Dramatic increase in alcoholic liver cirrhosis mortality in Estonia in 1992-2008.
OBJECTIVE
The aim of the study was to describe trends in alcoholic liver cirrhosis mortality rates in 1992-2008 and to examine socio-demographic differences in alcoholic liver cirrhosis mortality.


METHODS
Individual records of deaths from alcoholic liver cirrhosis among 25-64-year olds in 1992-2008 in Estonia were analysed. Age-standardized mortality rates for men and women aged 25-44 and 45-64 were calculated. Association between alcoholic liver cirrhosis mortality and socio-demographic variables (age, education and ethnicity) for the data of the years around the census in 2000 was measured by mortality rate ratios using Poisson regression models.


RESULTS
In 1992-2008, alcoholic liver cirrhosis mortality rates were higher among men than that in women and that in the older than in the younger age group. Over the whole study period, mortality from alcoholic liver cirrhosis increased steeply. The increase was sharper among men and women in the older age group. In 1998-2001, higher alcoholic liver cirrhosis mortality rates occurred in non-Estonians and those with lower levels of education.


CONCLUSIONS
Alcoholic liver cirrhosis mortality has increased steadily in Estonia, and is reflected in an increase in heavy drinking. National alcohol policies should address all strata of society. However, in order to reduce alcohol-related damage in the population most effectively, special attention should be paid to non-Estonians and people with low levels of education.
Pärna
Kersti
K
Department of Public Health, University of Tartu, Ravila 19, Tartu, Estonia. kersti.parna@ut.ee
Rahu
Kaja
K
D000328:Adult; D000437:Alcoholism / Q000209:etiology* / Q000401:mortality*; D004957:Estonia / Q000208:ethnology; D005006:Ethnicity / Q000208:ethnology; D005260:Female; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D008104:Liver Cirrhosis, Alcoholic / Q000208:ethnology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends