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Gueltzow M, Bijlsma MJ, van Lenthe FJ, Myrskylä M. The Contribution of Health Behaviors to Depression Risk Across Birth Cohorts. Epidemiology 2022; 33:880-889. [PMID: 35944161 PMCID: PMC9531992 DOI: 10.1097/ede.0000000000001524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND More recent birth cohorts are at a higher depression risk than cohorts born in the early 20th century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity, and obesity contribute to these birth cohort variations. METHODS We analyzed panel data from US adults born 1916-1966 enrolled in the Health and Retirement Study (N = 163,760 person-years). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. We thereby compared the predicted probability of elevated depressive symptoms (CES-D 8 score ≥3) in the natural course to a counterfactual scenario where all birth cohorts had the health behaviors of the 1945 birth cohort. We stratified analyses by sex and race-ethnicity. RESULTS We estimated that depression risk of the 1916-1949 and 1950-1966 birth cohort would be on average 2.0% (-2.3 to -1.7) and 0.5% (-0.9 to -0.1) higher with the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1% (1.8 to 2.4) higher for the 1916-1940 cohorts and 1.8% (-2.2 to -1.5) lower for the 1950-1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race-ethnicity groups, and the contribution of BMI more pronounced for women than for men. CONCLUSION Increased obesity levels were associated with exacerbated depression risk in recent birth cohorts in the United States, while drinking patterns only played a minor role.
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Affiliation(s)
- Maria Gueltzow
- From the Max Planck Institute for Demographic Research, Rostock, Germany
- Public Health Department, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Maarten J. Bijlsma
- From the Max Planck Institute for Demographic Research, Rostock, Germany
- Unit PharmacoTherapy, -Epidemiology, and -Economics (PTEE), Groningen Research Institute of Pharmacy, University of Groningen, the Netherlands
| | - Frank J. van Lenthe
- Public Health Department, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Mikko Myrskylä
- From the Max Planck Institute for Demographic Research, Rostock, Germany
- Center for Social Data Science, University of Helsinki, Helsinki, Finland
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Socioeconomic Inequalities in Chronic Liver Diseases and Cirrhosis Mortality in European Urban Areas before and after the Onset of the 2008 Economic Recession. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168801. [PMID: 34444557 PMCID: PMC8391471 DOI: 10.3390/ijerph18168801] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 01/16/2023]
Abstract
Objective: To analyse the trends in chronic liver diseases and cirrhosis mortality, and the associated socioeconomic inequalities, in nine European cities and urban areas before and after the onset of the 2008 financial crisis. Methods: This is an ecological study of trends in three periods of time: two before (2000–2003 and 2004–2008), and one after (2009–2014) the onset of the economic crisis. The units of analysis were the geographical areas of nine cities or urban areas in Europe. We analysed chronic liver diseases and cirrhosis standardised mortality ratios, smoothing them with a hierarchical Bayesian model by each city, area, and sex. An ecological regression model was fitted to analyse the trends in socioeconomic inequalities, and included the socioeconomic deprivation index, the period, and their interaction. Results: In general, chronic liver diseases and cirrhosis mortality rates were higher in men than in women. These rates decreased in all cities during the financial crisis, except among men in Athens (rates increased from 8.50 per 100,000 inhabitants during the second period to 9.42 during the third). Socioeconomic inequalities in chronic liver diseases and cirrhosis mortality were found in six cities/metropolitan areas among men, and in four among women. Finally, in the periods studied, such inequalities did not significantly change. However, among men they increased in Turin and Barcelona and among women, several cities had lower inequalities in the third period. Conclusions: There are geographical socioeconomic inequalities in chronic liver diseases and cirrhosis mortality, mainly among men, that did not change during the 2008 financial crisis. These results should be monitored in the long term.
