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Journal Article

The contribution of alcohol to the East-West life expectancy gap in Europe from 1990 onward

Trias Llimós, S., Kunst, A. E., Jasilionis, D., Janssen, F.

International Journal of Epidemiology (2017)

DOI:10.1093/ije/dyx244

Keywords: Europe, alcoholism, causes of death, mortality

Abstract

Background
Central and Eastern European (CEE) countries have lower life expectancies and higher alcohol-attributable mortality than Western European countries. We examine the contribution of alcohol consumption to mortality across Europe, and specifically to the East-West life expectancy gap from 1990 onward.
Methods
We retrieved alcohol-attributable mortality rates (GBD Study 2013) and all-cause mortality rates (Human Mortality Database) by age and sex for nine CEE countries and for the EU-15 countries. We assessed country-specific potential gains in life expectancy (PGLE) by eliminating alcohol-attributable mortality using associated single decrement life tables. We decomposed the life expectancy differences between each CEE country and the EU-15 population-weighted average for 1990–2012/13 into alcohol-attributable and non-alcohol-attributable mortality.
Results
In 2012/13, the PGLE for men and women were, respectively, 2.15 and 1.00 years in the CEE region and 0.90 and 0.44 years in the EU-15 region. The contribution of alcohol to the East-West gap in life expectancy was largest among men in Russia {2.88 years [uncertainty interval (UI): 1.57–4.06]}, Belarus [3.70 years (UI: 1.75–5.45)] and Ukraine [2.47 years (UI: 0.90–3.88)]. The relative contributions increased in most of the countries between 1990 and 2005 (on average, from 17.0% to 25.4% for men, and from 14.7% to 22.5% for women), and declined thereafter (20.2% for men and 20.5% for women in 2012/13).
Conclusions
Alcohol contributed substantially to the East-West life expectancy gap in Europe, and to its increase (1990–2005) and decline (2005 onward). Diminishing alcohol consumption in CEE countries to Western European levels can contribute to mortality convergence across Europe.

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