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Li J, Hui X, Lu Z, Ren X, Yan W, Yan P, Yao L, Yang K. PROTOCOL: The association between marital transitions and physical and mental health in late life: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1252. [PMID: 36911347 PMCID: PMC9175064 DOI: 10.1002/cl2.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: What is the association between marital transitions and physical health among people older than 60? What is the association between marital transitions and mental health among people older than 60? What is the role of gender, age, and education on the association between marital transitions and health among people older than 60? What is the influence of geographical region, housing, neighborhood, and social support on the association between marital transitions and health status among people older than 60?
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Affiliation(s)
- Jing Li
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
| | - Xu Hui
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
| | - Zhenxing Lu
- Institute of Medical ResearchNorthwestern Polytechnical UniversityXi'anChina
| | - Xiaocao Ren
- Clinical Medical CollegeLanzhou UniversityLanzhouChina
| | - Wenlong Yan
- Clinical Medical CollegeLanzhou UniversityLanzhouChina
| | - Peijing Yan
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
| | - Liang Yao
- Department of Health Research Methodology, Evidence and ImpactMcMaster UniversityHamiltonCanada
| | - Kehu Yang
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
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Jarroch R, Tajik B, Tuomainen TP, Kauhanen J. Economic Recession and the Long Term Risk of Psychiatric Disorders and Alcohol Related Diseases-A Cohort Study From Eastern Finland. Front Psychiatry 2022; 13:794888. [PMID: 35250662 PMCID: PMC8891480 DOI: 10.3389/fpsyt.2022.794888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long-term development of psychiatric disorders and alcohol-related diseases after economic recessions is insufficiently studied. We investigated the overall impact of the economic recession between 1991 and 1994 in Finland on the long-term incidence of psychiatric and alcohol-related diseases. METHODS A population-based sample of 1,774 women and men aged 53-73 years were examined between 1998 and 2001 from the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Participants completed comprehensive questionnaires on the possible impact of the 1990s recession in Finland on their lives. They were followed-up until 2018. Cox proportional hazards regression was used to estimate hazard ratios (HR) of new incident psychiatric and alcohol-related disorders during the 20-years follow-up after linkage to the National Hospital Registry. Logistic regression was used to estimate odds ratios (OR) of psychiatric disorders at baseline. RESULTS At baseline, 93 participants had psychiatric disorders. During 20-years follow-up, 138 new psychiatric disorders and 45 alcohol-related diseases were developed. The covariate-adjusted risk of psychiatric disorders was over twice higher among men who experienced recession-induced hardships compared to those who did not (HR = 2.20, 95%CI = 1.04-4.70, p = 0.04). The risk of alcohol-related diseases was more than four times higher among men with hardships (HR = 4.44, 95%CI = 1.04-18.90, p = 0.04). No such associations were observed among women. No association was observed between recession-induced hardships and having psychiatric disorders at baseline in both genders (multivariate-adjusted p = 0.63 for women, multivariate-adjusted p = 0.36 for men). CONCLUSION Long-term risk of psychiatric disorders and alcohol-related diseases was increased after the 1990s economic recession in Finland, but only among middle-age and older men.
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Affiliation(s)
- Rand Jarroch
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Behnam Tajik
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Amiri S. Smoking and alcohol use in unemployed populations: a systematic review and meta-analysis. J Addict Dis 2021; 40:254-277. [PMID: 34747337 DOI: 10.1080/10550887.2021.1981124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Unemployment is an economic and social phenomenon that has economic, social, personal, and health consequences. This study aimed to investigate the relationship between unemployment and alcohol use and smoking as a systematic review and meta-analysis. The two databases PubMed and Scopus were selected for the search and using a set of keywords, these two sources of scientific information were searched from 2004 to June 2021 and 1996 until June 2021, respectively. To meta-analyze the relationship between unemployment and smoking and alcohol use, odds ratio and confidence interval were calculated for this relationship. The meta-analysis was performed based on a random-effects. Subgroups were also performed for men and women. Heterogeneity in studies as well as publication bias were also examined. A total of 52 cross-sectional and cohort studies were included in the meta-analysis. In the relationship between unemployment and alcohol use, the odds ratio was 1.25 and the confidence interval was between 1.12 and 1.41. In the relationship between unemployment and smoking, the odds ratio was 1.43 and the confidence interval was between 1.13 and 1.81. According to the results, it can be said that unemployment increases the likelihood of alcohol use and smoking. Therefore, policymakers must pay more attention to the health consequences of economic problems, especially unemployment.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Bellos S, Petrikis P, Malliori M, Mavreas V, Skapinakis P. Prevalence of Alcohol Use Disorders and Their Association with Sociodemographic Determinants and Depression/Anxiety Disorders in a Representative Sample of the Greek General Population. PSYCHIATRY JOURNAL 2020; 2020:4841050. [PMID: 32095485 PMCID: PMC7035575 DOI: 10.1155/2020/4841050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/24/2019] [Accepted: 11/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Country-level epidemiological data about alcohol-related problems is useful for planning prevention and treatment services. Heavy Alcohol Consumption (HAC) and Alcohol Use Disorder (AUD) are two syndromes of alcohol-related problems that have been recognized worldwide. Study of the epidemiological determinants of HAC and AUD in different sociocultural contexts could inform hypotheses about the etiology or the consequences of alcohol-related problems. OBJECTIVES We assessed the prevalence and associations of HAC and AUD with sociodemographic variables adjusting for common mental disorders in a representative sample of the general population of Greece (N = 4894 participants). The period of data collection just preceded the emergence of the financial crisis in Greece. RESULTS The majority of the population did not report HAC, AUD or abstinence from alcohol. HAC was reported by 12.7% (95% CI: 11.8-13.6) of the population while 3.1% (95% CI: 2.7-3.6) met criteria for AUD. Younger age, divorce, lower educational level, living in an urban area, physical health problems, and smoking were associated with a higher prevalence of both conditions. Presence of severe financial difficulties and never married family status were associated with a higher prevalence of HAC but not AUD. HAC was associated with nonspecific psychiatric morbidity while AUD was associated with more specific psychiatric disorders. Conclusion/Importance. Both alcohol-related problems are frequent in the general population and have common and distinct determinants. The comparison between the findings of our study and those of similar studies during or after the period of financial austerity in Greece, would offer the opportunity to assess the possible effects of changes in the economical context in the determinants of alcohol-related problems.
