Alcohol and gender gaps in life expectancy in eight Central and Eastern European countries
Alcohol and gender gaps in life expectancy in eight Central and Eastern European countries
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DOI：
10.1093/eurpub/cky057
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发表时间：
2018-08-01
影响因子：
4.4
通讯作者：
Janssen, Fanny
中科院分区：
文献类型：
--
作者：
Trias-Llimos, Sergi;Janssen, Fanny
背景资料：在中欧和东欧（CEE），预期寿命（LE）的性别差异一直很大，酒精被假设为主要决定因素之一。我们研究了酒精在爱沙尼亚，立陶宛，拉脱维亚，摩尔多瓦，波兰，罗马尼亚，俄罗斯和乌克兰的LE性别差异中的作用，以及从1965年到2012年这一作用的变化。方法：我们将出生时LE的性别差异分解为与酒精和非酒精相关的死亡率。我们研究了整个时期内完全归因于酒精的死亡原因，并使用全球疾病负担研究中的酒精归因分数估计了从1990年起的额外酒精归因死亡率。结果如下：在8个中东欧国家，女性在劳动就业方面相对于男性的优势从1965年的平均7.3岁增加到2012年的平均10.0岁。1990年至2012年，所有可归因于酒精的死亡率对性别差异的贡献平均为1.9年（不确定区间（UI）：1.2-2.5; 18.8%）。在大多数国家，其相对贡献在2005年之前有所增加，此后有所下降，导致2012年的贡献至少为15%。除了波兰和爱沙尼亚，酒精对LE性别差距的绝对贡献与整体LE性别差异密切相关（Pearson's r>0.75）。结论：尽管最近有所下降，但过度饮酒的性别差异对LE性别差距的贡献是巨大的，不应被忽视。解决酒精消费和酒精所致死亡率方面的性别差异问题，将有助于在降低死亡率方面取得进一步进展。
Background: Gender differences in life expectancy (LE) have been traditionally large in Central and Eastern Europe (CEE), and alcohol has been hypothesized to be one of its main determinants. We examined the role of alcohol in gender differences in LE in Estonia, Lithuania, Latvia, Moldova, Poland, Romania, Russia and Ukraine, and changes in this role from 1965 until 2012. Methods: We decomposed the gender differences in LE at birth into alcohol- and non-alcohol-related mortality. We examined causes of death wholly attributable to alcohol over the whole period, and estimated from 1990 onwards additional alcohol-attributable mortality by using alcohol-attributable fractions from the Global Burden of Disease study. Results: In the eight CEE countries, women's advantage in LE relative to men increased from 7.3years on average in 1965 to 10.0years on average in 2012. All alcohol-attributable mortality contributed 1.9years on average (uncertainty intervals (Ul): 1.2-2.5; 18.8%) to the gender differences from 1990 to 2012. Its relative contribution increased in most countries until around 2005, and declined thereafter, resulting in a contribution of at least 15% in 2012. The absolute contribution of alcohol to the LE gender gap was strongly correlated with the overall LE gender differences (Pearson's r>0.75), except in Poland and Estonia. Conclusions: Despite recent declines, the contribution of sex differences in excessive alcohol consumption to the LE gender gap is substantial, and should not be neglected. Tackling gender differences in alcohol consumption and alcohol-attributable mortality would contribute to further progress in reducing mortality.