title: Small area associations between social context and alcohol-attributable mortality in a middle income country.
abstract: BACKGROUND
  Little is known about the association between alcohol-attributable mortality and small area socioeconomic variables when considering causes both wholly and partially attributable to alcohol.
  
  
  METHODS
  An ecological study was conducted of the entire Chilean population aged 15 and older in 345 municipalities nationwide between 2004 and 2009. Deaths were attributed to alcohol consumption either wholly or partially, along with the estimated attributable fractions for each specified cause. Each municipality was characterized according to its average income and educational attainment. Estimates of the ecological associations were produced using a hierarchical Bayesian model, separating out deaths caused by alcohol and dividing them into seven groups of causes.
  
  
  RESULTS
  Alcohol-attributable mortality risk showed an inverse association with income and education at the ecological level. A one-quintile increase in income was associated with an average decrease in risk of 10% (CI 95%: 10-20%) for cardiovascular deaths, 8% (6-10%) for intentional injuries and 7% (3-11%) for unintentional injuries. No associations were found between deaths due to cancers and other causes with income and education.
  
  
  CONCLUSIONS
  Municipalities with lower income and education have higher risk of alcohol-attributable mortality in Chile.
authors.affiliation: Doctoral Program in Public Health, University of Chile, Av. Independencia 939, Santiago, Chile; Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Agustinas 1235, Santiago, Chile. Electronic address: alvacasti@gmail.com.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Castillo-Carniglia
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, Quebec, Canada.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: Epidemiology Division, Salvador Allende School of Public Health, University of Chile, Av. Independencia 939, Santiago, Chile.
authors.forename: Paulina
authors.initials: P
authors.lastname: Pino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000191:economics* / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D002677:Chile / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Alcohol; Bayesian hierarchical models; Education; Income; Mortality