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Affiliation(s)
- Stefanos Bellos
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Petros Petrikis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Meni Malliori
- National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Petros Skapinakis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Ayano G, Yohannis K, Abraha M, Duko B. The epidemiology of alcohol consumption in Ethiopia: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy 2019; 14:26. [PMID: 31186050 PMCID: PMC6558840 DOI: 10.1186/s13011-019-0214-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 05/28/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Globally, excessive alcohol consumption is a major public health problem and is associated with social, mental, physical and legal consequences. However, no systematic review and meta-analysis has been performed to report the consolidated magnitude of alcohol consumption in Ethiopia. METHODS PubMed, EMBASE, and SCOPUS were systematically searched to identify pertinent studies. Subgroup and sensitivity analysis was conducted and Cochran's Q- and the I2 test were used to assess heterogeneity. Publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. RESULTS We included 26 articles with a total of 42,811 participants. The pooled current and lifetime prevalence of alcohol consumption was 23.86% (95%CI; 17.53-31.60) and 44.16% (95%CI; 34.20-54.62), respectively. The pooled prevalence of hazardous alcohol consumption was 8.94% (95%CI; 3.40-21.50). The prevalence of hazardous alcohol consumption was remarkably higher in men (11.58%) than in women (1.21%). The prevalence of current and lifetime alcohol consumptions among university students were 22.08% & 38.88% respectively. The pooled data revealed that male sex was found to be a significant predictor of hazardous alcohol consumption (OR 10.38; 95%CI 3.86 to 27.88) as well as current (OR 2.45; 95%CI 1.78 to 3.38) and lifetime (OR 2.14; 95%CI 1.39 to 3.29) consumption. The magnitude of alcohol consumption among university students was apparently lower than the magnitude in other population of the country. The current study suggested a remarkable recent increment in the magnitude of hazardous alcohol consumption in Ethiopia. CONCLUSION The current study revealed that the prevalence of alcohol consumption in Ethiopia is comparable with the global estimates of alcohol consumption from the World Health Organization (WHO). The prevalence of hazardous alcohol consumption was remarkably higher in men (11.58%) than in women (1.21%). Male sex was found to be a significant predictor of alcohol consumption. The present study also suggested considerable recent increment in the magnitude of hazardous alcohol consumption in Ethiopia.
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Affiliation(s)
- Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, PO BOX: 1971 Addis Ababa, Ethiopia
| | | | - Mebratu Abraha
- Department of Psychiatry, Paulo’s Millennium Medical College, Addis Ababa, Ethiopia
| | - Bereket Duko
- Department of Psychiatry, Hawassa University, Hawassa, Ethiopia
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Gugushvili A, Azarova A, Irdam D, Crenna-Jennings W, Murphy M, McKee M, King L. Correlates of frequent alcohol consumption among middle-aged and older men and women in Russia: A multilevel analysis of the PrivMort retrospective cohort study. Drug Alcohol Depend 2018; 188:39-44. [PMID: 29730584 DOI: 10.1016/j.drugalcdep.2018.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND A large proportion of premature deaths in Russia since the early 1990s, following the transition from communism, have been attributed to hazardous drinking. Little is known about the correlates of alcohol consumption. We present new data on the consumption of alcoholic beverages among middle-aged and older Russians and identify socio-demographic, socio-economic, and life-course correlates of frequent drinking. METHODS Within the framework of the PrivMort project, conducted in 30 industrial towns in the European part of Russia, we acquired information on the frequency of drinking among 22,796 respondents and 57,907 of their surviving and deceased relatives. We fit three-level mixed-effects logistic regression models of frequent drinking in which respondents' relatives, aged 40 and over, are nested in their families and towns. RESULTS Deceased male relatives consumed alcohol significantly more often, while deceased female relatives consumed alcohol significantly less often than the respondents of corresponding gender. In a multivariable analysis, we found that individuals' education, communication with family members, labour market status, history of unemployment, and occupational attainment are all significant correlates of frequent drinking in Russia. These associations are stronger among men rather than among women. CONCLUSION There are significant differences between frequency of drinking among surviving and deceased individuals and frequent drinking is associated with a wide array of individual socio-demographic, socio-economic, and life course factors that can partially explain high alcohol consumption in post-communist Russia.
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Affiliation(s)
- Alexi Gugushvili
- Department of Social Policy and Intervention and Nuffield College, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
| | - Aytalina Azarova
- Department of Sociology, University of Cambridge, 16 Mill Lane, Cambridge, CB2 1SB, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, 16 Mill Lane, Cambridge, CB2 1SB, UK
| | | | - Michael Murphy
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Lawrence King
- University of Massachusetts, 300 Massachusetts Ave, Amherst, MA, 01003, USA
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Axelrad H, Sabbath EL, Hawkins SS. The impact of the 2008 recession on the health of older workers: data from 13 European countries. Eur J Public Health 2017; 27:647-652. [PMID: 28961877 PMCID: PMC6251540 DOI: 10.1093/eurpub/ckx011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Fluctuations in the national economy shape labour market opportunities and outcomes, which in turn influence the health conditions of older workers. This study examined whether overall economic shifts during the 2008 recession was associated with four health indicators among older workers. Method Data came from 4917 respondents (16 090 contacts) aged 50-70 in 13 European countries (Austria, Belgium, Czech Republic, Denmark, France, Germany, Israel, Italy, Netherlands, Poland, Spain, Sweden, Switzerland) participating in the Survey of Health, Ageing and Retirement in Europe. Health and employment assessments from 2004-13 were linked to annual data on fluctuations in Gross Domestic Product (GDP) per capita, life expectancy and unemployment rates for each country. Using fixed effects models, we assessed the recession's implications on four individual health outcomes: body mass index (BMI), drinking alcohol, depression and general health, while isolating cyclical variation within countries and individual changes over time. Results Overall economic shifts had an effect on older workers: decreases in GDP were associated with a decline in average BMI, consumption of alcohol and deterioration in self-rated health; country-level unemployment rate had no effect on health outcomes, while life expectancy at birth was significant but not consistently across models. Being employed or retired were associated with fewer depressive symptoms and better self-rated health. Conclusions Overall economic shifts during recessions affect certain health outcomes of older workers, and better health conditions together with being employed or retired may limit the negative health consequences of a recession.
