Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality

Abstract Introduction Lower socioeconomic status (SES) has been shown to be associated with an increased risk of all-cause mortality, including alcohol-related mortality. The aim of this study was to investigate the association of different SES factors with deaths directly attributable to alcohol (DAA) compared to deaths from other causes. Methods The analysis included all deceased residents of Slovenia in the period 2013-2023 aged from 30 to 69 years at the time of death. A multivariate regression model was used to calculate odds ratios to investigate the association of education, employment status, marital status, and occupation with DAA deaths compared to deaths from other causes. Results The entire sample consisted of 61,160 persons, of whom 6,598 died from causes DAA and 54,562 died from other causes. Men are 2.2 times more likely than women to have died from causes DAA (p < 0.001). Deceased with primary and secondary level of education are 1.6 and 1,5 times more likely to have died from causes DAA compared to those who had high education (p < 0.001), respectively. The unemployed who were previously employed have a 2.4-fold higher chance of dying from causes DAA, the unemployed who are looking for their first job and farmers have a 2-fold higher chance, and retirees have a 1.3-fold higher chance of dying from causes DAA, compared to the employed (all p < 0.001). Statistically significant differences are also observed in terms of marital status (all p < 0.001). The divorced and widowed have a 1.7-fold higher chance of dying from causes DAA, compared to the married, and the single ones have a 1.5-fold higher chance. We also confirmed that occupation is significantly associated with alcohol-related deaths. Farmers, foresters and fishermen stand out the most, with a 3.8 times higher chance of dying from DAA causes than professionals (p < 0.001). Conclusions Strengthening the implementation of targeted interventions among identified groups and individuals is recommended. Key messages • Alcohol use causes disproportionately greater harm to health in individuals with lower SES. • To achieve better health outcomes, policies that reduce inequalities should be the basis of health policies.