The socioeconomic profile of alcohol-attributable mortality in South Africa: a modelling study.
The socioeconomic profile of alcohol-attributable mortality in South Africa: a modelling study.
复制标题
DOI：
10.1186/s12916-018-1080-0
复制
发表时间：
2018-06-25
期刊：
影响因子：
9.3
通讯作者：
Rehm J
中科院分区：
文献类型：
--
作者：
Probst C;Parry CDH;Wittchen HU;Rehm J
在全球范围内，疾病和预期寿命遵循社会梯度，使社会经济地位较低的人过早死亡的风险更高。酒精消费已被证明是造成死亡率社会经济差异的一个因素。然而，从低收入和中等收入国家获得的证据很少。这项研究的目的是量化2015年南非成年人（15岁以上）一般人群中因饮酒导致的死亡率，包括SES、年龄和性别。使用来自南非的个体和汇总数据以及文献中报告的风险关系进行了比较风险评估。酒精归因分数（AAF）和酒精归因死亡率估计的原因，具体的死亡率，社会经济地位，性别和年龄。采用Monte Carlo模拟技术计算95%不确定度区间（UI）。总体而言，2015年南非约有62，300名（95% UI 27，000 - 103，000）成年人死于酒精原因，其中60%的死亡发生在低社会经济地位人群中，15%发生在高社会经济地位人群中。每10万名成年人中，低SES组（727例死亡，95%UI 354-1208例死亡）的酒精标准化酒精归因死亡率最高，其次是中等SES组（377例死亡，95%UI 165-687例死亡）和高SES组（163例死亡，95%UI 71-289例死亡）。传染病死亡率的社会经济差异最大。低社会经济地位的人有较低的流行率，目前的酒精使用，但更重的饮酒模式在目前的饮酒者。在男性中，AAF在低和中等SES时升高，特别是在中等和更高年龄组（35岁以上）。在女性中，不同SES组的AAF差异较小，在最年轻的年龄组（15-34岁）中，高SES的女性AAF升高。饮酒导致了死亡率的巨大社会经济差异。在观察中，低和中等社会经济地位的人的AAF升高是由于当前饮酒者的消费水平较高，而不是由于当前饮酒本身的流行。研究结果可以指导对高危人群采取预防措施和干预措施。未来的研究需要调查社会经济差异的风险功能相关的酒精使用的原因特异性死亡率。本文的在线版本（10.1186/s12916-018-1080-0）包含补充材料，可供授权用户使用。
Globally, illness and life expectancy follow a social gradient that puts people of lower socioeconomic status (SES) at higher risk of dying prematurely. Alcohol consumption has been shown to be a factor contributing to socioeconomic differences in mortality. However, little evidence is available from low- and middle-income countries. The objective of this study was to quantify mortality attributable to alcohol consumption in the adult (15+ years) general population of South Africa in 2015 by SES, age, and sex. A comparative risk assessment was performed using individual and aggregate data from South Africa and risk relations reported in the literature. Alcohol-attributable fractions (AAFs) and alcohol-attributable mortality rates were estimated for cause-specific mortality by SES, sex, and age. Monte Carlo simulation techniques were used to calculate 95% uncertainty intervals (UI). Overall, approximately 62,300 (95% UI 27,000–103,000) adults died from alcohol-attributable causes in South Africa in 2015, with 60% of deaths occurring in people in the low and 15% in the high SES groups. Age-standardized, alcohol-attributable mortality rates per 100,000 adults were highest for the low SES group (727 deaths, 95% UI 354–1208 deaths) followed by the middle (377 deaths, 95% UI 165–687 deaths) and high SES groups (163 deaths, 95% UI 71–289 deaths). The socioeconomic differences were highest for mortality from infectious diseases. People of low SES had a lower prevalence of current alcohol use but heavier drinking patterns among current drinkers. Among men, AAFs were elevated at low and middle SES, particularly for the middle and higher age groups (35+). Among women, AAFs differed less across SES groups and, in the youngest age group (15–34), women of high SES had elevated AAFs. Alcohol use contributed to vast socioeconomic differences in mortality. Where observed, elevated AAFs for people of low and middle SES arose from higher levels of consumption among current drinkers and not from the prevalence of current alcohol use per se. The findings can direct preventive measures and interventions on those at highest risk. Future research is needed to investigate socioeconomic differences in the risk functions relating alcohol use to cause-specific mortality. The online version of this article (10.1186/s12916-018-1080-0) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
3.4
作者：
Byass, P;Fottrell, E;Van, DD
通讯作者：
Van, DD
影响因子：
1.4
作者：
Drivdal, Laura;Lawhon, Mary
通讯作者：
Lawhon, Mary
影响因子：
2.8
作者：
Bloomfield, Kim;Grittner, Ulrike;Gmel, Gerhard
通讯作者：
Gmel, Gerhard
影响因子：
1.9
作者：
Brown-Luthango, Mercy;Reyes, Elena;Gubevu, Mntungwa
通讯作者：
Gubevu, Mntungwa
影响因子：
4.5
作者：
Bellis, Mark A.;Hughes, Karen;Jones, Lisa
通讯作者：
Jones, Lisa