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Individual- and area-level characteristics associated with alcohol-related mortality among adult Lithuanian males: A multilevel analysis based on census-linked data

Author

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  • Pavel Grigoriev
  • Domantas Jasilionis
  • Daumantas Stumbrys
  • Vladislava Stankūnienė
  • Vladimir M Shkolnikov
Abstract
Background: Although excessive alcohol-related mortality in the post-Soviet countries remains the major public health threat, determinants of this phenomenon are still poorly understood. Aims: We assess simultaneously individual- and area-level factors associated with an elevated risk of alcohol-related mortality among Lithuanian males aged 30–64. Methods: Our analysis is based on a census-linked dataset containing information on individual- and area-level characteristics and death events which occurred between March 1st, 2011 and December 31st, 2013. We limit the analysis to a few causes of death which are directly linked to excessive alcohol consumption: accidental poisonings by alcohol (X45) and liver cirrhosis (K70 and K74). Multilevel Poisson regression models with random intercepts are applied to estimate mortality rate ratios (MRR). Results: The selected individual-level characteristics are important predictors of alcohol-related mortality, whereas area-level variables show much less pronounced or insignificant effects. Compared to married men, never married (MRR = 1.9, CI:1.6–2.2), divorced (MRR = 2.6, CI:2.3–2.9), and widowed (MRR = 2.4, CI: 1.8–3.1) men are disadvantaged groups. Men who have the lowest level of educational attainment have the highest mortality risk (MRR = 1.7 CI:1.4–2.1). Being unemployed is associated with a five-fold risk of alcohol-related death (MRR = 5.1, CI: 4.4–5.9), even after adjusting for all other individual variables. Lithuanian males have an advantage over Russian (MRR = 1.3, CI:1.1–1.6) and Polish (MRR = 1.8, CI: 1.5–2.2) males. After adjusting for all individual characteristics, only two out of seven area-level variables—i.e., the share of ethnic minorities in the population and the election turnout—have statistically significant direct associations. These variables contribute to a higher risk of alcohol-related mortality at the individual level. Conclusions: The huge and increasing socio-economic disparities in alcohol-related mortality indicate that recently implemented anti-alcohol measures in Lithuania should be reinforced by specific measures targeting the most disadvantaged population groups and geographical areas.

Suggested Citation

  • Pavel Grigoriev & Domantas Jasilionis & Daumantas Stumbrys & Vladislava Stankūnienė & Vladimir M Shkolnikov, 2017. "Individual- and area-level characteristics associated with alcohol-related mortality among adult Lithuanian males: A multilevel analysis based on census-linked data," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-14, July.
    • Handle: RePEc:plo:pone00:0181622
    DOI: 10.1371/journal.pone.0181622
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    References listed on IDEAS

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    1. Elizabeth Brainerd & David M. Cutler, 2005. "Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union," Journal of Economic Perspectives, American Economic Association, vol. 19(1), pages 107-130, Winter.
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    3. Shkolnikov, Vladimir M. & Jasilionis, Domantas & Andreev, Evgeny M. & Jdanov, Dmitri A. & Stankuniene, Vladislava & Ambrozaitiene, Dalia, 2007. "Linked versus unlinked estimates of mortality and length of life by education and marital status: Evidence from the first record linkage study in Lithuania," Social Science & Medicine, Elsevier, vol. 64(7), pages 1392-1406, April.
    4. Blomgren, Jenni & Martikainen, Pekka & Mäkelä, Pia & Valkonen, Tapani, 2004. "The effects of regional characteristics on alcohol-related mortality--a register-based multilevel analysis of 1.1 million men," Social Science & Medicine, Elsevier, vol. 58(12), pages 2523-2535, June.
    5. Mackenbach, Johan P. & Kulhánová, Ivana & Bopp, Matthias & Deboosere, Patrick & Eikemo, Terje A. & Hoffmann, Rasmus & Kulik, Margarete C. & Leinsalu, Mall & Martikainen, Pekka & Menvielle, Gwenn & Reg, 2015. "Variations in the relation between education and cause-specific mortality in 19 European populations: A test of the “fundamental causes” theory of social inequalities in health," Social Science & Medicine, Elsevier, vol. 127(C), pages 51-62.
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    1. Olga Navickienė & Asta Valackienė & Renata Činčikaitė & Ieva Meidute-Kavaliauskiene, 2023. "A Theoretical Model of the Development of Public Citizenship in a Sustainable Environment: Case of Lithuania," Sustainability, MDPI, vol. 15(4), pages 1-15, February.
    2. Renata Činčikaitė & Ieva Meidute-Kavaliauskiene, 2021. "Assessment of Social Environment Competitiveness in Terms of Security in the Baltic Capitals," Sustainability, MDPI, vol. 13(12), pages 1-19, June.
    3. Olga Navickienė & Ieva Meidutė-Kavaliauskienė & Renata Činčikaitė & Mangirdas Morkūnas & Asta Valackienė, 2023. "Modernisation of a Country in the Context of Social Environmental Sustainability: Example of Lithuania," Sustainability, MDPI, vol. 15(4), pages 1-18, February.

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