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Alcohol-Related Problems in Eastern Europe: A Comparative Perspective
Stockholm University, Faculty of Social Sciences, Department of Sociology.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates the association between alcohol consumption and alcohol-related harm in Eastern Europe. The main aim was to estimate to what extent changes in per capita alcohol consumption have an impact on different forms of alcohol-related mortality, and to put the results in an international comparative perspective. The thesis includes four papers; the first two papers use aggregate time-series analysis to assess how changes in per capita consumption affect rates in suicide mortality and fatal non-intentional injuries in several Eastern European countries, respectively. The third paper applies the same methodological approach to analyse the population-level relationship between alcohol and homicide in Russia and the U.S.. The fourth paper employs survey data to assess how the risk of experiencing alcohol-related problems in relation to volume of consumption in the Baltic countries compares to Sweden and Italy. The results of the first three papers suggests: (i) that changes in per capita consumption are significantly related to changes in mortality rates of suicide, non-intentional injuries and homicide in the countries under study; (ii) that the relationship is stronger for men than for women, and (iii) that the relationship tends to be stronger in the countries with more detrimental drinking patterns, e.g. Russia. The results of the fourth paper suggest that the risk of experiencing alcohol-related problems in relation to level of drinking in the Baltic countries is similar to the corresponding risk in Sweden, but considerably stronger than in Italy. In conclusion, the findings support the significance of a public health approach to alcohol-related problems in Eastern Europe, i.e., policy measures directed towards total alcohol consumption. In addition, strategies aimed at reducing the occurrence of binge drinking seem to have great potential for reducing alcohol-related harm and mortality in Eastern European countries.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University , 2010. , 46 p.
Series
Centre for Social Research on Alcohol and Drugs, ISSN 1650-819X ; 10
Keyword [en]
Eastern Europe, alcohol consumption, alcohol-related harm, time-series analysis
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-44215ISBN: 978-91-7447-177-9 (print)OAI: oai:DiVA.org:su-44215DiVA: diva2:360384
Public defence
2010-12-10, Nordenskiöldsalen, Geovetenskapens hus, Svante Arrhenius väg 12, Stockholm, 10:00 (English)
Opponent
Supervisors
Projects
Alcohol in Eastern Europe - a Public Health Perspective
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Manuscript. Paper 4: Manuscript.

Available from: 2010-11-18 Created: 2010-11-03 Last updated: 2016-08-25Bibliographically approved
List of papers
1. Alcohol and suicide in Eastern Europe
Open this publication in new window or tab >>Alcohol and suicide in Eastern Europe
2008 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 27, no 4, 361-373 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION AND AIMS: The aim of this paper was to estimate how suicide rates in seven eastern European countries are affected by changes in population drinking and to put the results into a comparative perspective. DESIGN AND METHODS: The analysis included data on annual suicide mortality rates and per capita consumption for the post-war period from: Russia, Belarus, Poland, Hungary, Bulgaria, the former Czechoslovakia and the former German Democratic Republic (GDR). Overall and gender-specific models were estimated using the Box-Jenkins technique for time-series analysis. The estimates were pooled into two groups, i.e. spirits countries (Russia, Belarus and Poland) and non-spirits countries (Hungary, Bulgaria, former Czechoslovakia and former GDR). RESULTS: All countries obtained positive alcohol effect estimates. The effects on the overall population were largest in the spirits countries, where a 1-litre increase in per capita consumption was associated with an increase in overall suicide rates of 5.7-7.5%. The effects were somewhat smaller in the non-spirits countries, 2.7-4.7%. The estimates for males were larger, but showed the same national variations as the overall population estimates. The female estimates were generally smaller than for men and did not differ between the two country groups. DISCUSSION AND CONCLUSIONS: The results suggest that per capita consumption matters for suicide mortality in these eastern European countries, but that the strength of the relationship is contingent upon the drinking culture, so that it tends to be stronger in countries with detrimental drinking patterns.

Keyword
Per capita alcohol consumption, suicide, time series analyses
National Category
Sociology
Identifiers
urn:nbn:se:su:diva-18424 (URN)10.1080/09595230802093778 (DOI)000257147500009 ()
Available from: 2009-01-26 Created: 2009-01-26 Last updated: 2010-11-03Bibliographically approved
2. Population drinking and fatal injuries in Eastern Europe: A time-series analysis of six countries
Open this publication in new window or tab >>Population drinking and fatal injuries in Eastern Europe: A time-series analysis of six countries
2010 (English)In: European Addiction Research, ISSN 1022-6877, E-ISSN 1421-9891, Vol. 16, no 1, 43-52 p.Article in journal (Refereed) Published
Abstract [en]

Aims: To estimate to what extent injury mortality rates in 6 Eastern European countries are affected by changes in population drinking during the post-war period. Data and Methods: The analysis included injury mortality rates and per capita alcohol consumption in Russia, Belarus, Poland, Hungary, Bulgaria and the former Czechoslovakia. Total population and gender-specific models were estimated using auto regressive integrated moving average time-series modelling. Results: The estimates for the total population were generally positive and significant. For Russia and Belarus, a 1-litre increase in per capita consumption was associated with an increase in injury mortality of 7.5 and 5.5 per 100,000 inhabitants, respectively. The estimates for the remaining countries ranged between 1.4 and 2.0. The gender-specific estimates displayed national variations similar to the total population estimates although the estimates for males were higher than for females in all countries. Conclusions: The results suggest that changes in per capita consumption have a significant impact on injury mortality in these countries, but the strength of the association tends to be stronger in countries where intoxication-oriented drinking is more common.

Keyword
Alcohol consumption, Central and Eastern Europe, Drinking patterns
National Category
Sociology
Identifiers
urn:nbn:se:su:diva-33800 (URN)10.1159/000264616 (DOI)000272893700006 ()
Projects
Alcohol in Eastern Europe: a public health perspective
Available from: 2009-12-29 Created: 2009-12-29 Last updated: 2011-11-23Bibliographically approved
3. Alcohol and homicide in Russia and the United States – a comparative analysis
Open this publication in new window or tab >>Alcohol and homicide in Russia and the United States – a comparative analysis
2011 (English)In: Journal of Studies on Alcohol and Drugs, ISSN 1937-1888, E-ISSN 1938-4114, Vol. 72, no 5, 723-730 p.Article in journal (Refereed) Published
Abstract [en]

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.

National Category
Sociology
Identifiers
urn:nbn:se:su:diva-62677 (URN)000295562500004 ()
Available from: 2011-09-27 Created: 2011-09-27 Last updated: 2017-12-08Bibliographically approved
4. Self-reported alcohol consumption and the risk of alcohol-related problems: A comparative risk-curve analysis of the three Baltic countries, Sweden and Italy
Open this publication in new window or tab >>Self-reported alcohol consumption and the risk of alcohol-related problems: A comparative risk-curve analysis of the three Baltic countries, Sweden and Italy
2012 (English)In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 36, no 1, 113-118 p.Article in journal (Refereed) Published
Abstract [en]

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.

Keyword
Self-reported volume of consumption, alcohol-related problems, graphical risk-curve analyses, the Baltic countries
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-58301 (URN)10.1111/j.1530-0277.2011.01597.x (DOI)000298730200014 ()
External cooperation:
Projects
Alcohol in Eastern Europe - A public health perspective
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2011-05-30 Created: 2011-05-30 Last updated: 2017-12-11Bibliographically approved

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