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Trias-Llimós S, Bardoutsos A, Janssen F. Future Alcohol-Attributable Mortality in France Using a Novel Generalizable Age-Period-Cohort Projection Methodology. Alcohol Alcohol 2021; 56:325-333. [PMID: 33089307 PMCID: PMC8085365 DOI: 10.1093/alcalc/agaa107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023] Open
Abstract
AIM To forecast age- and sex-specific alcohol-attributable mortality in France for the period 2015-2050 using a novel generalizable methodology that includes different scenarios regarding period and cohort change. METHODS For the French national population aged 25-90 years (1979-2014), we estimated alcohol-attributable mortality by mortality from the main causes of death wholly attributable to alcohol, plus liver cirrhosis mortality. We modelled sex-specific alcohol-attributable mortality by adjusting for age, period and birth cohort. We forecasted the model parameters to obtain future age- and sex-specific alcohol-attributable mortality up until 2050 using a conventional baseline, scenario I (favourable period change) and scenario II (unfavourable cohort change). RESULTS Alcohol-attributable mortality is clearly declining in France, with the decline decelerating from 1992 onwards. In 2014, the age-standardized alcohol-attributable mortality rates, in deaths per 100,000, were 34.7 among men and 9.9 among women. In 2050, the estimated rates are between 10.5 (prediction interval: 7.6-14.4; scenario I) and 17.6 (13.1-23.7; scenario II) among men, and between 1.1 (0.7-1.7; scenario I) and 1.8 (1.2-2.9; scenario II) among women; which implies declines of 58% for men and 84% for women (baseline). CONCLUSION Alcohol-attributable mortality in France is expected to further decline in the coming decades, accompanied by age pattern changes. However, France's levels are not expected to reach the current lower levels in Italy and Spain for 15 years or more. Our results point to the value of implementing preventive policy measures that discourage alcohol consumption among people of all ages, but especially among adolescents.
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Affiliation(s)
- Sergi Trias-Llimós
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 Groningen, The Netherlands
- Center for Demographic Studes, Centres de Recerca de Catalunya (CERCA), Carrer de Ca n’Altayó, Edifici E2, 08193 Bellaterra, Spain
| | - Anastasios Bardoutsos
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 Groningen, The Netherlands
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, KNAW/University of Groningen, Lange Houtstraat 19, 2511 The Hague, The Netherlands
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Janssen F, El Gewily S, Bardoutsos A, Trias-Llimós S. Past and Future Alcohol-Attributable Mortality in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9024. [PMID: 33287385 PMCID: PMC7730378 DOI: 10.3390/ijerph17239024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/10/2020] [Accepted: 11/29/2020] [Indexed: 12/11/2022]
Abstract
Although alcohol consumption is an important public health issue in Europe, estimates of future alcohol-attributable mortality for European countries are rare, and only apply to the short-term future. We project (age-specific) alcohol-attributable mortality up to 2060 in 26 European countries, after a careful assessment of past trends. For this purpose we used population-level country-, sex-, age- (20-84) and year-specific (1990-2016) alcohol-attributable mortality fractions (AAMF) from the Global Burden of Disease (GBD) study, which we adjusted at older ages. To these data we apply an advanced age-period-cohort projection methodology, that avoids unrealistic future differences and crossovers between sexes and countries. We project that in the future, AAMF levels will decline in all countries, and will converge across countries and sexes. For 2060, projected AAMF are, on average, 5.1% among men and 1.4% among women, whereas in 2016 these levels were 10.1% and 3.3%, respectively. For men, AAMF is projected to be higher in Eastern and South-western Europe than in North-western Europe. All in all, the share of mortality due to alcohol is projected to eventually decline in all 26 European countries. Achieving these projected declines will, however, require strong ongoing public health action, particularly for selected Eastern and North-western European countries.
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Affiliation(s)
- Fanny Janssen
- Netherlands Interdisciplinary Demographic Institute, KNAW/University of Groningen, Lange Houtstraat 19, 2511 CV The Hague, The Netherlands
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (S.E.G.); (A.B.)
| | - Shady El Gewily
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (S.E.G.); (A.B.)
| | - Anastasios Bardoutsos
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (S.E.G.); (A.B.)
