Alcohol-related morbidity and mortality within siblings

作者：Sondergaard Grethe; Osler Merete; Andersen Anne Marie Nybo; Andersen Per Kragh; Dalton Susanne Ok**jerg; Mortensen Laust H^*

来源：Addiction, 2015, 110(3): 451-460.

DOI：10.1111/add.12823

• Alcohol
• education
• family
• hospitalization
• morbidity
• mortality
• siblings
• social inequality in health

AimsTo estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals.
DesignCohort study.
SettingDenmark.
ParticipantsApproximately 1.4 million full siblings born in Denmark between 1950 and 1979 were followed from age 28-58years or censoring due to alcohol-related hospitalization and mortality.
MeasurementsCox regression analyses were used to estimate associations of educational status with alcohol-related outcomes. Results from cohort analyses based on non-related individuals and inter-sibling analyses were compared.
FindingsA lower educational status was associated with a higher rate of alcohol-related outcomes, especially among the youngest (aged 28-37 years) and individuals born 1970-79. Compared with the cohort analyses, the associations attenuated slightly in the inter-sibling analysis. For example, in the cohort analysis, females with a basic school education born 1970-79 had an increased rate of alcohol-related non-somatic morbidity and mortality [hazard rate ratio (HR)=4.05, 95% confidence interval (CI)=3.27-5.02] compared to those with a vocational education. In the inter-sibling analysis, the HR attenuated (HR=2.66, 95% CI=1.95-3.63). For alcohol-related somatic outcomes the corresponding figures were HR=3.47 (95% CI=2.63-4.58) and HR=3.36 (95% CI=2.10-5.38), respectively. In general, the associations were stronger among females than males (aged 28-37) in the analyses of alcohol-related non-somatic outcomes. Health conditions earlier in life explained only a minor part of the associations.
ConclusionsThe association between educational status and alcohol-related somatic and non-somatic morbidity and mortality is only driven by familial factors to a small degree.

• 出版日期2015-3