude of these inequalities differs between countries and whether these inequalities increase or decrease over time."
In the journal PLoS Medicine yesterday (1 December), they report on their study of deaths from alcoholic psychosis, dependence, and abuse; alcoholic cardiomyopathy; alcoholic liver cirrhosis; and accidental alcohol poisoning from the mortality registers of 17 European countries.
This showed that "rates of alcohol-related mortality are higher in lower educational and occupational groups in all countries". Both relative and absolute inequalities are largest in Eastern Europe, and Finland and Denmark also have very large absolute inequalities in alcohol-related mortality, they found.
"Over time, the relative inequality in alcohol-related mortality has increased in many countries, but the main change is a strong rise of absolute inequality in several countries in Eastern Europe (Hungary, Lithuania, Estonia) and Northern Europe (Finland, Denmark) because of a rapid rise in alcohol-related mortality in lower socioeconomic groups," the authors write.
"In some of these countries, alcohol-related causes now account for 10% or more of the socioeconomic inequality in total mortality."
They also say that, because the study relies on routinely collected information on underlying causes of death, "it is likely that our results underestimate the true extent of the problem".
Policy-makers in these countries would benefit from further research into why such increases have not occurred in countries like France, Switzerland, Spain, and Italy, they suggest.
Mackenbach, J. P. et al. Inequalities in Alcohol-Related Mortality in 17 European Countries: A Retrospective Analysis of Mortality Registers. PLoS Medicine 1 December 2015 doi:10.1371/journal.pmed.1001909
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