| 1. |
- Raninen, Jonas, et al.
(författare)
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To drink or not to drink : A study of the association between rates of non-drinkers and per drinker mean alcohol consumption in the Swedish general population
- 2022
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Ingår i: Drug and Alcohol Review. - : John Wiley & Sons. - 0959-5236 .- 1465-3362. ; 41:6, s. 1475-1483
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Understanding how the mean consumption per drinker and rates of non-drinking interplay to form overall per capita alcohol consumption is imperative for our understanding of population drinking. The aim of the present study is to examine the association between rates of non-drinkers and per drinker mean alcohol consumption in the Swedish adult population and for different percentiles of drinkers.METHODS: Data came from a monthly telephone survey of drinking habits in the Swedish adult population between 2002 and 2013. Alcohol consumption and non-drinking during the last 30 days were measured by beverage-specific quantity-frequency questions. Regression models estimated the association between the rate of non-drinkers and per drinker volume on annual data. Auto-regressive integrated moving average time-series models estimated the association on monthly data.RESULTS: A significant (P < 0.01) negative association (-0.849) was found between the rate of non-drinkers and per drinker mean volume on annual data. A unit increase in non-drinking was associated with a decline of 0.85 cl of pure alcohol among drinkers. This finding was mirrored across all percentiles of consumption. The semi-log models found that a 1% unit increase in the rate of non-drinkers was followed by a 2% reduction in per drinker mean consumption. Auto-regressive integrated moving average time-series models verified these results.DISCUSSION AND CONCLUSIONS: There is a significant association between the proportion of non-drinkers and the amount of drinking among drinkers. The theory of collectivity of drinking cultures should also include the non-drinking part of the population.
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| 2. |
- Berg, Lisa, 1980-, et al.
(författare)
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Using repeated measures to study the contribution of alcohol consumption and smoking to the social gradient in all‐cause mortality : Results from the Stockholm Public Health Cohort
- 2023
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Ingår i: Drug and Alcohol Review. - 0959-5236 .- 1465-3362. ; 42:7, s. 1850-1859
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The social gradient in consumption behaviours has been suggestedto partly explain health inequalities. The majority of previous studies have onlyincluded baseline measurements and not considered potential changes in behav-iours over time. The study aimed to investigate the contribution of alcohol con-sumption and smoking to the social gradient in mortality and to assess whetherthe use of repeated measurements results in larger attenuations of the main asso-ciation compared to using single baseline assessments.Methods: Longitudinal survey data from the population-based Stockholm PublicHealth Cohort from 2006 to 2014 was linked to register data on mortality until2018 for 13,688 individuals and analysed through Cox regression.Results: Low socioeconomic position (SEP) was associated with increased mortal-ity compared with high SEP; hazard ratios 1.56 (95% CI 1.30–1.88) for occupa-tional status and 1.77 (95% CI 1.49–2.11) for education, after adjustment fordemographic characteristics. Using repeated measurements, alcohol consumptionand smoking explained 44% of the association between occupational status andall-cause mortality. Comparing repeated and baseline measures, the percentageattenuation due to alcohol consumption increased from 11% to 18%, whereas itremained similar for smoking (25–23%).Discussion and Conclusions: Smoking and alcohol consumption explained alarge part of the association between SEP and mortality. Comparing results fromtime-fixed and time-varying models, there was an increase in overall percentageattenuation that was mainly due to the increased proportion explained by alcoholconsumption. Repeated measurements provide a better estimation of the contri-bution of alcohol consumption, but not smoking, for the association between SEPand mortality.
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| 3. |
- Carlsson, Emma, et al.
(författare)
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Do early life factors explain the educational differences in early labour market exit? A register-based cohort study
- 2023
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Ingår i: BMC Public Health. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Socioeconomic inequalities in labour market participation are well established. However, we do not fully know what causes these inequalities. The present study aims to examine to what extent factors in childhood and late adolescence can explain educational differences in early labour market exit among older workers.Methods: All men born in 1951–1953 who underwent conscription examination for the Swedish military in 1969–1973 (n = 145 551) were followed from 50 to 64 years of age regarding early labour market exit (disability pension, long-term sickness absence, long-term unemployment and early old-age retirement with and without income). Early life factors, such as cognitive ability, stress resilience, and parental socioeconomic position, were included. Cox proportional-hazards regressions were used to estimate the association between the level of education and each early labour market exit pathway, including adjustment for early life factors.Results: The lowest educated men had a higher risk of exit through disability pension (HR: 2.72), long-term sickness absence (HR: 2.29), long-term unemployment (HR: 1.45), and early old-age retirement with (HR: 1.29) and without income (HR: 1.55) compared to the highest educated men. Factors from early life explained a large part of the educational differences in disability pension, long-term sickness absence and long-term unemployment but not for early old-age retirement. Important explanatory factors were cognitive ability and stress resilience, whilst cardiorespiratory fitness had negligible impact.Conclusions: The association between education and early exit due to disability pension, long-term sickness absence and long-term unemployment was to a large part explained by factors from early life. However, this was not seen for early old-age retirement. These results indicate the importance of taking a life-course perspective when examining labour market participation in later working life.