| | - Sergi Trias-Llimós
- Centre d’Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Carrer de Ca n’Altayó, Buildings E2, Autonomous University of Barcelona, 08193 Bellaterra, Spain;
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
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Busschots D, Toghanian S, Bielen R, Salomonsson S, Koc ÖM, Hendrickx G, Jadoul M, Nevens F, Sokal E, Brixko C, Peerlinck K, Apers L, Robaeys G, Lazarus JV. Eliminating viral hepatitis C in Belgium: the micro-elimination approach. BMC Infect Dis 2020; 20:181. [PMID: 32106819 PMCID: PMC7045456 DOI: 10.1186/s12879-020-4898-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 02/17/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hepatitis C virus is one of the leading causes of chronic liver disease and liver-related deaths worldwide. The estimated prevalence of chronic hepatitis C viral infection among the general Belgian population was 0.57% (n = 64,000) in 2015. Although Belgium has had a 'Hepatitis C Plan' since 2014, elimination efforts are unclear. This study employs the best available data and modelling estimates to define the burden of hepatitis C viral infection among key subgroups in Belgium, identify information gaps and propose potential approaches to screening, linkage to care and treatment, and cure. METHODS We examined the peer-reviewed and grey literature since 2012 for data on the prevalence of hepatitis C viral infection in Belgium in key subgroups identified by national experts and in the literature. Ultimately, this research is primarily based on data provided by the key stakeholders themselves due to a lack of reliable data in the literature. Based on this, we modelled the treatment rates required to reach elimination of hepatitis C in several subgroups. RESULTS Eleven potential subgroups were identified. There were no data available for two subgroups: generational cohorts and men who have sex with men. In six subgroups, fewer than 3000 people were reported or estimated to have hepatitis C infection. Migrants and people who inject drugs were the most affected subgroups, and children were the least affected subgroup. Only two subgroups are on target to achieve elimination by 2030: patients living with haemophilia and transplant recipients. CONCLUSIONS Removing Belgian treatment reimbursement restrictions in January 2019 was a big step towards eliminating HCV. In addition, increasing surveillance, including with a national registry, treatment prescription by other health-care providers and availability of treatment in local pharmacies are central to improving the current situation and getting on track to reach the 2030 WHO hepatitis C elimination targets in Belgium.
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Affiliation(s)
- Dana Busschots
- Faculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Samira Toghanian
- MSD, Centre of Observational Real-world Evidence (CORE), Stockholm, Sweden
| | - Rob Bielen
- Faculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Stina Salomonsson
- MSD, Centre of Observational Real-world Evidence (CORE), Stockholm, Sweden
| | - Özgür M Koc
- Faculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Medical Microbiology, School of NUTRIM, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Greet Hendrickx
- Viral Hepatitis Prevention Board, Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Michel Jadoul
- Service de Néphrologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Frederik Nevens
- Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Etienne Sokal
- Service Gastroentérologie Hépatologie Pédiatrique, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Christian Brixko
- Department of Hepato-Gastroenterology and Digestive Oncology, CHR Citadelle, Liège, Belgium
| | - Kathelijne Peerlinck
- Division of Cardiovascular Disorders, Haemophilia Center, University Hospitals KU Leuven, Leuven, Belgium
| | - Ludwig Apers
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Geert Robaeys
- Faculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
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Holmes J, Ally AK, Meier PS, Pryce R. The collectivity of British alcohol consumption trends across different temporal processes: a quantile age-period-cohort analysis. Addiction 2019; 114:1970-1980. [PMID: 31325193 DOI: 10.1111/add.14754] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/16/2019] [Accepted: 07/15/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIMS UK alcohol consumption per capita has fallen by 18% since 2004, while the alcohol-specific death rate has risen by 6%. Inconsistent consumption trends across the population may explain this. Drawing on the theory of the collectivity of drinking cultures and age-period-cohort analyses, we tested whether consumption trends are consistent across lighter and heavier drinkers for three temporal processes: (i) the life-course, (ii) calendar time and (iii) successive birth cohorts. DESIGN Sex-specific quantile age-period-cohort regressions using repeat cross-sectional survey data. SETTING Great Britain, 1984-2011. PARTICIPANTS Adult (18+) drinkers responding to 17 waves of the General Lifestyle Survey (total n = 175 986). MEASUREMENTS Dependent variables: the 10th, 25th, 50th, 75th, 90th, 95th and 99th quantiles of the logged weekly alcohol consumption distribution (excluding abstainers). INDEPENDENT VARIABLES seven age groups (18-24, 25-34… 65-74, 75+ years), five time-periods (1984-88… 2002-06, 2008-11) and 16 five-year birth cohorts (1915-19… 1990-94). Additional control variables: ethnicity and UK country. FINDINGS Within age, period and cohort trends, changes in consumption were not consistently in the same direction at different quantiles of the consumption distribution. When they were, the scale of change sometimes differed between quantiles. For example, between 1996-2000 and 2008-2011, consumption among women decreased by 18% [95% confidence interval (CI) = -32 to -2%] at the 10th quantile but increased by 11% (95% CI = 2-21%) at the median and by 28% (95% CI = 19-38%) at the 99th quantile, implying that consumption fell among lighter drinkers and rose among heavier drinkers. This type of polarized trend also occurred between 1984-88 and 1996-2000 for men and women. Age trends showed collectivity, but cohort trends showed a mixture of collectivity and polarization. CONCLUSIONS Countervailing alcohol consumption and alcohol-related harm trends in the United Kingdom may be explained by lighter and heavier drinkers having different period and cohort trends, as well as by the presence of cohort trends that mean consumption may rise in some age groups while falling in others.