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Affiliation(s)
- Hila Axelrad
- Center on Aging and Work, Boston College, 140 Commonwealth Avenue Chestnut
Hill, MA 02467, USA
| | - Erika L. Sabbath
- School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
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Alonso I, Vallejo F, Regidor E, Belza MJ, Sordo L, Otero-García L, Barrio G. Changes in directly alcohol-attributable mortality during the great recession by employment status in Spain: a population cohort of 22 million people. J Epidemiol Community Health 2017; 71:736-744. [DOI: 10.1136/jech-2016-208759] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/27/2017] [Accepted: 03/18/2017] [Indexed: 01/16/2023]
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Gough M. A couple-level analysis of participation in physical activity during unemployment. SSM Popul Health 2017; 3:294-304. [PMID: 29349224 PMCID: PMC5769039 DOI: 10.1016/j.ssmph.2017.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 11/20/2022] Open
Abstract
There is a well-documented negative correlation between unemployment and health. Yet, little research has examined how unemployment relates to participation in physical activity, and few researchers have considered how an individual's unemployment may affect the health of their spouse or partner. The purpose of this study is to answer three questions: 1. Is one's own unemployment associated with changes in physical activity participation? 2. Is one's partner's unemployment associated with changes in physical activity participation? 3. Do changes in physical activity behaviors associated with unemployment differ by gender? This study uses nationally representative, longitudinal data on couples in the United States, covering the period 1999–2013. These data, obtained from the Panel Study of Income Dynamics, are used to estimate fixed-effects models of the relationships between one's own, and one's partner's, unemployment and participation in physical activity. I find that for men unemployment is not associated with changes in physical activity time. For women, own unemployment is associated with increases in physical activity, whereas a partner's unemployment is associated with decreases in physical activity. I argue that unemployed women, unlike men, are able to take advantage of the increased availability of time through reduced labor supply to invest in their health during unemployment, which could have positive long-run consequences. Results suggest the importance of studying unemployment and health at the household level and suggest a need for further investigation into gender differences in unemployment and health. Limited research has examined how unemployment affects physical activity. Research examining how unemployment affects one's spouse is also limited. Study uses Panel Study of Income Dynamics data to investigate these issues. Unemployed men do not experience changes in physical activity. Women increase activity during unemployment but do less during partner unemployment.
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Affiliation(s)
- Margaret Gough
- Department of Sociology & Anthropology, University of La Verne, Hoover Building, La Verne, CA, 91750, United States
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de Goeij MCM, van der Wouden B, Bruggink JW, Otten F, Kunst AE. Impact of the post-2008 economic crisis on harmful drinking in the Dutch working-age population. Drug Alcohol Depend 2016; 161:50-8. [PMID: 26919789 DOI: 10.1016/j.drugalcdep.2016.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/12/2016] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Studies on the impact of economic crises on alcohol consumption have yielded ambiguous results. Therefore, we studied changes in trends in harmful drinking among Dutch working-age men and women after the post-2008 economic crisis started. We also assessed whether these trend changes differed across age and socioeconomic groups. METHODS We used repeated cross-sectional data from the Dutch Health Interview Survey conducted by Statistics Netherlands. Representative samples were independently drawn each month (January, 2004-December, 2013). Our working-age study population consisted of 20,140 men and 22,394 women aged 25-64. For men and women, episodic drinking was defined as drinking ≥6 glasses on one day at least once a week. Chronic drinking was defined as consuming ≥14 glasses/week for women and ≥21 for men. Segmented logistic regression was used to model trend changes separately in men and women. RESULTS A downward trend in episodic and chronic drinking before the crisis slowed down after the crisis started. For episodic drinking, we observed a ceasing-of-decline among men aged 35-44/45-54/55-64, compared to a start-of-decline among those aged 25-34 (p-interaction=0.042/0.020/0.047). For chronic drinking, we observed a ceasing-of-decline among women (p=0.023) but not among men in general (p=0.238). Among men, a ceasing-of-decline did occur in those with a high income, but a start-of-decline was found among those with a low income (p-interaction=0.049). CONCLUSION In some subgroups of the Dutch working-age population, the downward trend in episodic and chronic drinking ceased after the crisis started. This suggests that the crisis had an upward effect on harmful drinking, but only in specific populations.
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Affiliation(s)
- Moniek C M de Goeij
- Department of Public Health, Academic Medical Center (AMC)-University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Bregje van der Wouden
- Department of Public Health, Academic Medical Center (AMC)-University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Jan-Willem Bruggink
- Statistics Netherlands, Department of Socio-Economic and Spatial Statistics, P.O. Box 4481, 6401 CZ Heerlen, The Netherlands
| | - Ferdy Otten
- Statistics Netherlands, Department of Socio-Economic and Spatial Statistics, P.O. Box 4481, 6401 CZ Heerlen, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center (AMC)-University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
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McCartney G, Bouttell J, Craig N, Craig P, Graham L, Lakha F, Lewsey J, McAdams R, MacPherson M, Minton J, Parkinson J, Robinson M, Shipton D, Taulbut M, Walsh D, Beeston C. Explaining trends in alcohol-related harms in Scotland, 1991-2011 (I): the role of incomes, effects of socio-economic and political adversity and demographic change. Public Health 2016; 132:13-23. [PMID: 26917268 DOI: 10.1016/j.puhe.2015.12.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/21/2015] [Accepted: 12/25/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This paper tests the extent to which differing trends in income, demographic change and the consequences of an earlier period of social, economic and political change might explain differences in the magnitude and trends in alcohol-related mortality between 1991 and 2011 in Scotland compared to England & Wales (E&W). STUDY DESIGN Comparative time trend analyses and arithmetic modelling. METHODS Three approaches were utilised to compare Scotland with E&W: 1. We modelled the impact of changes in income on alcohol-related deaths between 1991-2001 and 2001-2011 by applying plausible assumptions of the effect size through an arithmetic model. 2. We used contour plots, graphical exploration of age-period-cohort interactions and calculation of Intrinsic Estimator coefficients to investigate the effect of earlier exposure to social, economic and political adversity on alcohol-related mortality. 3. We recalculated the trends in alcohol-related deaths using the white population only to make a crude approximation of the maximal impact of changes in ethnic diversity. RESULTS Real incomes increased during the 1990s but declined from around 2004 in the poorest 30% of the population of Great Britain. The decline in incomes for the poorest decile, the proportion of the population in the most deprived decile, and the inequality in alcohol-related deaths, were all greater in Scotland than in E&W. The model predicted less of the observed rise in Scotland (18% of the rise in men and 29% of the rise in women) than that in E&W (where 60% and 68% of the rise in men and women respectively was explained). One-third of the decline observed in alcohol-related mortality in Scottish men between 2001 and 2011 was predicted by the model, and the model was broadly consistent with the observed trends in E&W and amongst women in Scotland. An age-period interaction in alcohol-related mortality was evident for men and women during the 1990s and 2000s who were aged 40-70 years and who experienced rapidly increasing alcohol-related mortality rates. Ethnicity is unlikely to be important in explaining the trends or differences between Scotland and E&W. CONCLUSIONS The decline in alcohol-related mortality in Scotland since the early 2000s and the differing trend to E&W were partly described by a model predicting the impact of declining incomes. Lagged effects from historical social, economic and political change remain plausible from the available data.
