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Drinking alcohol in moderation is associated with lower rate of all-cause mortality in individuals with higher rather than lower educational level: findings from the MORGAM project
Mediterranea Cardiocentro, Naples, Italy.
Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy.
Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy.
Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
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2023 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 38, no 8, p. 869-881Article in journal (Refereed) Published
Abstract [en]

The association between socioeconomic status (SES) and alcohol-related diseases has been widely explored. Less is known, however, on whether the association of moderate drinking with all-cause mortality is modified by educational level (EL). Using harmonized data from 16 cohorts in the MORGAM Project (N = 142,066) the association of pattern of alcohol intake with hazard of all-cause mortality across EL (lower = primary-school; middle = secondary-school; higher = university/college degree) was assessed using multivariable Cox-regression and spline curves. A total of 16,695 deaths occurred in 11.8 years (median). In comparison with life-long abstainers, participants drinking 0.1–10 g/d of ethanol had 13% (HR = 0.87; 95%CI: 0.74–1.02), 11% (HR = 0.89; 0.84–0.95) and 5% (HR = 0.95; 0.89–1.02) lower rate of death in higher, middle and lower EL, respectively. Conversely, drinkers > 20 g/d had 1% (HR = 1.01; 0.82–1.25), 10% (HR = 1.10; 1.02–1.19) and 17% (HR = 1.17; 1.09–1.26) higher rate of death. The association of alcohol consumption with all-cause mortality was nonlinear, with a different J-shape by EL levels. It was consistent across both sexes and in various approaches of measuring alcohol consumption, including combining quantity and frequency and it was more evident when the beverage of preference was wine. We observed that drinking in moderation (≤ 10 g/d) is associated with lower mortality rate more evidently in individuals with higher EL than in people with lower EL, while heavy drinking is associated with higher mortality rate more evidently in individuals with lower EL than in people with higher EL, suggesting that advice on reducing alcohol intake should especially target individuals of low EL.

Place, publisher, year, edition, pages
Springer Nature, 2023. Vol. 38, no 8, p. 869-881
Keywords [en]
Alcohol, All-cause mortality, Educational levels, Social status
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-212087DOI: 10.1007/s10654-023-01022-3ISI: 001020680000001Scopus ID: 2-s2.0-85163579302OAI: oai:DiVA.org:umu-212087DiVA, id: diva2:1782806
Funder
EU, FP7, Seventh Framework Programme, HEALTH-F3-2010–242244EU, FP7, Seventh Framework Programme, HEALTH-F2-2011–278913EU, Horizon 2020, 825903EU, Horizon 2020, 847770Region Västerbotten, RV-967561Umeå UniversityAvailable from: 2023-07-17 Created: 2023-07-17 Last updated: 2023-10-12Bibliographically approved

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Söderberg, StefanNordendahl, Maria

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