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| 4. |
- Landberg, Jonas, 1974-
(författare)
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Alcohol-Related Problems in Eastern Europe : A Comparative Perspective
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis investigates the association between alcohol consumption and alcohol-related harm in Eastern Europe. The main aim was to estimate to what extent changes in per capita alcohol consumption have an impact on different forms of alcohol-related mortality, and to put the results in an international comparative perspective. The thesis includes four papers; the first two papers use aggregate time-series analysis to assess how changes in per capita consumption affect rates in suicide mortality and fatal non-intentional injuries in several Eastern European countries, respectively. The third paper applies the same methodological approach to analyse the population-level relationship between alcohol and homicide in Russia and the U.S.. The fourth paper employs survey data to assess how the risk of experiencing alcohol-related problems in relation to volume of consumption in the Baltic countries compares to Sweden and Italy. The results of the first three papers suggests: (i) that changes in per capita consumption are significantly related to changes in mortality rates of suicide, non-intentional injuries and homicide in the countries under study; (ii) that the relationship is stronger for men than for women, and (iii) that the relationship tends to be stronger in the countries with more detrimental drinking patterns, e.g. Russia. The results of the fourth paper suggest that the risk of experiencing alcohol-related problems in relation to level of drinking in the Baltic countries is similar to the corresponding risk in Sweden, but considerably stronger than in Italy. In conclusion, the findings support the significance of a public health approach to alcohol-related problems in Eastern Europe, i.e., policy measures directed towards total alcohol consumption. In addition, strategies aimed at reducing the occurrence of binge drinking seem to have great potential for reducing alcohol-related harm and mortality in Eastern European countries.
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| 5. |
- Landberg, Jonas, 1974-, et al.
(författare)
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Distribution of sickness absence risk across different levels and patterns of drinking : findings from the Stockholm Public Health Cohort
- 2021
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 38:3, s. 305-318
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study estimated (i) the risk function between different indicators of alcohol use and long-term sickness absence, adjusting for possible confounding factors, (ii) whether the risk function between average volume of consumption and sickness absence is modified by heavy episodic drinking (HED), and (iii) to what extent the risk for sickness absence among abstainers is due to health selection bias. Data and methods: The study was based on data from the Stockholm Public Health Cohort 2006, with an analytical sample of 16,477 respondents aged 18–64 years. The outcome included register-based long-term (> 14 days) sickness absence. Negative binominal regression was used to estimate the association between sickness absence and average weekly volume of consumption, frequency of HED, and both in interaction. Results: Abstainers, chronic heavy drinkers and respondents with the highest frequency of HED had approximately two-fold higher rates of sickness absence relative to the reference groups, i.e., moderate drinkers and those with HED one to 6 times per year. Adjustment for confounding factors did not materially affect the shape of the risk function. After exclusion of abstainers with alcohol-related problems, or poor health, the estimates for abstainers became non-significant. Moderate drinkers with HED did not have significantly higher rates of sickness absence than moderate drinkers without HED. Conclusions: Our results suggest a significant association between alcohol use and sickness absence. There were indications that the U-shaped risk function may largely be due to health selection bias among abstainers. We found no indication of effect modification of HED on moderate drinking.
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| 6. |
- Landberg, Jonas, 1974-, et al.
(författare)
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Is the association between alcohol use and sickness absence modified by socioeconomic position? findings from the Stockholm public health cohort
- 2023
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Ingår i: BMC Public Health. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe distribution of sickness absence tends to be socially patterned less is however known about the underlying mechanisms and pathways of the social gradient found in sickness absence. The present study aims to investigate (i) if the risk function between average volume of alcohol consumption and sickness absence is modified by socio-economic position (SEP), and (ii) whether such an effect modification can be attributed to differences in drinking patterns and other risk factors including other lifestyle behaviours, health status, and working conditions.MethodsThe study was based on data from the Stockholm public health cohort 2006, with an analytical sample of 13 855 respondents aged 18-64 years. Self-reported information on occupational class (a measure of SEP), alcohol consumption, other lifestyle behaviour, health and working conditions was collected from the survey. The outcome of long-term (> 14 days) sickness absence between 2006 and 2008 was obtained from national registers. Negative binomial regression was used to estimate the Incidence Rate Ratios (IRR) with 95% confidence intervals (CI).ResultsIn the initial analyses, heavy drinking manual workers had a 5-fold increased risk of long-term sickness absence compared to non-manual employees who were moderate drinkers, and approximately 60% of the excess risk among heavy drinking manual workers was attributable to an interaction between alcohol use and SEP. Adjusting for working conditions was associated with the largest attenuation of the risk estimate, compared to other lifestyle behaviors and health. In the fully adjusted model, the IRR was further attenuated for the manual workers and the joint effect of SEP and heavy drinking remained in the final model with an attributable proportion of 49%.ConclusionsIndividuals in Sweden with lower levels of SEP appear to be more vulnerable to alcohol consumption in relation to sickness absence, where differences in working conditions explained a large part but not all of the differential vulnerability.
