The Contribution of Alcohol Use, Other Lifestyle Factors and Working Conditions to Socioeconomic Differences in Sickness Absence

2020. Jonas Landberg (et al.). European Addiction Research 26 (1), 40-51

Article

Introduction: This study investigates how alcohol use contributes to the social gradient in sickness absence. Other factors assessed include lifestyle factors (smoking, physical activity and body mass index), physical and psychosocial working conditions. Methods: The study used baseline data from the Stockholm public health cohort 2006, with an analytical sample of 17,008 respondents aged 25-64 years. Outcome variables included self-reported short-term (<14 days) and register-based long-term (>14 days) sickness absence. Socioeconomic position (SEP) was measured by occupational class. Alcohol use was measured by average weekly volume and frequency of heavy episodic drinking. Negative binominal regression was used to estimate sex-specific SEP differences in sickness absence, before and after adjusting for alcohol use and the additional explanatory factors. Results: Adjusting for alcohol use attenuated the SEP differences in long-term sickness absence by 20% for men and 14% for women. Alcohol use explained a smaller proportion of the differences in short-term sickness absence. Alcohol use in combination with other lifestyle factors attenuated the SEP differences (20-35%) for both outcomes. Physical working conditions explained more than half of the gradient in long-term sickness absence, whereas psychosocial conditions had greater impact on short-term sickness absence among men. Discussion/Conclusion: Alcohol use explains a substantial proportion of the SEP disparities in long-term sickness absence among men. The effect is smaller among women and for short-term sickness absence. Our findings support the notion that physical working conditions constitute the key explanatory variable for SEP differences in long-term sickness absence, but add that psychosocial working conditions have greater impact on the gradient in short-term sickness absence among men.

The link between per capita alcohol consumption and alcohol‐related harm in educational groups

2020. Thor Norström, Jonas Landberg. Drug and Alcohol Review

Article

Introduction and Aims

Research based on individual‐level data suggests that the same amount of alcohol yields more harm in low‐socioeconomic status (SES) groups than in high‐SES groups. Little is known whether the effect of changes in population‐level alcohol consumption on harm rates differs by SES‐groups. The aim of this study was to elucidate this issue by estimating the association between per capita alcohol consumption and SES‐specific rates of alcohol‐related mortality.

Design and Methods

Per capita alcohol consumption was proxied by Systembolaget's alcohol sales (litres 100% alcohol per capita 15+). Quarterly data on mortality and alcohol consumption spanned the period 1991Q1‐2017Q4. We used two outcomes: (i) alcohol‐specific mortality (deaths with an explicit alcohol diagnosis); and (ii) violent deaths. SES was measured by education. We used three educational groups: (i) low (<10 years); (ii): intermediate (10–12 years); and (iii) high (13+ years). We applied error correction modelling to estimate the association between alcohol and alcohol‐specific mortality, and seasonal autoregressive integrated moving average‐modelling to estimate the association between alcohol and violent deaths.

Results

The estimated associations between per capita consumption and the two outcomes were positive and statistically significant in the two groups with low and intermediate education, but not in the high education group. There was a significant gradient in the level of association between alcohol consumption and alcohol‐related harm by educational group; the association was stronger the lower the educational group.

Discussion and Conclusions

Our findings suggest that the association between per capita consumption and alcohol‐related harm was stronger the lower the educational group.

The new suit of the Centre for Social Research on Alcohol and Drugs (SoRAD)

2020. Jessica Storbjörk, Jonas Landberg, Robin Room. Nordic Studies on Alcohol and Drugs

Article

This overview reviews the establishment and evolution of the Centre for Social Research on Alcohol and Drugs (SoRAD). It outlines its current organization and updated research direction, and discusses SoRAD’s future challenges and opportunities. SoRAD was established at Stockholm University to strengthen and support Swedish social science research on alcohol and drugs. It became active in 1999, and quickly grew in research efforts and reputation, while experiencing setbacks around 2006 and 2017. In 2018 SoRAD merged with the Centre for Health Equity Studies (CHESS), to form a new Department of Public Health Sciences. In its new suit, SoRAD acts as a research centre within the teaching department. The research activities on alcohol and other drugs and gambling behaviour and problems may be categorized into four main areas: Social epidemiology; Subcultures and social worlds of use and heavy use; Policy formation, implementation and societal responses; and Societal and other collective definitions of problems and solutions. The new arrangements, with an increased staff pool and close interplay with higher education, provides a more stable and long-term platform for achieving the main mission of promoting and developing social science research on addictive substances and behaviours and related problems.