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Affiliation(s)
- G McCartney
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - J Bouttell
- Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - N Craig
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - L Graham
- Public Health and Intelligence, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, UK.
| | - F Lakha
- NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh EH1 3EG, UK.
| | - J Lewsey
- Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - R McAdams
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - M MacPherson
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - J Minton
- Urban Studies, School of Social and Political Sciences, University of Glasgow, 25 Bute Gardens, University of Glasgow, Glasgow, UK.
| | - J Parkinson
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - M Robinson
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - D Shipton
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - M Taulbut
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - D Walsh
- Glasgow Centre for Population Health, Olympia Building, Bridgeton Cross, Glasgow, G40 2QH, UK.
| | - C Beeston
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
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Dom G, Samochowiec J, Evans-Lacko S, Wahlbeck K, Van Hal G, McDaid D. The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010122. [PMID: 26771628 PMCID: PMC4730513 DOI: 10.3390/ijerph13010122] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/29/2015] [Accepted: 01/04/2016] [Indexed: 11/16/2022]
Abstract
Background: From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be identified; Methods: In this review we explore and systematize the available data on the effect of the 2008 economic crisis on patterns of substance use and related disorders, within the E.U. countries; Results: The results show that effects of the recession need to be differentiated. A number of studies point to reductions in population’s overall substance use. In contrast, an increase in harmful use and negative effects is found within specific subgroups within the society. Risk factors include job-loss and long-term unemployment, and pre-existing vulnerabilities. Finally, our findings point to differences between types of substances in their response on economic crisis periods; Conclusions: the effects of the 2008 economic crisis on substance use patterns within countries of the European Union are two-sided. Next to a reduction in a population’s overall substance use, a number of vulnerable subgroups experience serious negative effects. These groups are in need of specific attention and support, given that there is a real risk that they will continue to suffer negative health effects long after the economic downfall has formally been ended.
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Affiliation(s)
- Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University, Antwerp 2640, Belgium.
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin 71-460, Poland.
| | - Sara Evans-Lacko
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, SE5 8AF, UK.
| | | | - Guido Van Hal
- Medical Sociology and Health Policy, Antwerp University, Antwerp 2640, Belgium.
| | - David McDaid
- Personal Social Services Research Unit, London School of Economics and Political Science, London WC2A 2AE, UK.
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de Goeij MCM, Suhrcke M, Toffolutti V, van de Mheen D, Schoenmakers TM, Kunst AE. How economic crises affect alcohol consumption and alcohol-related health problems: a realist systematic review. Soc Sci Med 2015; 131:131-46. [PMID: 25771482 DOI: 10.1016/j.socscimed.2015.02.025] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Economic crises are complex events that affect behavioral patterns (including alcohol consumption) via opposing mechanisms. With this realist systematic review, we aimed to investigate evidence from studies of previous or ongoing crises on which mechanisms (How?) play a role among which individuals (Whom?). Such evidence would help understand and predict the potential impact of economic crises on alcohol consumption. Medical, psychological, social, and economic databases were used to search for peer-reviewed qualitative or quantitative empirical evidence (published January 1, 1990-May 1, 2014) linking economic crises or stressors with alcohol consumption and alcohol-related health problems. We included 35 papers, based on defined selection criteria. From these papers, we extracted evidence on mechanism(s), determinant, outcome, country-level context, and individual context. We found 16 studies that reported evidence completely covering two behavioral mechanisms by which economic crises can influence alcohol consumption and alcohol-related health problems. The first mechanism suggests that psychological distress triggered by unemployment and income reductions can increase drinking problems. The second mechanism suggests that due to tighter budget constraints, less money is spent on alcoholic beverages. Across many countries, the psychological distress mechanism was observed mainly in men. The tighter budget constraints mechanism seems to play a role in all population subgroups across all countries. For the other three mechanisms (i.e., deterioration in the social situation, fear of losing one's job, and increased non-working time), empirical evidence was scarce or absent, or had small to moderate coverage. This was also the case for important influential contextual factors described in our initial theoretical framework. This realist systematic review suggests that among men (but not among women), the net impact of economic crises will be an increase in harmful drinking. Such a different net impact between men and women could potentially contribute to growing gender-related health inequalities during a crisis.
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Affiliation(s)
- Moniek C M de Goeij
- Department of Public Health, Academic Medical Center (AMC) - University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Marc Suhrcke
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom; United Kingdom Clinical Research Collaboration (UKCRC) Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge CB2 0SR, United Kingdom; Centre for Health Economics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Veronica Toffolutti
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom
| | - Dike van de Mheen
- IVO Addiction Research Institute, Heemraadssingel 194, 3021 DM Rotterdam, The Netherlands; Erasmus MC - University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Maastricht University, Department of Health Promotion, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Tim M Schoenmakers
- IVO Addiction Research Institute, Heemraadssingel 194, 3021 DM Rotterdam, The Netherlands; Erasmus MC - University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center (AMC) - University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
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Haw C, Hawton K, Gunnell D, Platt S. Economic recession and suicidal behaviour: Possible mechanisms and ameliorating factors. Int J Soc Psychiatry 2015; 61:73-81. [PMID: 24903684 DOI: 10.1177/0020764014536545] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND A growing body of research evidence from countries around the world indicates that economic recession is associated with increases in suicide, particularly in males of working age. AIMS To explore contributory and ameliorating factors associated with economic recession and suicide and thereby stimulate further research in this area and encourage policy makers to consider how best to reduce the impact of recession on mental health and suicidal behaviour. METHOD We conducted a selective review of the worldwide literature focusing on possible risk factors, mechanisms and preventative strategies for suicidal behaviour linked to economic recession. RESULTS A model of how recession might affect suicide rates is presented. A major and often prolonged effect of recession is on unemployment and job insecurity. Other important effects include those exerted by financial loss, bankruptcy and home repossession. It is proposed these factors may lead directly or indirectly to mental health problems such as depression, anxiety and binge drinking and then to suicidal behaviour. Countries with active labour market programmes and sustained welfare spending during recessions have less marked increases in suicide rates than those that cut spending on welfare and job-search initiatives for the unemployed. Other measures likely to help include targeted interventions for unemployed people, membership of social organisations and responsible media reporting. Good primary care and mental health services are needed to cope with increased demand in times of economic recession but some governments have in fact reduced healthcare spending as an austerity measure. CONCLUSION The research evidence linking recession, unemployment and suicide is substantial, but the evidence for the other mechanisms we have investigated is much more tentative. We describe the limitations of the existing body of research as well as make suggestions for future research into the effects of economic recession on suicidal behaviour.
