Finland is the only country in which detailed studies have been conducted. Studies of trends in inequalities in alcohol-related mortality are even scarcer. Investigating whether there are differences is important because such differences might provide useful insights into the explanation of these inequalities, and into the potential for reducing them. Comparative studies are, however, lacking, and it is therefore unknown whether there are important differences between countries in the magnitude of socioeconomic inequalities in alcohol-related mortality. Recent literature reviews have shown that mortality from alcohol-related conditions is higher in lower socioeconomic groups in most of the available studies, including studies from Finland, Sweden, the United Kingdom, and Estonia. In many European countries, the frequency of drinking and sometimes also the levels of consumption are higher in higher socioeconomic groups, whereas problematic forms of consumption, like binge drinking, and alcohol-related health and social problems, are more frequent in lower socioeconomic groups. Like many other health-related behaviors, alcohol consumption is strongly patterned by socioeconomic status, as indicated by level of education, occupational class, and income. Mortality from these conditions has been rising in many European countries. This has been attributed to the culture of binge drinking, characterized by non-daily drinking and frequent intoxication, in Northern Europe, which is also common in Eastern Europe. Within Europe, mortality from alcoholic psychosis, alcohol poisoning, and alcohol dependence appears to have a geographical pattern different from that of mortality from liver cirrhosis, with relatively high rates of the former in the Nordic countries. Patterns and trends of mortality from other alcohol-related conditions have been studied less often. By contrast, mortality from liver cirrhosis has increased in Central and Eastern Europe, in Finland, and in the United Kingdom. Mortality from liver cirrhosis used to be high in Southern Europe, too, but since the 1970s and 1980s it has declined substantially in France, Italy, Spain, Greece, and other Mediterranean countries. Liver cirrhosis mortality is high in Europe, particularly in Central and Eastern European countries. Acute intoxication is a risk factor for injuries, both accidental and non-accidental, and for cardiovascular disease, whereas chronic heavy drinking is a risk factor for liver cirrhosis, various forms of cancer, and cardiovascular disease.

In some of these countries, alcohol-related causes now account for 10% or more of the socioeconomic inequality in total mortality.Д«ecause our study relies on routinely collected underlying causes of death, it is likely that our results underestimate the true extent of the problem.ДЄlcohol consumption, particularly in higher doses, is a risk factor for many fatal and nonfatal health problems.

Over time, the relative inequality in alcohol-related mortality has increased in many countries, but the main change is a strong rise of absolute inequality in several countries in Eastern Europe (Hungary, Lithuania, Estonia) and Northern Europe (Finland, Denmark) because of a rapid rise in alcohol-related mortality in lower socioeconomic groups. For example, for educational inequality among Finnish men, the relative index of inequality is 3.6 (95% CI 3.3вЂ“4.0) and the slope index of inequality is 112.5 (95% CI 106.2вЂ“118.8) deaths per 100,000 person-years. Both relative and absolute inequalities are largest in Eastern Europe, and Finland and Denmark also have very large absolute inequalities in alcohol-related mortality. Rates of alcohol-related mortality are higher in lower educational and occupational groups in all countries. Mortality was age-standardized using the European Standard Population, and measures for both relative and absolute inequality between low and high socioeconomic groups (as measured by educational level and occupational class) were calculated.

We collected and harmonized data on mortality from four alcohol-related causes (alcoholic psychosis, dependence, and abuse alcoholic cardiomyopathy alcoholic liver cirrhosis and accidental poisoning by alcohol) by age, sex, education level, and occupational class in 20 European populations from 17 different countries, both for a recent period and for previous points in time, using data from mortality registers.

The omnipresence of death o.68