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| 7. |
- Landberg, Jonas, 1974-
(författare)
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Per Capita Alcohol Consumption and Suicide Rates in the U.S., 1950–2002
- 2009
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Ingår i: Journal of Suicide and Life-threatening Behaviour. - : Wiley. - 0363-0234 .- 1943-278X. ; 38:4, s. 452-459
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper was to estimate how suicide rates in the United States are affected by changes in per capita consumption during the postwar period. The analysis included Annual suicide rates and per capita alcohol consumption data (total and beverage specific) for the period 1950–2002. Gender- and age-specific models were estimated using the Box-Jenkins technique for time series analysis. No significant estimate was found for males. For females the total alcohol estimate (0.059) was significant at the 10% level whereas the spirits estimate was significant with an effect of 0.152. The results imply that a change in U.S. per capita consumption would result in a change in female suicide rates, whereas the male rates would not be affected.
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| 8. |
- Landberg, Jonas, 1974-
(författare)
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Population drinking and fatal injuries in Eastern Europe : A time-series analysis of six countries
- 2010
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 16:1, s. 43-52
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To estimate to what extent injury mortality rates in 6 Eastern European countries are affected by changes in population drinking during the post-war period. Data and Methods: The analysis included injury mortality rates and per capita alcohol consumption in Russia, Belarus, Poland, Hungary, Bulgaria and the former Czechoslovakia. Total population and gender-specific models were estimated using auto regressive integrated moving average time-series modelling. Results: The estimates for the total population were generally positive and significant. For Russia and Belarus, a 1-litre increase in per capita consumption was associated with an increase in injury mortality of 7.5 and 5.5 per 100,000 inhabitants, respectively. The estimates for the remaining countries ranged between 1.4 and 2.0. The gender-specific estimates displayed national variations similar to the total population estimates although the estimates for males were higher than for females in all countries. Conclusions: The results suggest that changes in per capita consumption have a significant impact on injury mortality in these countries, but the strength of the association tends to be stronger in countries where intoxication-oriented drinking is more common.
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| 9. |
- Norström, Thor, 1948-, et al.
(författare)
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The association between population drinking and ischemic heart disease mortality in educational groups
- 2023
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Ingår i: Alcohol and Alcoholism. - 0735-0414 .- 1464-3502.
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Tidskriftsartikel (refereegranskat)abstract
- A large number of observational studies have found a J-shaped relationship between alcohol intake and ischemic heart disease (IHD) risk. However, some studies suggest that the alleged cardio-protective effect may be an artifact in the way that the elevated risk for abstainers is due to self-selection on risk factors for IHD. The aim of this paper is to estimate the association between alcohol and IHD-mortality on the basis of aggregate time-series data, where the problem with selection effects is not present. In addition, we will analyze SES-specific mortality to investigate whether there is any socio-economic gradient in the relationship at issue. SES was measured by educational level. We used IHD-mortality in three educational groups as outcome. Per capita alcohol consumption was proxied by Systembolaget’s alcohol sales (litres of alcohol 100% per capita 15+). Swedish quarterly data on mortality and alcohol consumption spanned the period 1991Q1–2020Q4. We applied SARIMA time-series analysis. Survey data were used to construct an indicator of heavy SES-specific episodic drinking. The estimated association between per capita consumption and IHD-mortality was positive and statistically significant in the two groups with primary and secondary education, but not in the group with postsecondary education. The association was significantly stronger the lower the educational group. Although the associations were generally stronger for males than for females, these differences were not statistically significant (P > 0.05). Our findings suggest that the detrimental impact of per capita consumption on IHD-mortality was stronger the lower the educational group.
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| 10. |
- Thern, Emelie, et al.
(författare)
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Educational qualification differences and early labor market exit among men : the contribution of labor market marginalization measured across the working life
- 2022
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The present study aims to investigate the association between educational qualification and early labor market exit among men and to examine the contribution of labor market marginalization measured across the working life on this association.Method: A register-linked cohort study was conducted including men who completed military service in 1969/70 (born between 1949 and 1951) and were alive at age 55 and not disability pension beneficiaries (n = 40 761). Information on the highest level of educational qualification and the outcome of early exit (disability pension, sickness absence, unemployment, and early old-age pension) was obtained from Swedish nationwide registers between the ages of 55 and 64 years. Labor market marginalization was defined as periods of long-term unemployment and sickness absence over the working life and up to follow-up. Cox regression analyses were used to obtain hazard ratios (HR) with 95% confidence intervals (CI).Results: Low-educated men were more likely to leave the labor force early due to disability pension or sickness absence (HR: 2.48), unemployment (HR: 2.09), and early old-age pension with- (HR:1.25) and without -income (HR: 1.58). Labor market marginalization across the working life explained a large part of the association for the more involuntary early exit routes (disability pensions, sickness absence, unemployment) and explained very little with regards to the more voluntary early exit routes (early old-age pension with and without income).Conclusion: Exposure to labor market marginalization across the working life was important in explaining educational differences in early labor market exit due to disability pension or sickness absence and unemployment. This study underscores the importance of identifying and implementing preventive measures in the workplace (e.g. adaptions) to prevent new spells of sickness absence and unemployment, especially among low educated individuals.
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