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Affiliation(s)
- John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Abdallah K Ally
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Bielen R, Kremer C, Koc ÖM, Busschots D, Hendrickx DM, Vanelderen P, Hens N, Nevens F, Robaeys G. Screening for hepatitis C at the emergency department: Should babyboomers also be screened in Belgium? Liver Int 2019; 39:667-675. [PMID: 30525269 DOI: 10.1111/liv.14016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Patients are not screened adequately for hepatitis C virus infection in Belgium. In the USA, the Center for Disease Control recommends screening for patients born in the babyboom period (1945-1965). In Europe, the babyboom cohort was born between 1955 and 1974, but no screening policy has been targeted to this group. We aimed to study the prevalence of hepatitis C virus in an emergency department population in Belgium and the risk factors associated with hepatitis C virus infection. METHOD We performed a monocentric, cross-sectional seroprevalence study between January and November 2017 in a large Belgian non-university hospital. Patients aged 18-70 years presenting at the emergency department were eligible. Patients completed a risk assessment questionnaire and were screened for hepatitis C virus antibodies (Ab) with reflex hepatitis C virus ribonucleic acid testing. RESULTS Of 2970 patients, 2366 (79.7%) agreed to participate. hepatitis C virus Ab prevalence was 1.31%. Twenty-one (67.7%) hepatitis C virus Ab-positive patients were born between 1955 and 1974. With a previous treatment uptake of 54.5%, the prevalence of viremia was 0.9% in retrospect; 0.2% were newly diagnosed. The weighted multiple logistic regression model identified males born in the 1955-1974 cohort, intravenous drug use and high endemic birth country as significant risk factors for hepatitis C virus infection (P < 0.05). CONCLUSION Although the prevalence of hepatitis C virus Ab at the emergency department was higher than previously estimated for the general population in Belgium, the number of newly diagnosed patients with viremia was low. To optimize screening strategies, screening should be offered to males born in the 1955-1974 cohort, but especially in drug users, the prison population and immigrants from high endemic countries.
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Affiliation(s)
- Rob Bielen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology, Ziekenhuis-Oost Limburg, Genk, Belgium
| | - Cécile Kremer
- Faculty of Science, Center for statistics, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
| | - Özgür M Koc
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology, Ziekenhuis-Oost Limburg, Genk, Belgium.,Medical Microbiology, School of NUTRIM, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Dana Busschots
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology, Ziekenhuis-Oost Limburg, Genk, Belgium
| | - Diana M Hendrickx
- Faculty of Science, Center for statistics, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
| | - Pascal Vanelderen
- Department of Anaesthesiology, Intensive Care Medicine, Emergency Care and Pain Therapy, Ziekenhuis-Oost Limburg, Genk, Belgium
| | - Niel Hens
- Faculty of Science, Center for statistics, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium.,Centre for Health Economic Research and Modelling of Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute(VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Frederik Nevens
- Department of Gastroenterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium
| | - Geert Robaeys
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology, Ziekenhuis-Oost Limburg, Genk, Belgium.,Department of Gastroenterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium
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Janssen F, de Beer J. The timing of the transition from mortality compression to mortality delay in Europe, Japan and the United States. GENUS 2019. [DOI: 10.1186/s41118-019-0057-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Martinez P, Kerr WC, Subbaraman MS, Roberts SCM. New Estimates of the Mean Ethanol Content of Beer, Wine, and Spirits Sold in the United States Show a Greater Increase in Per Capita Alcohol Consumption than Previous Estimates. Alcohol Clin Exp Res 2019; 43:509-521. [PMID: 30742317 DOI: 10.1111/acer.13958] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 01/08/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Recent increases in alcohol-related morbidity and mortality have not occurred alongside notable increases in per capita alcohol consumption (PCC). This discrepancy may be partially due to U.S. PCC estimates not including annual estimates of the percentage of alcohol by volume (%ABV) of beer, wine, and spirits, but rather relying on time-invariant %ABV values. METHODS Building on a prior study covering 1950 to 2002, estimates of the annual mean %ABV of beer, wine, and spirits sold in the United States were calculated using the %ABV of major brands and sales of each beverage type for each state and nationally for the period 2003 to 2016. We applied these estimates to the calculation of annual beverage-specific and total PCC, and made descriptive comparisons between our PCC estimates and those estimates using invariant %ABV values. RESULTS