Ignacio Alonso1, Fernando Vallejo2,3, Enrique Regidor3,4, M José Belza1,3, Luis Sordo2,3,4, Laura Otero-García3,5, Gregorio Barrio1. 1. National School of Public Health, Carlos III Health Institute, Madrid, Spain. 2. National Epidemiology Center, Carlos III Health Institute, Madrid, Spain. 3. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. 4. Department of Preventive Medicine and Public Health, Madrid Complutense University, Madrid, Spain. 5. Departmental Nursing Section, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.
Abstract
BACKGROUND: Macroeconomic fluctuations can impact differentially on alcohol-related problems across sociodemographic groups. We assess trend changes in directly alcohol-attributable (DAA) mortality in the population aged 25-64 during the post-2008 recession in Spain according to employment status and other sociodemographic factors. METHODS: Nationwide cohort study covering 21.9 million people living in Spain in 2001. People were classified by employment status and other factors. The annual percentage change (APC) in mortality rates during 2002-2007 (precrisis) and 2008-2011 (crisis) was estimated by the Poisson regression. The period effect size was then calculated as the difference between crisis and precrisis APCs. RESULTS: The age-adjusted APCs in DAA mortality were 6.9% in 2002-2007 and 3.7% in 2008-2011 among employed people, and -4.3% and -0.4%, respectively, among non-employed people. Statistically significant trend changes in such mortality during the crisis were found, which were favourable in certain employed subgroups (manual workers and employees aged 25-49), and unfavourable in the total non-employed population and certain non-employed subgroups (men, non-married and especially medium/high-wealth people). The greatest unfavourable change corresponded to non-employed people living in households of 72-104 m2 who had 2 or more cars. Favourable changes were also found in the remaining employed subgroups, especially women and non-married people, although they did not reach statistical significance. CONCLUSIONS: Our findings suggest that the post-2008 Spanish crisis had a heterogeneous impact across sociodemographic subgroups on DAA mortality, and that employment status seemed to have an important effect. The impact was especially unfavourable on the non-employed, particularly those with substantial material wealth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: Macroeconomic fluctuations can impact differentially on alcohol-related problems across sociodemographic groups. We assess trend changes in directly alcohol-attributable (DAA) mortality in the population aged 25-64 during the post-2008 recession in Spain according to employment status and other sociodemographic factors. METHODS: Nationwide cohort study covering 21.9 million people living in Spain in 2001. People were classified by employment status and other factors. The annual percentage change (APC) in mortality rates during 2002-2007 (precrisis) and 2008-2011 (crisis) was estimated by the Poisson regression. The period effect size was then calculated as the difference between crisis and precrisis APCs. RESULTS: The age-adjusted APCs in DAA mortality were 6.9% in 2002-2007 and 3.7% in 2008-2011 among employed people, and -4.3% and -0.4%, respectively, among non-employed people. Statistically significant trend changes in such mortality during the crisis were found, which were favourable in certain employed subgroups (manual workers and employees aged 25-49), and unfavourable in the total non-employed population and certain non-employed subgroups (men, non-married and especially medium/high-wealth people). The greatest unfavourable change corresponded to non-employed people living in households of 72-104 m2 who had 2 or more cars. Favourable changes were also found in the remaining employed subgroups, especially women and non-married people, although they did not reach statistical significance. CONCLUSIONS: Our findings suggest that the post-2008 Spanish crisis had a heterogeneous impact across sociodemographic subgroups on DAA mortality, and that employment status seemed to have an important effect. The impact was especially unfavourable on the non-employed, particularly those with substantial material wealth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Marc Saez; Maria Antònia Barceló; Carme Saurina; Andrés Cabrera; Antonio Daponte Journal: Int J Environ Res Public Health Date: 2019-07-11 Impact factor: 3.390