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Affiliation(s)
- Camilla Haw
- St Andrew's Academic Centre, St Andrew's Healthcare, Northampton, UK School of Health, University of Northampton, Northampton, UK Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Stephen Platt
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Melchior M, Chollet A, Elidemir G, Galéra C, Younès N. Unemployment and substance use in young adults: does educational attainment modify the association? Eur Addict Res 2015; 21:115-23. [PMID: 25472491 DOI: 10.1159/000365887] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 07/12/2014] [Indexed: 11/19/2022]
Abstract
We studied whether patterns of substance use in relation to unemployment vary depending on educational level. Data come from 1,126 community-based young adults in France (18-35 years of age in 2011) and their parents (TEMPO and GAZEL studies). Tobacco use (≥1 cigarette/day, 22.5% prevalence), nicotine dependence (Fagerström test ≥2, 7.1% prevalence), alcohol use (≥2 units/week, 25.3% prevalence), alcohol abuse (WHO AUDIT ≥7 in women and ≥8 in men, 10.8% prevalence), cannabis use (≥1 time, 16.5% prevalence), and cannabis abuse (CAST ≥2, 5.0% prevalence) were assessed by interview. We conducted logistic regression analyses controlled for inverse probability weights of unemployment, calculated based on demographics, negative life events, health, and juvenile and parental characteristics. Compared to participants who were always employed, those who were unemployed and had no higher education were more likely to smoke tobacco (OR: 2.76, 95% CI: 1.86-4.10), to be nicotine dependent (OR: 5.70, 95% CI: 3.03-10.73), to use cannabis (OR: 2.27, 95% CI: 1.42-3.64), and to abuse cannabis (OR: 3.38, 95% CI: 1.63-7.04). Those who were unemployed and had higher education were especially likely to abuse alcohol (OR: 1.89, 95% CI: 1.16-3.09). Increases in unemployment may impact population levels of substance use, particularly in young adults with low educational attainment.
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Pacula RL, Kilmer B, Wagenaar AC, Chaloupka FJ, Caulkins JP. Developing public health regulations for marijuana: lessons from alcohol and tobacco. Am J Public Health 2014; 104:1021-8. [PMID: 24825201 PMCID: PMC4062005 DOI: 10.2105/ajph.2013.301766] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 12/12/2022]
Abstract
Until November 2012, no modern jurisdiction had removed the prohibition on the commercial production, distribution, and sale of marijuana for nonmedical purposes-not even the Netherlands. Government agencies in Colorado and Washington are now charged with granting production and processing licenses and developing regulations for legal marijuana, and other states and countries may follow. Our goal is not to address whether marijuana legalization is a good or bad idea but, rather, to help policymakers understand the decisions they face and some lessons learned from research on public health approaches to regulating alcohol and tobacco over the past century.
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Affiliation(s)
- Rosalie Liccardo Pacula
- At the time this work was conducted, Rosalie Liccardo Pacula and Beau Kilmer were with the Drug Policy Research Center, RAND Corporation, Santa Monica, CA. Alexander C. Wagenaar was with the Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville. Frank J. Chaloupka was with the Institute for Health Research and Policy, University of Illinois, Chicago. Jonathan P. Caulkins was with the Heinz School of Public Policy, Carnegie Mellon University, Pittsburgh, PA
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Nandi A, Charters TJ, Strumpf EC, Heymann J, Harper S. Economic conditions and health behaviours during the ‘Great Recession’. J Epidemiol Community Health 2013; 67:1038-46. [DOI: 10.1136/jech-2012-202260] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Lewis Brown R, Richman JA. Sex differences in mediating and moderating processes linking economic stressors, psychological distress, and drinking. J Stud Alcohol Drugs 2013; 73:811-9. [PMID: 22846245 DOI: 10.15288/jsad.2012.73.811] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Given the recent downturn in the U.S. economy, we considered in this study the processes linking economic stressors, psychological distress, and two alcohol-related outcomes (past-month drinking and problematic drinking). METHOD Data were drawn from a mail survey of a national sample of 663 respondents. Structural equation modeling was used to assess whether psychological distress mediates the associations between economic stressors and the alcohol-related outcomes considered and whether these associations varied by gender. RESULTS Controlling for correlations among the outcomes and the effects of the sociodemographic control variables, psychological distress was found to partly explain the association between economic stressors and problematic drinking. The mediating effects on problematic drinking were significantly greater for men than women. CONCLUSIONS The findings demonstrate the utility of considering interrelationships among alcohol-related outcomes and, in this context, reveal the circumstances in which gender matters most for understanding the associations among economy-related stressors, psychological distress, and drinking.
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Bor J, Basu S, Coutts A, McKee M, Stuckler D. Alcohol use during the great recession of 2008-2009. Alcohol Alcohol 2013; 48:343-8. [PMID: 23360873 DOI: 10.1093/alcalc/agt002] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
AIMS The aim of this study was to assess changes in alcohol use in the USA during the Great Recession. METHODS Drinking participation, drinking frequency, drinking intensity, total alcohol consumption and frequency of binge drinking were assessed in a nationally representative sample of 2,050,431 US women and men aged 18 and older, interviewed between 2006 and 2010. RESULTS The prevalence of any alcohol use significantly declined during the economic recession, from 52.0% in 2006-2007 to 51.6% in 2008-2009 (P < 0.05), corresponding to 880,000 fewer drinkers (95% confidence interval [CI] 140,000 to 1.6 million). There was an increase, however, in the prevalence of frequent binging, from 4.8% in 2006-2007 to 5.1% in 2008-2009 (P < 0.01), corresponding to 770,000 more frequent bingers (95% CI 390,000 to 1.1 million). Non-Black, unmarried men under 30 years, who recently became unemployed, were at highest risk for frequent binging. CONCLUSION During the Great Recession there was an increase in abstention from alcohol and a rise in frequent binging.
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Affiliation(s)
- Jacob Bor
- Department of Global Health and Population, Harvard School of Public Health, 677 Huntington Avenue, Building 1, 11th Floor, Boston, MA 02115, USA.
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Investigating the Time Lag Effect between Economic Recession and Suicide Rates in Agriculture, Fisheries, and Forestry Workers in Korea. Saf Health Work 2012; 3:294-7. [PMID: 23251845 PMCID: PMC3521928 DOI: 10.5491/shaw.2012.3.4.294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 08/27/2012] [Accepted: 08/27/2012] [Indexed: 11/14/2022] Open
Abstract
Previous studies on the vast increase in suicide mortality in Southeast Asia have indicated that suicide rates increase in parallel with a rise in unemployment or during periods of economic recession. This paper examines the effects of economic recession on suicidal rates amongst agriculture, fisheries, and forestry workers in Korea. Monthly time-series gross domestic product (GDP) data were linked with suicidal rates gathered from the cause of death records between1993-2008. Data were analyzed using generalized additive models to analyze trends, while a polynomial lag model was used to assess the unconstrained time lag effects of changes in GDP on suicidal rate. We found that there were significant inverse correlations between changes in GDP and suicide for a time lag of one to four months after the occurrence of economic event. Furthermore, it was evident that the overall relative risks of suicide were high enough to bring about social concern.