For all beverage types, our mean %ABV estimates increased nationally and for all but 5 states. The PCC estimates from wine and spirits utilizing variable %ABV values were lower than estimates using invariant %ABV, and consumption from beer was higher. Our total PCC estimates were also lower than %ABV-invariant estimates; however, the percent change for %ABV-invariant estimates was 5.8% compared to a 7.9% change in our %ABV-variant estimates over the 2003 to 2016 period. CONCLUSIONS Given the application of PCC estimates to understand changes in alcohol-related morbidity and mortality, the inclusion of annual estimates of the %ABV of alcoholic beverages sold in the United States is necessary to ensure the precision of PCC measures such that the conclusions drawn from these applications are accurate and valid.
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Affiliation(s)
- Priscilla Martinez
- Alcohol Research Group , Public Health Institute, Emeryville, California
| | - William C Kerr
- Alcohol Research Group , Public Health Institute, Emeryville, California
| | | | - Sarah C M Roberts
- Advancing New Standards in Reproductive Health (ANSIRH) , Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California
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Vidra N, Bijlsma MJ, Trias-Llimós S, Janssen F. Past trends in obesity-attributable mortality in eight European countries: an application of age-period-cohort analysis. Int J Public Health 2018; 63:683-692. [PMID: 29868930 PMCID: PMC6015618 DOI: 10.1007/s00038-018-1126-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives To assess age, period, and birth cohort effects and patterns of obesity-attributable mortality in Czech Republic, Finland, France, Germany, Hungary, Italy, Poland, and the UK (UK). Methods We obtained obesity prevalence and all-cause mortality data by age (20–79), sex and country for 1990–2012. We applied Clayton and Schifflers’ age–period–cohort approach to obesity-attributable mortality rates (OAMRs). Results Between 1990 and 2012, obesity prevalence increased and age-standardised OAMRs declined, although not uniformly. The nonlinear birth cohort effects contributed significantly (p < 0.01) to obesity-attributable mortality trends in all populations, except in Czech Republic, Finland, and among German women, and Polish men. Their contribution was greater than 25% in UK and among French women, and larger than that of the nonlinear period effects. In the UK, mortality rate ratios (MRRs) increased among the cohorts born after 1950. In other populations with significant birth cohort effects, MRRs increased among the 1935–1960 cohorts and decreased thereafter. Conclusions Given its potential effects on obesity-attributable mortality, the cohort dimension should not be ignored and calls for interventions early in life next to actions targeting broader societal changes. Electronic supplementary material The online version of this article (10.1007/s00038-018-1126-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nikoletta Vidra
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV, Groningen, The Netherlands.
| | | | - Sergi Trias-Llimós
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV, Groningen, The Netherlands
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
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12
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Piontek D, Kraus L. Trends in alcohol-related mortality in East and West Germany, 1980-2014: age, period and cohort variations. Addiction 2018; 113:836-844. [PMID: 29318691 DOI: 10.1111/add.14152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/14/2017] [Accepted: 12/15/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Several indicators suggest that the extent and trends of alcohol-related mortality differ between East and West Germany. Regional drinking patterns and differences in health-care systems are assumed to affect the risk of dying from an alcohol-induced disease. The study addresses two questions: (1) what are the unbiased and independent age, period and cohort effects on alcohol-related mortality trends in Germany; and (2) do these trends differ between East and West Germany? METHODS Data on alcohol-related mortality for East and West Germany came from the national causes of death register for the years 1980-2014. Analyses included all deaths fully attributable to alcohol based on the International Classification of Diseases (ICD-9 and ICD-10). Gender-stratified age-period-cohort analyses were conducted using the intrinsic estimator model. RESULTS Age effects showed a concave pattern with a peak at ages 55-64 years in both regions. Incidence rate ratios (IRR) in East Germany were highest in the years 1990-1994 (men and women: IRR = 1.52) and declined thereafter. In West Germany, IRR were lowest in 1980-1984 (men: IRR = 0.81, women: IRR = 0.75) and stabilized at approximately 1.10 since 1995-1999. Cohort effects showed continuously lower IRR for those born after 1955-1959 in the East and those born after 1945-1949 in the West. Patterns for males and females were comparable. CONCLUSIONS The results suggest that alcohol-related mortality showed different trends in East and West Germany, which can be explained partly by different drinking patterns before and changes in the health-care system after the reunification.
