Medical net cost of low alcohol consumption - a cause to reconsider improved health as the link between alcohol and wage?

<p>Abstract</p> <p>Background</p> <p>Studies have found a positive effect of low/moderate alcohol consumption on wages. This has often been explained by referring to epidemiological research showing that alcohol has protective effects on certain diseases, i.e., the health link is normally justified using selected epidemiological information. Few papers have tested this link between alcohol and health explicitly, including all diseases where alcohol has been shown to have either a protective or a detrimental effect.</p> <p>Aim</p> <p>Based on the full epidemiological information, we study the effect of low alcohol consumption on health, in order to determine if it is reasonable to explain the positive effect of low consumption on wages using the epidemiological literature.</p> <p>Methods</p> <p>We apply a non-econometrical cost-of-illness approach to calculate the medical care cost and episodes attributable to low alcohol consumption.</p> <p>Results</p> <p>Low alcohol consumption carries a net cost for medical care and there is a net benefit only for the oldest age group (80+). Low alcohol consumption also causes more episodes in medical care then what is saved, although inpatient care for women and older men show savings.</p> <p>Conclusion</p> <p>Using health as an explanation in the alcohol-wage literature appears invalid when applying the full epidemiological information instead of selected information.</p

Measuring harm from drinking in Sweden : Self-reports from drinkers in the general population

There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data. Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002. It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed

Measuring harm from drinking in Sweden : Self-reports from drinkers in the general population

There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data. Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002. It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed

Informal social control of drinking in intimate relationships - A comparative analysis

A number of studies have shown that pressure from others is an important element in decision making concerning entering treatment and that the pressure most often comes from one's partner. Is has also been found that, besides actual drinking habits, togetherness of drinking, i.e., proportion of drinking occasions spent together with partner, is reversely connected to pressure from partner to drink less. This article examines these relationships in a comparative perspective, using GENACIS survey data from 16 countries. The results confirmed that on both individual and aggregated level, there is a relationship between drinking and pressure from partner. There is more pressure reported in “dry” cultures and heavy drinking individuals are more often the object than others—in all cultures studied. In only a few countries with rather a different drinking culture, drinking together prevents the pressure, also when controlled for actual consumption. Except for Uganda and UK, men are generally more exposed to pressure to drink less exerted by their female partners and this cannot only be explained by the fact that they actually drink more. </jats:p