Changes in Alcohol-Related Mortality and its Socioeconomic Differences After a Large Reduction in Alcohol Prices: A Natural Experiment Based on Register Data

Abstract

The authors examined the effect of a large reduction in the price of alcohol in Finland in 2004 on alcohol-related mortality by age and socioeconomic group. For this register-based study of Finns aged >or=15 years, data on independent variables were extracted from the employment statistics of Statistics Finland. Mortality follow-up was carried out for 2001-2003 (before the price reduction) and 2004-2005 (after). Alcohol-related causes were defined using both underlying and contributory causes of death. Alcohol-related mortality increased by 16% among men and by 31% among women; 82% of the increase was due to chronic causes, particularly liver diseases. The increase in absolute terms was largest among men aged 55-59 years and women aged 50-54 years. Among persons aged 30-59 years, it was biggest among the unemployed or early-age pensioners and those with low education, social class, or income. The relative differences in change between the education and social class subgroups were small. The employed and persons aged <35 years did not suffer from increased alcohol-related mortality during the 2 years after the change. These results imply that a large reduction in the price of alcohol led to substantial increases in alcohol-related mortality, particularly among the less privileged, and in chronic diseases associated with heavy drinking.

Cross-border health and productivity effects of alcohol policies

“…In this paper, we focus on the Finnish alcohol tax cut of 2004 which was precisely the kind of abrupt policy change that should allow for clean identification. The health effects of this policy change in Finland have been studied by Herttua et al (2008). In what is essentially a before and after comparison of mortality rates, the authors find that alcohol-related mortality increased sharply (16% for men and 31% for women) after March 2004, when the Finnish alcohol tax rates were cut.…”

“…As low alcohol content drinks can also be sold in supermarkets, data are only complete for the retail sales of mild drinks and spirits. The data cover the years 2000-2007for North Finland and 1998-2008 The analysis population for the study of health effects is restricted to individuals living in northern Sweden within 450 km from the nearest town in Finland that has an Alko store. We chose this limit because this area roughly covers the northernmost counties in Sweden and includes all the regions with reasonable driving distances to the Finnish border town of Tornio.…”

What happened to alcohol consumption and problems in the Nordic countries when alcohol taxes were decreased and borders opened?

“…In Finland, the price cuts were estimated to have resulted in no increase in assaults (Sirén & Lehti, 2006) but a significant increase in alcohol-related mortality (Herttua, Mäkelä, & Martikainen, 2008) and hospitalizations (Herttua, 2010) that was largest for peoplein the age group 50-69 years and for liver disease mortality. In age groups below 40 years, only alcoholrelated hospitalizations of men increased.…”

Associations between mortality and alcohol consumption in Lithuanian population

“…Analogiškas išvadas padarė Suomijos mokslininkai, išanalizavę alkoholinių gėrimų kainų sumažinimo efektą šaliai įstojus į ES, kuris pasireiškė ryškiu ilgalaikiu mirtingumo padidėjimu (14). Autoriai šį reiškinį įvardijo "natūraliu eksperimentu" Suomijos populiacijoje.…”