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Affiliation(s)
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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13
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Trias-Llimós S, Martikainen P, Mäkelä P, Janssen F. Comparison of different approaches for estimating age-specific alcohol-attributable mortality: The cases of France and Finland. PLoS One 2018; 13:e0194478. [PMID: 29566081 PMCID: PMC5864025 DOI: 10.1371/journal.pone.0194478] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/05/2018] [Indexed: 12/19/2022] Open
Abstract
Background Accurate estimates of the impact of alcohol on overall and age-specific mortality are crucial for formulating health policies. However, different approaches to estimating alcohol-attributable mortality provide different results, and a detailed comparison of age-specific estimates is missing. Methods Using data on cause of death, alcohol consumption, and relative risks of mortality at different consumption levels, we compare eight estimates of sex- and age-specific alcohol-attributable mortality in France (2010) and Finland (2013): five estimates using cause-of-death approaches (with one accounting for contributory causes), and three estimates using attributable fraction (AF) approaches. Results AF-related approaches and the approach based on alcohol-related underlying and contributory causes of death provided estimates of alcohol-attributable mortality that were twice as high as the estimates found using underlying cause-of-death approaches in both countries and sexes. The differences across the methods were greatest among older age groups An inverse U-shape in age-specific alcohol-attributable mortality (peaking at around age 65) was observed for cause-of-death approaches, with this shape being more pronounced in Finland. AF-related approaches resulted in different estimates at older ages: i.e., mortality was found to increase with age in France; whereas in Finland mortality estimates depended on the underlying assumptions regarding the effects of alcohol consumption on cardiovascular mortality. Conclusions While the most detailed approaches (i.e., the AF-related approach and the approach that includes underlying and contributory causes) are theoretically able to provide more accurate estimates of alcohol-attributable mortality, they–especially the AF approaches- depend heavily on data availability and quality. To enhance the reliability of alcohol-attributable mortality estimates, data quality for older age groups needs to be improved.
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Affiliation(s)
- Sergi Trias-Llimós
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Pekka Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Pia Mäkelä
- Alcohol, Drugs and Addictions Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
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14
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Papatheodoridis GV, Hatzakis A, Cholongitas E, Baptista-Leite R, Baskozos I, Chhatwal J, Colombo M, Cortez-Pinto H, Craxi A, Goldberg D, Gore C, Kautz A, Lazarus JV, Mendão L, Peck-Radosavljevic M, Razavi H, Schatz E, Tözün N, van Damme P, Wedemeyer H, Yazdanpanah Y, Zuure F, Manns MP. Hepatitis C: The beginning of the end-key elements for successful European and national strategies to eliminate HCV in Europe. J Viral Hepat 2018; 25 Suppl 1:6-17. [PMID: 29508946 DOI: 10.1111/jvh.12875] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 12/14/2017] [Indexed: 12/12/2022]
Abstract
Hepatitis C virus (HCV) infection is a major public health problem in the European Union (EU). An estimated 5.6 million Europeans are chronically infected with a wide range of variation in prevalence across European Union countries. Although HCV continues to spread as a largely "silent pandemic," its elimination is made possible through the availability of the new antiviral drugs and the implementation of prevention practices. On 17 February 2016, the Hepatitis B & C Public Policy Association held the first EU HCV Policy Summit in Brussels. This summit was an historic event as it was the first high-level conference focusing on the elimination of HCV at the European Union level. The meeting brought together the main stakeholders in the field of HCV: clinicians, patient advocacy groups, representatives of key institutions and regional bodies from across European Union; it served as a platform for one of the most significant disease elimination campaigns in Europe and culminated in the presentation of the HCV Elimination Manifesto, calling for the elimination of HCV in Europe by 2030. The launch of the Elimination Manifesto provides a starting point for action in order to make HCV and its elimination in Europe an explicit public health priority, to ensure that patients, civil society groups and other relevant stakeholders will be directly involved in developing and implementing HCV elimination strategies, to pay particular attention to the links between hepatitis C and social marginalization and to introduce a European Hepatitis Awareness Week.
