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Income inequality and alcohol attributable harm in Australia

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dc.contributor.author Dietze, Paul M.
dc.contributor.author Jolley, Damien J.
dc.contributor.author Chikritzhs, Tanya N.
dc.contributor.author Clemens, Susan
dc.contributor.author Catalano, Paul
dc.contributor.author Stockwell, Tim
dc.date.accessioned 2014-05-13T21:28:09Z
dc.date.available 2014-05-13T21:28:09Z
dc.date.copyright 2009 en_US
dc.date.issued 2009-02-25
dc.identifier.citation Dietze et al. Income inequality and alcohol attributable harm in Australia. BMC Public Health 2009 9:70 en_US
dc.identifier.uri http://www.biomedcentral.com/1471-2458/9/70
dc.identifier.uri http://dx.doi.org/10.1186/1471-2458-9-70
dc.identifier.uri http://hdl.handle.net/1828/5406
dc.description BioMed Central en_US
dc.description.abstract Background: There is little research on the relationship between key socioeconomic variables and alcohol related harms in Australia. The aim of this research was to examine the relationship between income inequality and the rates of alcohol-attributable hospitalisation and death at a local-area level in Australia. Method: We conducted a cross sectional ecological analysis at a Local Government Area (LGA) level of associations between data on alcohol caused harms and income inequality data after adjusting for socioeconomic disadvantage and remoteness of LGAs. The main outcome measures used were matched rate ratios for four measures of alcohol caused harm; acute (primarily related to the short term consequences of drinking) and chronic (primarily related to the long term consequences of drinking) alcohol-attributable hospitalisation and acute and chronic alcohol-attributable death. Matching was undertaken using control conditions (non-alcohol-attributable) at an LGA level. Results: A total of 885 alcohol-attributable deaths and 19467 alcohol-attributable hospitalisations across all LGAs were available for analysis. After weighting by the total number of cases in each LGA, the matched rate ratios of acute and chronic alcohol-attributable hospitalisation and chronic alcohol-attributable death were associated with the squared centred Gini coefficients of LGAs. This relationship was evident after adjusting for socioeconomic disadvantage and remoteness of LGAs. For both measures of hospitalisation the relationship was curvilinear; increases in income inequality were initially associated with declining rates of hospitalisation followed by large increases as the Gini coefficient increased beyond 0.15. The pattern for chronic alcohol-attributable death was similar, but without the initial decrease. There was no association between income inequality and acute alcoholattributable death, probably due to the relatively small number of these types of death. Conclusion: We found a curvilinear relationship between income inequality and the rates of some types of alcohol-attributable hospitalisation and death at a local area level in Australia. While alcohol-attributable harms generally increased with increasing income inequality, alcohol-attributable hospitalisations actually showed the reverse relationship at low levels of income inequality. The curvilinear patterns we observed are inconsistent with monotonic trends found in previous research making our findings incompatible with previous explanations of the relationship between income inequality and health related harms. en_US
dc.description.sponsorship This research was funded by the Alcohol Education and Rehabilitation Foundation. The first author is in receipt of a Career Development Award from the National Health and Medical Research Council. en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.title Income inequality and alcohol attributable harm in Australia en_US
dc.type Article en_US
dc.description.scholarlevel Faculty en_US
dc.description.reviewstatus Reviewed en_US


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