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PLoS One. 2018 Mar 22;13(3):e0194478. doi: 10.1371/journal.pone.0194478. eCollection 2018.

Comparison of different approaches for estimating age-specific alcohol-attributable mortality: The cases of France and Finland.

Author information

1
Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands.
2
Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
3
Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden.
4
Max Planck Institute for Demographic Research, Rostock, Germany.
5
Alcohol, Drugs and Addictions Unit, National Institute for Health and Welfare, Helsinki, Finland.
6
Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands.

Abstract

BACKGROUND:

Accurate estimates of the impact of alcohol on overall and age-specific mortality are crucial for formulating health policies. However, different approaches to estimating alcohol-attributable mortality provide different results, and a detailed comparison of age-specific estimates is missing.

METHODS:

Using data on cause of death, alcohol consumption, and relative risks of mortality at different consumption levels, we compare eight estimates of sex- and age-specific alcohol-attributable mortality in France (2010) and Finland (2013): five estimates using cause-of-death approaches (with one accounting for contributory causes), and three estimates using attributable fraction (AF) approaches.

RESULTS:

AF-related approaches and the approach based on alcohol-related underlying and contributory causes of death provided estimates of alcohol-attributable mortality that were twice as high as the estimates found using underlying cause-of-death approaches in both countries and sexes. The differences across the methods were greatest among older age groups An inverse U-shape in age-specific alcohol-attributable mortality (peaking at around age 65) was observed for cause-of-death approaches, with this shape being more pronounced in Finland. AF-related approaches resulted in different estimates at older ages: i.e., mortality was found to increase with age in France; whereas in Finland mortality estimates depended on the underlying assumptions regarding the effects of alcohol consumption on cardiovascular mortality.

CONCLUSIONS:

While the most detailed approaches (i.e., the AF-related approach and the approach that includes underlying and contributory causes) are theoretically able to provide more accurate estimates of alcohol-attributable mortality, they-especially the AF approaches- depend heavily on data availability and quality. To enhance the reliability of alcohol-attributable mortality estimates, data quality for older age groups needs to be improved.

PMID:
29566081
PMCID:
PMC5864025
DOI:
10.1371/journal.pone.0194478
[Indexed for MEDLINE]
Free PMC Article

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