Area of residence and alcohol-related mortality risk: a five-year follow-up study.
OBJECTIVE
To examine differences in alcohol-related mortality risk between areas, while adjusting for the characteristics of the individuals living within these areas.


METHODS
A 5-year longitudinal study of individual and area characteristics of those dying and not dying from alcohol-related deaths.


METHODS
The Northern Ireland Mortality study.


METHODS
A total of 720,627 people aged 25-74, enumerated in the Northern Ireland 2001 Census, not living in communal establishments.


METHODS
Five hundred and seventy-eight alcohol-related deaths.


RESULTS
There was an increased risk of alcohol-related mortality among disadvantaged individuals, and divorced, widowed and separated males. The risk of an alcohol-related death was significantly higher in deprived areas for both males [hazard ratio (HR) 3.70; 95% confidence interval (CI) 2.65, 5.18] and females (HR 2.67 (95% CI 1.72, 4.15); however, once adjustment was made for the characteristics of the individuals living within areas, the excess risk for more deprived areas disappeared. Both males and females in rural areas had a reduced risk of an alcohol-related death compared to their counterparts in urban areas; these differences remained after adjustment for the composition of the people within these areas.


CONCLUSIONS
Alcohol-related mortality is higher in more deprived, compared to more affluent areas; however, this appears to be due to characteristics of individuals within deprived areas, rather than to some independent effect of area deprivation per se. Risk of alcohol-related mortality is lower in rural than urban areas, but the cause is unknown.
Connolly
Sheelah
S
Centre for Public Health, Queen's University Belfast, Belfast, UK. sheelah.connolly@qub.ac.uk
O'Reilly
Dermot
D
Rosato
Michael
M
Cardwell
Chris
C
D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000401:mortality*; D001336:Automobiles / Q000706:statistics & numerical data; D019352:Censuses; D004812:Epidemiologic Methods; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland / Q000453:epidemiology; D011204:Poverty Areas; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012423:Rural Health; D012923:Social Class; D014504:Urban Health