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Pitel L, Madarasova Geckova A, Reijneveld SA, van Dijk JP. Socioeconomic gradient shifts in health-related behaviour among Slovak adolescents between 1998 and 2006. Int J Public Health 2012; 58:171-6. [PMID: 22735992 PMCID: PMC3607714 DOI: 10.1007/s00038-012-0382-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 04/25/2012] [Accepted: 06/02/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES We aimed to assess the development of the socioeconomic gradient in health-related behaviour (HRB) among Slovak adolescents between 1998 and 2006. METHODS Data were collected in 1998 (n = 2,616; 14.9 ± 0.6 years) and in 2006 (n = 1,081; 14.3 ± 0.6 years). ORs of socioeconomic differences-as measured by parental education-were calculated for each cohort in smoking, alcohol consumption and physical inactivity, and the interactions of socioeconomic position and the time period on these behaviours were calculated. RESULTS The higher odds of smoking in the low socioeconomic group compared to the high socioeconomic group decreased among boys (interaction OR 0.54), but became evident among girls (interaction OR 1.96). In alcohol consumption, no socioeconomic differences were found among boys, but the higher odds among girls from high socioeconomic position compared with those from low socioeconomic position disappeared in 2006. In physical inactivity, socioeconomic differences increased among boys but not among girls. CONCLUSION During this period, socioeconomic differences in HRB developed in a different way among boys than among girls. Prevalence rates in substance use increased especially among girls from the low socioeconomic group. This group should be particularly targeted by prevention programs.
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Affiliation(s)
- Lukas Pitel
- Institute of Experimental Psychology, Slovak Academy of Sciences, Dubravska cesta 9, Bratislava, 813 64, Slovakia.
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Richman JA, Rospenda KM, Johnson TP, Cho YI, Vijayasira G, Cloninger L, Wolff JM. Drinking in the age of the Great Recession. J Addict Dis 2012; 31:158-72. [PMID: 22540437 DOI: 10.1080/10550887.2012.665692] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The United States has been experiencing the most severe economic crisis since the Great Depression. This article presents the Life Change Consequences of the Great Recession (LCCGR), an instrument depicting work and personal life-related stressors reflecting the enduring effects of the Great Recession. A national sample of 663 respondents completed a mail survey including this instrument and measures of drinking outcomes. Multiple regression analyses addressed the links between the LCCGR and drinking. Economy-related stressors manifested significant effects on both male and female consumptions patterns, but most LCCGR subscales were more clearly related to problematic drinking patterns in men compared with women.
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Affiliation(s)
- Judith A Richman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
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Abstract
OBJECTIVE High rates of alcohol-related harm have been reported in the European Union, including Ireland, for more than 20 years. This article's goal is to contextualise such rates by examining gender-based pathways to alcohol use disorders from the perspective of those self-identifying as in recovery using data collected midway through this 20-year trend. METHODS Sixteen informants (nine men and seven women) were interviewed between 1998 and 1999 in Dublin, Ireland. Using qualitative methods, informants were asked to reflect upon their experiences of problem drinking and recovery. RESULTS Drinking expectancies, pub-based socialising, social anxiety and perceived social expectations to drink were cited as common pathways to problem drinking by informants, highlighting contradictions in drinking practices and the symbolic functions of alcohol. Drinking contexts identified by informants were public pub-based drinking for men and home-based drinking for women. Primary barriers to problem acceptance centered on pub-based socialising norms and gender-based shame. Benefits of support group membership included establishing new social networks and learning alternative ways to cope with negative emotions. CONCLUSION Consideration of drinking expectancies, the social contexts in which problematic drinking occurs, gender ideologies, the cultural meanings of drinking behaviours, and attention to feelings of isolation or loneliness experienced by those exhibiting problematic consumption behaviours might further understandings of potentially harmful drinking, especially in periods of economic uncertainty.
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Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors. Psychopharmacology (Berl) 2011; 218:1-17. [PMID: 21373787 PMCID: PMC3755727 DOI: 10.1007/s00213-011-2236-1] [Citation(s) in RCA: 280] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 02/16/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Exposure to stress is potentially important in the pathway to alcohol use and alcohol use disorders. Stressors occur at multiple time points across the life course, with varying degrees of chronicity and severity. METHOD We review evidence from epidemiologic studies on the relationship between four different stressors (fateful/catastrophic events, child maltreatment, common adult stressful life events in interpersonal, occupational, financial, and legal domains, and minority stress) and alcohol consumption and alcohol use disorders. RESULTS Studies generally demonstrate an increase in alcohol consumption in response to exposure to terrorism or other disasters. Research has demonstrated little increase in incident alcohol use disorders, but individuals with a history of alcohol use disorders are more likely to report drinking to cope with the traumatic event. Childhood maltreatment is a consistent risk factor for early onset of drinking in adolescence and adult alcohol use disorders, and accumulating evidence suggests that specific polymorphisms may interact with child maltreatment to increase risk for alcohol consumption and disorder. Stressful life events such as divorce and job loss increase the risk of alcohol disorders, but epidemiologic consensus on the specificity of these associations across gender has not been reached. Finally, both perceptions of discrimination and objective indicators of discrimination are associated with alcohol use and alcohol use disorders among racial/ethnic and sexual minorities. CONCLUSION Taken together, these literatures demonstrate that exposure to stress is an important component in individual differences in risk for alcohol consumption and alcohol use disorders. However, many areas of this research remain to be studied, including greater attention to the role of various stressors in the course of alcohol use disorders and potential risk moderators when individuals are exposed to stressors.
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Ceccherini-Nelli A, Priebe S. Economic factors and suicide rates: associations over time in four countries. Soc Psychiatry Psychiatr Epidemiol 2011; 46:975-82. [PMID: 20652218 DOI: 10.1007/s00127-010-0275-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Accepted: 07/08/2010] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Suicides account for more than 30,000 deaths per year in the US alone. Suicide rates change over time, and the factors influencing them remain poorly understood. Economic factors, in particular unemployment, have been suggested as a major influence. However, the evidence for this has been inconsistent, which may be partly explained by shortcomings of the statistical methods used. METHODS Time series analytical techniques (unit root and co-integration tests) were applied to test the associations over time between economic factors, i.e. unemployment, real gross domestic product per capita (RGDP) and the consumer price index (CPI) and death rates by suicide as collected by national agencies in the UK (1901-2006), US (1900-1997), France (1970-2004) and Italy (1970-2001). Traditional correlation analyses were used when appropriate. RESULTS Co-integration and correlation tests showed a long-run association between economic factors and suicide rates. Increase/decrease of unemployment predicted an increase/decrease of suicide rates over long historical periods and in different nations. RGDP and the CPI were also linked with suicide rates, but this was not consistently so and the direction of the association varied. CONCLUSIONS Unemployment is a major factor influencing suicide rates over long periods of time and in different national contexts. It needs to be considered as a confounding factor in evaluations of suicide prevention strategies.
