The effect of sample attrition in the EU Statistics on Income and Living Conditions on the estimates of Eurostat's Healthy Life Years.

Eurostat's official Healthy Life Years (HLY) estimates are based on European Union Statistics on Income and Living Conditions (EU-SILC) cross-sectional data. As EU-SILC has a rotational sample design, the largest part of the samples are longitudinal, health-related attrition constituting a potential source of bias of these estimates. Bland-Altman plots assessing the agreement between pairs of HLY based on total and new rotational, representative samples demonstrated no significant, systematic attrition-related bias. However, the wide limits of agreement indicate considerable uncertainty, larger than accounted for in the confidence intervals of HLY estimates.

Alcohol-related mortality in four European countries: A multiple-cause-of-death study.

INTRODUCTION: The impact of conditions that partly or indirectly contribute to drinking-related mortality is usually underestimated. We investigate all alcohol-related multiple (underlying and contributory) causes of death and compare mortality distributions in countries with different levels and patterns of drinking. METHOD: Analysis of population-level mortality data for persons aged 20 and over in Austria, Czechia, Poland and Spain. Age-standardised death rates and standardised ratios of multiple to underlying cause were calculated for alcohol-related causes of death. RESULTS: Multiple-cause mortality ranged from 20 to 58 deaths per 100,000 for men and from 5 to 16 per 100,000 for women. Liver diseases were the most common underlying and multiple causes, but mental and behavioural disorders were the second or third, depending on country and sex, most prevalent multiple mentions. Two distinct age patterns of alcohol-related mortality were observed: in Czechia and Poland an inverted-U distribution with a peak at the age of 60-64, in Austria and Spain a distribution increasing with age and then levelling off for older age groups. DISCUSSION AND CONCLUSION: The importance of alcohol-related conditions that indirectly impact mortality can be re-assessed with the use of contributory mentions. The multiple-cause-of-death approach provides convergent results for countries characterised by similar patterns of alcohol consumption. Multiple-cause mortality was almost double the level of mortality with alcohol as the underlying cause, except in Poland. Mental and behavioural disorders were mostly certified as contributory to other, non-alcohol-related underlying causes of death.

Sex Differences in Alcohol Attributable Mortality in Poland, 2002-2018.

We study patterns and developments in sex differences in alcohol-attributable mortality (AAM) in Poland over the years 2002-2018. Sex gap and sex-specific mortality patterns according to age, educational level and urbanrural settlements are contrasted with findings for other developed countries. Premature AAM of the population 20-64 years old is quantified with age-standardized alcohol-attributable mortality rates (AASMR) by sex and selected characteristics. For the age pattern, we study the gender gap in alcohol-attributable crude death rates for 10-year age groups. Data comes from the World Health Organization database or directly from the Polish Central Statistical Office. In 2002, in Poland, men died 9-times more often than women from causes attributable to alcohol consumption. As a result of faster growth in AASMR among women, the relative sex gap halved between 2002 and 2018. However, this relative change was accompanied by an increase in the absolute gap, resulting from a larger increase in the total number of deaths attributed to alcohol consumption among men than women. Due to the substantially higher alcohol consumption and mortality among men, differences in AAM according to age, education and place of residence, and their changes over the study years, are much more pronounced for men than women. Polish men and women are characterized by similar patterns and developments of alcohol-attributable mortality in the study years. Different from that observed for other developed countries narrowing the sex gap, we observe in Poland perseverance of male elevated AAM. An important contribution of the study is the evidence that to understand differences between men and women in AAM and their developments, we need to study both relative and absolute sex gaps.