Fathers’ alcohol use and suicidal behaviour in offspring during youth and young adulthood

2019. Jonas Landberg, Anna-Karin Danielsson, Tomas Hemmingsson. Acta Psychiatrica Scandinavica 140 (6), 563-573

Article

Objective

To examine the association between various indicators of father's alcohol use and suicidal behaviour in offspring during youth and young adulthood.

Methods

The study is based on a cohort of 68 910 Swedish citizens who were born between 1970 and 1985 and have fathers who participated in conscription for compulsory military training in 1969/70. Information on fathers’ alcohol use was collected during conscription. Offspring was followed for suicide attempts or completed suicides (through linkage with national registers) from age 12 to end of follow‐up in 2008.

Results

After adjustment for confounders, the hazard ratio (HR) for offspring to fathers who were heavy drinkers was 1.4 (95% CI 1.02, 1.93) while the associations turned non‐significant for offspring to fathers who often drank into intoxication, HR 1.14 (0.68, 1.90). The highest risk for suicidal behaviour was found for offspring to fathers who had been apprehended for drunkenness two times or more, or with an alcohol‐related hospitalization, with adjusted HRs of 2.1 (1.4, 3,14) and 1.9 (1.27, 2,85) respectively.

Conclusion

Fathers’ alcohol use is associated with increased risk of suicidal behaviour among offspring in youth and young adulthood.

Social Inequalities in Harmful Drinking and Alcohol-Related Problems Among Swedish Adolescents

2019. Siri Thor, Patrik Karlsson, Jonas Landberg. Alcohol and Alcoholism 54 (5), 532-539

Article

Aims

The study aims to examine how socio-economic status (SES) among youth is related to binge-drinking and alcohol-related problems using three SES indicators: (i) SES of origin (parental education level), (ii) SES of the school environment (average parental education level at student’s school) and (iii) SES of destination (academic orientation).

Methods

Cross-sectional data on upper secondary students (n= 4448) in Sweden. Multilevel logistic and negative binomial regression were used to estimate the relationship between each SES indicator and binge-drinking and alcohol-related problems, respectively.

Results

Only SES of destination was significantly associated with binge-drinking, with higher odds for students in vocational programmes (OR= 1.42, 95% CI= 1.13–1.80). For the second outcome, SES of destination (rr=1.25; 95%CI=1.08–1.45) and SES of the school environment (rr=1.19, 95% CI=1.02–1.39) indicated more alcohol-related problems in vocational programmes and in schools with lower-educated parents. After adjustment for drinking patterns, the relationship remained for SES of the school environment, but became non-significant for SES of destination.

Conclusion

Our results suggest that the SES gradient among youth is stronger for alcohol-related problems than for harmful drinking. By only focusing on SES differences in harmful alcohol use, researchers may underestimate the social inequalities in adverse alcohol-related outcomes among young people. Our findings also support the notion that the environment young people find themselves in matters for social inequalities in alcohol-related harm.

Fathers' Alcohol Consumption and Long-Term Risk for Mortality in Offspring

2018. Jonas Landberg (et al.). Alcohol and Alcoholism 53 (6), 753-759

Article

Aim: This study examined associations between fathers' alcohol consumption and risk for total and cause-specific mortality in offspring. Short summary: We examined the associations between fathers' alcohol consumption and total and cause-specific mortality in adult offspring. Fathers' alcohol consumption was associated with increased risk of alcohol-related mortality in offspring. The association appeared to be weaker for causes of death in which alcohol plays a smaller, or less direct, role. Methods: Data on fathers' alcohol consumption, and offspring's risky use of alcohol, smoking, mental health and contact with police/childcare authorities were collected among 46,284 men (sons) aged 18-20 years, during conscription for compulsory military training in 1969/70. Data on offspring mortality were obtained from the National Cause of Death register, 1971-2008. The mortality outcomes included total mortality, alcohol-related causes of death and violent causes of death (categorized into suicides vs violent/external causes excluding suicides). Results: Compared to sons whose fathers never used alcohol, the risk for total and alcohol-related mortality among sons increased with the father's consumption level. The risk of violent death was significantly elevated among sons whose fathers drank alcohol occasionally or often, but the risk of suicide increased in the highest consumption category only. After adjustment for covariates, the results remained for alcohol-related mortality whereas they were significantly attenuated, or disappeared, for total mortality, violent death and suicide. Conclusions: Fathers' alcohol consumption is associated with increased risk of alcohol-related mortality in the offspring. Alcohol use among fathers also increases the offspring's risk of later total mortality, suicide and violent death, but these associations appear to be mediated or confounded by factors related to parental drinking and/or adverse childhood psychosocial circumstances.