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Pacula RL. Substance use and recessions: What can be learned from economic analyses of alcohol? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2011; 22:326-34. [DOI: 10.1016/j.drugpo.2011.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/29/2011] [Accepted: 07/02/2011] [Indexed: 10/17/2022]
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Burazeri G, Kark JD. Prevalence and determinants of binge drinking in middle age in a transitional post-communist country: a population-based study in Tirana, Albania. Alcohol Alcohol 2010; 45:180-7. [PMID: 20061509 DOI: 10.1093/alcalc/agp089] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To assess the prevalence and determinants of binge drinking in the middle-age population of transitional post-communist Albania, for which data were previously unavailable. METHODS A population-based sample aged 35-74 years, interviewed and examined in Tirana in 2003-2006, included 450 men and 235 women for whom data on alcohol intake were collected (65.5% response). Multivariable-adjusted logistic regression was used to assess the association of drinking patterns with sociodemographic, socioeconomic and psychosocial characteristics and coronary risk factors. RESULTS Age-standardized to the 2005 census, 9.2% (95% confidence interval, CI = 6.5-11.9%) and 10.3% (95% CI = 7.4-13.1%) of men reported two to three or more annual episodes of drunkenness and hangovers, respectively. In women, the prevalence of both these markers of binging was 1.4% (95% CI = 0-3.1%). Among men, 8.9% (95% CI = 6.2-11.6%) reported drinking > or =60 g alcohol per session. In multivariable-adjusted models in men, binge drinking was related to low educational level (odds ratio, OR = 1.8, 95% CI = 1.0-3.3), financial loss in the pyramid collapse (OR = 1.6, 95% CI = 1.0-2.5) and religiosity (inversely) in both Muslims and Christians (OR = 0.2, 95% CI = 0.1-0.4). CONCLUSIONS Among men in this transitional Southeast European country, social disadvantage and financial stress appear to promote alcohol abuse (which is rare in women), and traditionalism may be protective.
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Affiliation(s)
- Genc Burazeri
- Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
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Kestilä L, Martelin T, Rahkonen O, Joutsenniemi K, Pirkola S, Poikolainen K, Koskinen S. Childhood and current determinants of heavy drinking in early adulthood. Alcohol Alcohol 2008; 43:460-9. [PMID: 18364362 DOI: 10.1093/alcalc/agn018] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations. METHOD The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >or=280 g/week and for women >or=140 g/week). RESULTS 8% of young adult men and 5% of women were heavy drinkers. In both genders, parental alcohol problems and other childhood adversities, poor own education, and unemployment status increased the risk of heavy drinking. The impact of childhood on heavy drinking was partly independent and partly mediated by adult characteristics, in particular, for both genders, low level of education. CONCLUSIONS Childhood adversities are associated with heavy drinking in early adulthood among both genders. Childhood social circumstances as well as low educational level and unemployment should be taken into account in planning preventive policies to tackle the harms caused by excessive alcohol use at the individual and population level.
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Affiliation(s)
- Laura Kestilä
- Department of Health and Functional Capacity, National Public Health Institute (KTL), Mannerheimintie 166, FI-00300 Helsinki, Finland.
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Tomkins S, Saburova L, Kiryanov N, Andreev E, McKee M, Shkolnikov V, Leon DA. Prevalence and socio-economic distribution of hazardous patterns of alcohol drinking: study of alcohol consumption in men aged 25-54 years in Izhevsk, Russia. Addiction 2007; 102:544-53. [PMID: 17362291 PMCID: PMC1890567 DOI: 10.1111/j.1360-0443.2006.01693.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To estimate the prevalence of hazardous drinking and its socio-economic distribution among Russian men. DESIGN Participants were an age-stratified, population-based random sample of men aged 25-54 years living in Izhevsk, a city in the Urals, Russia. Interviewers administered questionnaires to cohabiting proxy respondents about behavioural indicators of hazardous drinking derived from frequency of hangover, frequency of drinking beverage spirits, episodes in the last year of extended periods of drunkenness during which the participant withdraws from normal life (zapoi), consumption of alcoholic substances not intended to be drunk (surrogates) and socio-economic position. Logistic regression was used to examine associations between socio-economic position and indicators of hazardous drinking in the past year. FINDINGS Of 1750 men, 79% drank spirits and 8% drank surrogates at least sometimes in the past year; 25% drank spirits and 4% drank surrogates at least weekly and 10% had had an episode of zapoi in the past year. After adjustment for other socio-economic factors, education was strongly associated with indicators of hazardous drinking. Men with the lowest level of education compared to the highest level of education had an odds ratio of surrogate drinking of 7.7 (95% CI 3.2-18.5), of zapoi of 5.2 (2.3-11.8) and of frequent hangover of 3.7 (1.8-7.4). These indicators of hazardous drinking were also independently strongly associated with being unemployed (versus employed) and with levels of household wealth/amenities. Associations of all these variables with daily consumption of beverage spirits were weaker. CONCLUSION Using a novel range of indicator variables of hazardous drinking, this paper shows that the prevalence of these behaviours is high among working-age men in this Russian city. Moreover, these hazardous behaviours show very clear socio-economic patterns, with particularly high prevalence among those who have had the least education and are not in employment. In contrast, more conventional measures of heavy drinking, based on frequency of consumption of beverage spirits, are less prevalent and show much weaker associations with socio-economic position.
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Affiliation(s)
- S Tomkins
- London School of Hygiene and Tropical Medicine, London, UK
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Cable N, Sacker A. The role of adolescent social disinhibition expectancies in moderating the relationship between psychological distress and alcohol use and misuse. Addict Behav 2007; 32:282-95. [PMID: 16806722 DOI: 10.1016/j.addbeh.2006.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2006] [Accepted: 04/17/2006] [Indexed: 11/26/2022]
Abstract
We examined the effects of adolescent social disinhibition expectancies and adult psychological distress on alcohol use and misuse in adulthood, using the 1970 British Cohort Study data. Multivariate imputation by chained equations filled in incomplete cases for 7023 men and 6896 women. A propensity to heavy alcohol use and misuse was predicted by social expectations of the releasing effects of alcohol acquired in adolescence (adolescent social disinhibition expectancies). Psychological distress at age 30 increased the likelihood of very heavy alcohol use in men and misuse of alcohol in men and women. An absence of adolescent social disinhibition expectancies protects adults from drinking alcohol. Moreover, among men without these expectancies, psychological distress did not predict heavy alcohol use, whereas this association was present among men with expectations of alcohol. Policies that aim to manage adult alcohol use should be initiated in adolescence. Reduction of psychological distress will prevent both men and women from misusing alcohol.
