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Area of residence and alcohol-related mortality risk: a five-year follow-up study
Article first published online: 15 SEP 2010
DOI: 10.1111/j.1360-0443.2010.03103.x
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction
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How to Cite
Connolly, S., O'Reilly, D., Rosato, M. and Cardwell, C. (2011), Area of residence and alcohol-related mortality risk: a five-year follow-up study. Addiction, 106: 84–92. doi: 10.1111/j.1360-0443.2010.03103.x
Publication History
- Issue published online: 10 DEC 2010
- Article first published online: 15 SEP 2010
- Submitted 1 December 2009; initial review completed 18 February 2010; final version accepted 14 June 2010
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Keywords:
- Alcohol-related mortality;
- composition;
- context;
- deprivation;
- longitudinal analysis;
- Northern Ireland;
- urban/rural
ABSTRACT
Aims To examine differences in alcohol-related mortality risk between areas, while adjusting for the characteristics of the individuals living within these areas.
Design A 5-year longitudinal study of individual and area characteristics of those dying and not dying from alcohol-related deaths.
Setting The Northern Ireland Mortality study.
Participants A total of 720 627 people aged 25–74, enumerated in the Northern Ireland 2001 Census, not living in communal establishments.
Measurements Five hundred and seventy-eight alcohol-related deaths.
Findings There was an increased risk of alcohol-related mortality among disadvantaged individuals, and divorced, widowed and separated males. The risk of an alcohol-related death was significantly higher in deprived areas for both males [hazard ratio (HR) 3.70; 95% confidence interval (CI) 2.65, 5.18] and females (HR 2.67 (95% CI 1.72, 4.15); however, once adjustment was made for the characteristics of the individuals living within areas, the excess risk for more deprived areas disappeared. Both males and females in rural areas had a reduced risk of an alcohol-related death compared to their counterparts in urban areas; these differences remained after adjustment for the composition of the people within these areas.
Conclusions Alcohol-related mortality is higher in more deprived, compared to more affluent areas; however, this appears to be due to characteristics of individuals within deprived areas, rather than to some independent effect of area deprivation per se. Risk of alcohol-related mortality is lower in rural than urban areas, but the cause is unknown.