The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis

Abstract Background Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the a...

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Autores principales:	Charlotte Probst, Shannon Lange, Carolin Kilian, Celine Saul, Jürgen Rehm
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Socioeconomic status Inequality Dose-response Socioeconomic deprivation Alcohol use Mortality Medicine R
Acceso en línea:	https://doaj.org/article/78fefa8518ef4d388e8524c729cbd11a
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spelling	oai:doaj.org-article:78fefa8518ef4d388e8524c729cbd11a2021-11-08T10:45:49ZThe dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis10.1186/s12916-021-02132-z1741-7015https://doaj.org/article/78fefa8518ef4d388e8524c729cbd11a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12916-021-02132-zhttps://doaj.org/toc/1741-7015Abstract Background Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. Methods We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). Results We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70–2.59], 50th: 3.43 [2.67–4.49], 75th: 4.43 [3.62–5.50], 100th: 4.50 [3.26–6.40]; men: 25th: 2.34 [1.98–2.76], 50th: 4.22 [3.38–5.24], 75th: 5.87 [4.75–7.10], 100th: 6.28 [4.89–8.07]. Conclusions The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.Charlotte ProbstShannon LangeCarolin KilianCeline SaulJürgen RehmBMCarticleSocioeconomic statusInequalityDose-responseSocioeconomic deprivationAlcohol useMortalityMedicineRENBMC Medicine, Vol 19, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Socioeconomic status Inequality Dose-response Socioeconomic deprivation Alcohol use Mortality Medicine R
spellingShingle	Socioeconomic status Inequality Dose-response Socioeconomic deprivation Alcohol use Mortality Medicine R Charlotte Probst Shannon Lange Carolin Kilian Celine Saul Jürgen Rehm The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
description	Abstract Background Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. Methods We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). Results We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70–2.59], 50th: 3.43 [2.67–4.49], 75th: 4.43 [3.62–5.50], 100th: 4.50 [3.26–6.40]; men: 25th: 2.34 [1.98–2.76], 50th: 4.22 [3.38–5.24], 75th: 5.87 [4.75–7.10], 100th: 6.28 [4.89–8.07]. Conclusions The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.
format	article
author	Charlotte Probst Shannon Lange Carolin Kilian Celine Saul Jürgen Rehm
author_facet	Charlotte Probst Shannon Lange Carolin Kilian Celine Saul Jürgen Rehm
author_sort	Charlotte Probst
title	The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
title_short	The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
title_full	The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
title_fullStr	The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
title_full_unstemmed	The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
title_sort	dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/78fefa8518ef4d388e8524c729cbd11a
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The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk—a systematic review and meta-analysis

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