Contribution of deaths related to alcohol use to socioeconomic variation in mortality: register based follow up study

BMJ 1997; 315 doi: (Published 26 July 1997) Cite this as: BMJ 1997;315:211
  1. Pia Mäkelä (pia.makela{at}, researchera,
  2. Tapani Valkonen, professora,
  3. Tuija Martelin, researchera
  1. a Population Research Unit, Department of Sociology, PO Box 18, 00014 University of Helsinki, Finland
  1. Correspondence to: Ms Mäkelä
  • Accepted 25 April 1997


Objective: To estimate the contribution of excessive alcohol use to socioeconomic variation in mortality among men and women in Finland.

Design: Register based follow up study.

Subjects: The population covered by the 1985 and 1990 censuses, aged ≥20 in the follow up period 1987-93.

Main outcome measures: Total mortality and alcohol related mortality from all causes, from diseases, and from accidents and violence according to socioeconomic position. The excess mortality among other classes compared with upper non-manual employees and differences in life expectancy between the classes were used to measure mortality differentials.

Results: Alcohol related mortality constituted 11% of all mortality among men aged ≥20 and 2% among women and was higher among manual workers than among other classes. It accounted for 14% of the excess all cause mortality among manual workers over upper non-manual employees among men and 4% among women and for 24% and 9% of the differences in life expectancy, respectively. Half of the excess mortality from accidents and violence among male manual workers and 38% among female manual workers was accounted for by alcohol related deaths, whereas in diseases the role of alcohol was modest. The contribution of alcohol related deaths to relative mortality differentials weakened with age.

Conclusions: Class differentials in alcohol related mortality are an important factor in the socioeconomic mortality differentials in Finland, especially among men, among younger age groups, and in mortality from accidents and violence.

Key messages

  • Alcohol related deaths constituted 11% of all deaths in Finland among men aged 20 and above and 2% among women; the corresponding proportions were much larger for accidental and violent deaths and smaller for deaths from diseases

  • Relative socioeconomic differentials were much larger in alcohol related mortality than in overall mortality, the largest rates being among manual workers

  • Alcohol related mortality accounted for 14% of the mortality differentials between manual workers and upper non-manual employees among men, 4% among women, and 24% and 9% of the differentials in life expectancy, respectively

  • The role of alcohol in the socioeconomic differentials was modest in deaths from diseases but substantial in accidental and violent deaths—for example, one half of the difference between upper non-manual employees and manual workers in accidental and violent mortality could be attributed to alcohol related deaths

  • The impact of alcohol on relative socioeconomic mortality differentials increased with decreasing age


    • Accepted 25 April 1997
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