Self-reported alcohol consumption and the risk of alcohol-related problems

2012. Jonas Landberg. Alcoholism 36 (1), 113-118

Article

Background: Previous research has suggested a positive risk-relationship between volume of consumption and adverse behavioural and social consequences of drinking. However, because the risk-relationship may be modified by factors such as pattern of drinking, attributes of social drinking contexts and drunken comportment, the shape of the risk-function appear to be contingent upon the larger cultural context of drinking. Methods: In this paper I use graphical risk-curve analyses and model estimations to assess how the risk of experiencing alcohol-related problems is associated with self-reported volume of alcohol consumption in the three Baltic countries; Estonia, Latvia and Lithuania as well as Sweden and Italy. The rationale behind the choice of countries was to obtain a basis for comparing the risk curves for the Baltic countries with the risk-curves for two countries representing distinct types of the western European drinking cultures. The analyses utilised data from two general population surveys (including Sweden plus Italy and the Baltic countries, respectively) with approximately 1000 respondents from each country. Results: The slopes of the risk-curves for the Baltic countries were generally parallel to those of for Sweden, but significantly steeper than for Italy. This result suggests that (i) the risk for alcohol-related problems in the Baltic countries increases with volume of consumption in a way that is similar to northern Europe, and (ii) that increasing volume of consumption is associated with a considerably higher risk of experiencing alcohol-related problems in the Baltic countries (and Sweden) than in Italy. The result also suggests that increasing volume of consumption is associated with the risk of experiencing a larger number of different problems in the Baltic countries and Sweden than in Italy. Conclusions: The results were in line with the hypothesis of a European north to south gradient in the strength of the risk-relationship, but also add that the Baltic countries may be placed alongside the Nordic countries in this context. Since only volume of consumption is considered, the results cannot be used to specify which factors and mechanisms that actually modify the shape of the risk-function in each culture.

Alcohol and homicide in Russia and the United States – a comparative analysis

2011. Jonas Landberg, Thor Norström. Journal of Studies on Alcohol and Drugs 72 (5), 723-730

Article

Objective: The object of this study was to perform a comparative analysis of the aggregate relationship between alcohol and homicide in Russia and in the United States. The comparison was based on the magnitude of the alcohol effect, the alcohol attributable fraction (AAF), and the degree to which total consumption could account for trends in homicide. Method: We analyzed total and sex-specific homicide rates for the age groups 15-64 years, 15-34 years, and 35-64 years. The study period was 1959-1998 for Russia and 1950-2002 for the United States. For the United States, alcohol consumption was gauged by sales of alcohol; for Russia, estimated unrecorded consumption was included as well. The data were analyzed through autoregressive integrated moving average (ARIMA) modeling. Results: The results show that, for Russia as well as for the United States, a 1-L increase in consumption was associated with an increase in homicides of about 10%, although the absolute effect was markedly larger in Russia because of differences in homicide rates. The AAF estimates suggested that 73% and 57% of the homicides would be attributable to alcohol in Russia and in the United States, respectively. Most of the temporal variation in the Russian homicide rate could be accounted for by the trend in drinking, whereas the U.S. trend in total alcohol consumption had a more limited ability to predict the trend in homicides. Conclusions: We conclude that the role of alcohol in homicide seems to be larger in Russia than in the United States.

Jonas LandbergStudy Director/Lecturer

Research projects

Publications

The Contribution of Alcohol Use, Other Lifestyle Factors and Working Conditions to Socioeconomic Differences in Sickness Absence

The link between per capita alcohol consumption and alcohol‐related harm in educational groups

The new suit of the Centre for Social Research on Alcohol and Drugs (SoRAD)

Fathers’ alcohol use and suicidal behaviour in offspring during youth and young adulthood

Social Inequalities in Harmful Drinking and Alcohol-Related Problems Among Swedish Adolescents

Fathers' Alcohol Consumption and Long-Term Risk for Mortality in Offspring

Self-reported alcohol consumption and the risk of alcohol-related problems

Alcohol and homicide in Russia and the United States – a comparative analysis