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Affiliation(s)
- Noriko Cable
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
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Berggren F, Nystedt P. Changes in alcohol consumption: an analysis of self-reported use of alcohol in a Swedish national sample 1988-89 and 1996-97. Scand J Public Health 2006; 34:304-11. [PMID: 16754589 DOI: 10.1080/14034940500342454] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM To analyse factors associated with alcohol consumption, and how these changed over the period 1988-97, a period during which Sweden entered the European Union. METHODS Data were used from two waves (1988-89 and 1996-97) of the representative longitudinal micro-level ULF survey in Sweden to estimate a two-part model of consumption. RESULTS Experiencing financial stress, monthly salary, and not being married were all correlated with alcohol consumption, especially for males in 1988-89. In 1996-97 these correlations were much weaker, revealing a levelling-out trend towards conformity. The pattern was less clear for females. Further, the youngest age group (16-29 years) increased its consumption significantly more than the older age groups. CONCLUSION There were significant changes in alcohol behaviour, especially for males, coinciding with Sweden joining the EU and preceding the very substantial general increase in consumption levels since 1998. This underlying process should be kept in mind when analysing the more recent trends. The results support the contention that alcohol policy should be a combination of measures targeting the whole population (e.g. via public health campaigns) with specific measures directed towards more vulnerable groups (e.g. young people).
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Affiliation(s)
- Fredrik Berggren
- Department of Community Medicine, Malmö University Hospital, Lund University, Sweden
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Khang YH, Lynch JW, Kaplan GA. Impact of economic crisis on cause-specific mortality in South Korea. Int J Epidemiol 2006; 34:1291-301. [PMID: 16338946 DOI: 10.1093/ije/dyi224] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Economic changes can be powerful determinants of health. In the late 1990s, South Korea experienced a steep economic decline. This study examines whether the massive economic changes affected trends in all-cause and cause-specific mortality in South Korea. METHOD Mid-year population estimates of 5 year age groups (denominators) and death certificate data (numerators) from the National Statistical Office of Korea were used to compute cause-specific age-standardized mortality rates before and after the economic crisis. RESULTS All-cause mortality continued to decrease in both sexes and all age groups during the crisis. Cerebrovascular accidents, stomach cancer, and liver disease contributed most to this decline. A remarkable decrease in transport accident mortality rates was also observed. The most salient increase in mortality was suicidal death. Mortality from homicide, pneumonia, and alcohol dependence increased during the economic crisis, but these accounted for a small proportion of total mortality. CONCLUSIONS Short-term mortality effects of the South Korean economic crisis were relatively small. It appears that any short-term effects of the economic decline were overwhelmed by the momentum of large declines in causes of death such as stroke, stomach cancer, and liver disease, which are probably related to exposures with much longer aetiological periods. However, this study focused on rather immediate mortality effects and follow-up studies are needed to elucidate any longer-term health effects of the South Korean economic crisis.
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Affiliation(s)
- Young-Ho Khang
- Department of Preventive Medicine, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea.
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Eng PM, Kawachi I, Fitzmaurice G, Rimm EB. Effects of marital transitions on changes in dietary and other health behaviours in US male health professionals. J Epidemiol Community Health 2005; 59:56-62. [PMID: 15598728 PMCID: PMC1763358 DOI: 10.1136/jech.2004.020073] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVE To examine the effect of change in marital status on health behaviours among men. DESIGN Longitudinal study of repeated measures of marital status and health behaviours collected at four year intervals (1986-90; 1990-94). SETTING US male health professionals. PARTICIPANTS 38 865 men aged 40-75 in 1986. MAIN RESULTS Relative to men who stayed married over four years, men who became widowed increased their alcohol consumption. Men who become divorced or widowed experienced decreases in body mass index. Compared with men who remained unmarried, men who remarried exhibited increases in body mass index along with decreased physical activity. Becoming divorced or widowed was associated with decreased vegetable intake while remarriage was linked to greater consumption. CONCLUSIONS Marital termination may adversely affect health and dietary behaviours among men.
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Affiliation(s)
- Patricia Mona Eng
- Department of Epidemiology, Harvard School of Public Health, MA, USA.
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Sulander T, Helakorpi S, Rahkonen O, Nissinen A, Uutela A. Smoking and alcohol consumption among the elderly: trends and associations, 1985-2001. Prev Med 2004; 39:413-8. [PMID: 15226054 DOI: 10.1016/j.ypmed.2004.02.049] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite their clear association with health, smoking and alcohol consumption among elderly people have not been extensively researched. This study examined changes in smoking and alcohol consumption and their sociodemographic patterning among the Finnish population aged 65-79 years over the period 1985-2001. METHODS Population-based monitoring surveys conducted biennially from 1985 to 2001 were pooled into three time periods. Trends in smoking and alcohol consumption and their sociodemographic variations among 5870 men and 5923 women were calculated. Logistic regression was used as the main method of analysis. RESULTS Smoking declined slightly among men, and consumption of higher levels of alcohol rose in both genders from the mid-1980s to the early 2000s. Smoking among women remained at a very low level throughout the study period. Smoking and higher level of alcohol consumption were more prevalent among the younger elderly and among the men than among their counterparts. Higher alcohol use was more common among retired office workers than other former employees. Smoking was clearly more prevalent among unmarried than married people. CONCLUSIONS Declining numbers of male smokers and remarkably few female smokers, together with positive changes already noted in diet and functional ability, suggest healthier senior years ahead. On the other hand, the rising trend of alcohol use poses a challenge to future public health.
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Affiliation(s)
- Tommi Sulander
- Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
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Khan S, Murray RP, Barnes GE. A structural equation model of the effect of poverty and unemployment on alcohol abuse. Addict Behav 2002; 27:405-23. [PMID: 12118628 DOI: 10.1016/s0306-4603(01)00181-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The short- and long-term effects of poverty and unemployment on alcohol abuse are investigated using structural equation modelling (SEM) to better understand the observed conflicting relationships among them. We studied 795 community residents who provided complete data in both 1989 and 1991 in the Winnipeg Health and Drinking Survey (WHDS), with equal representation of males and females. Results indicate that (a) increased poverty causes increased alcohol use and alcohol problems, and (b) recent unemployment decreases alcohol use while longer unemployment increases it. It is concluded that the effect of unemployment on alcohol abuse changes direction with time and, thus, both cross-sectional and longitudinal data are required to assess any meaningful relationship between them.
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Affiliation(s)
- Shaila Khan
- Department of Psychology, Tougaloo College, MS 39174, USA.
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Burnley IH, Rintoul D. Inequalities in the transition of cerebrovascular disease mortality in New South Wales, Australia 1969-1996. Soc Sci Med 2002; 54:545-59. [PMID: 11848274 DOI: 10.1016/s0277-9536(01)00050-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
With reference to epidemiological transition theory, this paper examines change in cerebrovascular disease mortality in Australia's most populous state in the 28 year period, 1969-1996. The hypotheses were that in the context of overall stroke mortality decline over the period, marital status, occupational status and spatial differences decreased. However, while overall mortality declined, differentials increased. The reasons for this are considered, with particular implications for epidemiological transition theory and for the targeting of populations at risk in policy terms.
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Affiliation(s)
- Ian H Burnley
- University of New South Wales, School of Geography, Sydney, Australia
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