Alcohol death rate greater for women and men in routine jobs

Men whose jobs are classified as ‘routine’, such as van drivers and labourers, face 3.5 times the risk of dying from an alcohol-related disease than those in higher managerial and professional jobs.

Women in ‘routine’ jobs, such as cleaners and sewing machinists, face 5.7 times the chance of dying from an alcohol-related disease than women in higher professional jobs such as doctors and lawyers.

These are two of the conclusions contained in a new report published by the Office for National Statistics (ONS). It is the first analysis of the social inequalities in adult alcohol-related mortality in England and Wales at the start of the 21st century as measured by the National Statistics Socio-economic Classification (NS-SEC).

The analysis highlighted the fact that the number of alcohol-related deaths in England and Wales doubled between 1991 and 2008, rising from 3,415 (6.4 per 100,000 population) in 1991 to 7,344 (12.4 per 100,000) in 2008. However, the most recent data in 2009 indicated a drop in alcohol-related deaths of 3.3%, to 7,099.

The focus of the current analysis was social inequality in alcohol-related mortality. Mortality rates from alcohol-related causes were consistently higher for men than women across all the NS-SEC analysis classes in England and Wales.

The highest mortality rate of all classes occurred in routine workers, for men at age 50-54, 52.2 per 100,000, and for women at age 45-49, 42.0 per 100,000.

For the less advantaged groups, alcohol-related mortality peaked in middle age and then declined, whereas for managers and professionals, the risk of mortality increased steadily with age. This means that alcohol-related deaths in the less advantaged groups tend to occur younger as well as being more common.

Region

The highest mortality rate for men in all occupied classes combined was found in the North West of England (26.9 per 100,000) followed by the North East (23.7), the West Midlands (23.6) and London (21.3). These regions all had significantly higher mortality rates for all occupied classes combined than England and Wales as a whole, where the figure was 19.0 per 100,000. The lowest mortality rate for all occupied classes combined occurred in the East of England (12.4 per 100,000), half of that seen in the North West. The second lowest was the South West (15.2) followed by the East Midlands and the South East, both 15.5 per 100,000. Similar regional patterns were observed for women, but with lower overall death rates.

Previous survey results have suggested that less advantaged social groups drink less in total than the more advantaged groups. Therefore the explanation for these inequalities is not a simple one, and may be associated with differences in the detailed patterns of drinking among different groups or with the influence of underlying factors other than alcohol consumption.

Alcohol-related deaths include only those causes defined as being most directly due to alcohol consumption, including alcoholic liver disease (accounting for approximately two-thirds of all alcohol-related deaths), fibrosis and cirrhosis of the liver, (accounting for about 18% of deaths), mental disorders due to the use of alcohol (about 9% of deaths) and accidental alcohol poisoning (about 3%). It does not include other diseases where alcohol has been shown to contribute to the risk of death, such as cancers of the mouth, oesophagus and liver. It also excludes deaths from accidents and violence where alcohol may have played a part.

Social inequalities in alcohol-related adult mortality by National Statistics Socio-economic Classification, England and Wales, 2001-03 - Statistical Bulletin

The article, which can be found in ‘Health Statistics Quarterly 50’ at http:// www.statistics.gov.uk/hsq/hsqissue/, gives the first detailed breakdown of alcoholrelated deaths by NS-SEC, age, gender and region and underlines the fact that people from less advantaged sections of society in England and Wales are disproportionately dying from alcohol-related causes at earlier ages.