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Affiliation(s)
- G V Papatheodoridis
- Medical School of National, Kapodistrian University of Athens, Athens, Greece
| | - A Hatzakis
- Medical School of National, Kapodistrian University of Athens, Athens, Greece
| | - E Cholongitas
- Medical School of National, Kapodistrian University of Athens, Athens, Greece
| | - R Baptista-Leite
- Institute of Health Sciences, Católica University of Portugal, Lisbon, Portugal.,Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - J Chhatwal
- Massachusetts General Hospital' s, Institute for Technology Assessment and Harvard Medical School, Boston, MA, USA
| | - M Colombo
- Clinical and Research Center Humanitas, Rozzano, Italy
| | - H Cortez-Pinto
- European Association for the Study of the Liver, Geneva, Switzerland.,Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal
| | - A Craxi
- University of Palermo, Palermo, Italy
| | - D Goldberg
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - C Gore
- Hepatitis C Trust, World Hepatitis Alliance, London, UK
| | - A Kautz
- Leberhilfe Projekt gUG, Cologne, Germany
| | - J V Lazarus
- Barcelonai Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.,CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - L Mendão
- Portuguese Activist Group for HIV/AIDS Treatment, Lisbon, Portugal.,European AIDS Treatment Group, Brussels, Belgium
| | | | - H Razavi
- Center for Disease Analysis, Lafayette, CO, USA
| | - E Schatz
- Correlation Network, Amsterdam, The Netherlands
| | - N Tözün
- Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - P van Damme
- Antwerp University, Antwerp, Belgium.,Viral Hepatitis Prevention Board, Antwerp, Belgium
| | | | | | - F Zuure
- Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M P Manns
- Hannover Medical School, Hannover, Germany
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15
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Rosén M, Haglund B. Follow-up of an age-period-cohort analysis on alcohol-related mortality trends in Sweden 1970-2015 with predictions to 2025. Scand J Public Health 2018; 47:446-451. [PMID: 29334866 DOI: 10.1177/1403494817752521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Several studies have indicated that birth cohorts are important in explaining trends in alcohol-related mortality. An earlier study from Sweden with data up to 2002 showed that birth cohorts that grew up under periods of more liberal alcohol policies had higher alcohol-related mortality than those cohorts growing up under more restrictive time periods. In spite of increasing alcohol consumption, predictions in 2002 also indicated lower alcohol-related mortality in the future. The aim of this study is to follow-up whether the effects of birth cohorts and the predictions made for Sweden still holds using data up to 2015. METHOD The study comprised an age-period-cohort analysis and predictions based on population predictions from Statistics Sweden. The analysis was based on all alcohol-related deaths in the Swedish population between 1969 and 2015 for the cohorts born in the decades 1920 through 1990. Data were restricted to people 15-84 years of age. In total, the analysis covered 68,341 deaths and more than 284 million person-years. RESULTS Male and female cohorts born in the 1940s to 1950s exhibited the highest alcohol-related mortality, while those born in the 1970s continued to have the lowest alcohol-related mortality rates. The predicted mortality rates for males are still anticipated to decrease somewhat through 2025. CONCLUSIONS The updated age-period-cohort analysis further supports the importance of focusing on restrictive alcohol policies targeting adolescents.
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Affiliation(s)
- Måns Rosén
- 1 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
| | - Bengt Haglund
- 2 Centre for Pharmacoepidemiology, Karolinska Institutet, Sweden
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16
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Lazarus JV, Bromberg DJ. Commentary on Trias-Llimós et al. (2017): Birth cohort research-an essential tool to guide public health interventions. Addiction 2017; 112:259-260. [PMID: 28078704 DOI: 10.1111/add.13679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 10/24/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute of Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain.,CHIP-Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Daniel J Bromberg
- CHIP-Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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