The distribution of alcohol-attributable healthcare encounters across the population of alcohol users in Ontario, Canada

Andreacchi, Alessandra T.; Smith, Brendan T.; Rehm, Jürgen; Crépault, Jean-François; Sherk, Adam; Hobin, Erin

doi:10.1016/j.pmedr.2023.102388

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…It is likely that the results reported in this study are underestimates of the true association between SEP and alcohol-attributable ED visits because of our narrow definition of alcohol-attributable harms which focused on wholly attributable conditions [45]. Of note, more than two thirds of all alcohol-attributable ED visits in Ontario in 2019 were from partially attributable conditions.…”

Section: Limitationsmentioning

confidence: 70%

Socio‐economic inequities in emergency department visits for wholly alcohol‐attributable acute and chronic harms in Canada, 2003–2017

Benny,

Hobin,

Andreacchi

et al. 2024

Drug and Alcohol Review

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IntroductionIndividuals with low socio‐economic position (SEP) experience disproportionate alcohol‐attributable harm. Limited research has investigated whether these inequities are driven by alcohol‐attributable conditions that are acute or chronic. The study aimed to estimate the sex‐specific associations between SEP and incident wholly alcohol‐attributable emergency department (ED) visits for acute and chronic harms, respectively.MethodsA cohort study was conducted using the Canadian Community Health Survey (2003–2008) linked to the National Ambulatory Care Reporting System (2002–2017) in Alberta and Ontario. SEP was measured using educational attainment. Acute and chronic ED visits were captured in the National Ambulatory Care Reporting System follow‐up data. Hazard models were fit to estimate the association between SEP and acute and chronic wholly alcohol‐attributable ED visits.ResultsThe analytical sample included 88,865 respondents. In men and women, individuals with lower SEP had increased hazard of acute ED visits (women hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.07–2.87; men HR 3.47, 95% CI 2.29–5.25) and chronic ED visits (women HR 2.24, 95% CI 1.04–4.80; men HR 5.02, 95% CI 2.88–8.75). Acute and chronic wholly alcohol‐attributable ED visit rates were higher in men than women.Discussion and ConclusionsThe findings indicated lower SEP was associated with greater harms for both acute and chronic wholly alcohol‐attributable ED visits when compared to their higher SEP counterparts. We conclude that gradients in SEP are associated with acute and chronic harms. These results highlight a need for equitable interventions that reduce the absolute burden of inequities in both acute and chronic wholly alcohol‐attributable ED visits.

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Section: Limitationsmentioning

confidence: 70%

Socio‐economic inequities in emergency department visits for wholly alcohol‐attributable acute and chronic harms in Canada, 2003–2017

Benny,

Hobin,

Andreacchi

et al. 2024

Drug and Alcohol Review

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Age, period and cohort effects of heavy episodic drinking by sex/gender and socioeconomic position in Canada, 2000–2021

Andreacchi,

Hobin,

Siddiqi

et al. 2024

Addiction

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Background and AimsHeavy episodic drinking (HED) trends have not been comprehensively examined in Canada. We measured age, period and birth cohort trends in HED in Canada by sex/gender and socioeconomic position.Design and setting.We analyzed repeat cross‐sectional data from the 10 provinces in the Canadian Community Health Surveys from 2000 to 2021 using hierarchical cross‐classified random effects logistic regression.Participants1 167 831 respondents aged 12+ .MeasurementsHED was defined as 4+ standard drinks for women or 5+ for men at least monthly in the past 12 months. Socioeconomic position was measured using household income and education.FindingsWe observed steeper HED decreases in young adult men (aged 18–29) than women (by 14.4% and 8.7%, respectively, from 2015 to 2021) and HED increases in middle adult women (ages 50–64) (by 8.0% from 2000 to 2014). Sex/gender‐specific age‐period‐cohort models revealed strong age and birth cohort effects. In women and men, respectively, HED peaked in young adulthood (18.2% and 33.8%) and decreased with age, and HED was greatest in the 1980–1989 cohort (20.7% and 35.8%) and decreased in the most recent cohort born in 1990–2009 (15.6% and 19.8%), particularly in men. Higher household incomes had greater HED across age, periods and cohorts, while trends varied by education. Compared with lower education groups, people with a bachelor's degree or above had the lowest HED in middle adulthood. People with a bachelor's degree or above had low HED in earlier cohorts, which converged with other education groups in recent cohorts due to a pronounced HED increase, particularly in women.ConclusionThe sex/gender gap in heavy episodic drinking (HED) appears to be converging in Canada: current young adult men are reducing HED, while high‐risk cohorts of women are aging into middle adulthood with greater HED. Recent birth cohorts with a bachelor's degree or above experienced pronounced HED increases, which among women suggests greater educational attainment contributes to the converging gender gap in HED.

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The distribution of alcohol-attributable healthcare encounters across the population of alcohol users in Ontario, Canada

Cited by 2 publications

References 19 publications

Socio‐economic inequities in emergency department visits for wholly alcohol‐attributable acute and chronic harms in Canada, 2003–2017

Socio‐economic inequities in emergency department visits for wholly alcohol‐attributable acute and chronic harms in Canada, 2003–2017

Age, period and cohort effects of heavy episodic drinking by sex/gender and socioeconomic position in Canada, 2000–2021

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