Patterns of drinking behaviour and incidence of diseases amongst Scottish adults
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Transcript of Patterns of drinking behaviour and incidence of diseases amongst Scottish adults
Patterns of drinking behaviour Patterns of drinking behaviour and incidence of diseases amongst and incidence of diseases amongst
Scottish adultsScottish adults
Presented by:
Dami Olajide
BackgroundBackground
o Alcohol is linked to major diseases and a major risk factor for morbidity and mortality in the UK: In Scotland, 2,882 (or 5% of total) deaths are attributable to alcohol & 1,492
deaths prevented in 2003 (Grant et al 2010). Alcohol attributable deaths increased by 15% from 2001-2005, while hospital
admissions increased by 7% (ScotPHO 2008).
o Important heterogeneities exists in alcohol consumption; Protective effects of alcohol; The majority of diseases/conditions are partly attributable to alcohol; Associated burden of diseases vary by demographics (e.g. age and gender) &
other characteristics; Individuals tend to under-report their drinking behaviour by up to 50%
(ScotPHO 2008).
Aim and objectivesAim and objectives
o Aim is to shed some light on the nature of heterogeneities in alcohol consumption and disease burden amongst Scottish adults:
(i) Exploit data linkage to identify the underlying patterns of consumption, based on individuals’ self-reported drinking status and hospital admissions; and
(ii) Examine associated characteristics of the individual.
o Major contribution is that (i) and (ii) are jointly undertaken in a single model.
Methods (1): DataMethods (1): Data
o Linked data set: Hospitalisation episodes from the Scottish Morbidity Records (SMR); Respondent characteristics from the Scottish Health Survey (SHeS).
o Incidence of an alcohol-related disease/condition: Presence of specific ICD9 & ICD10 codes (N=4,984 or 24%) Wholly or partially attributable to alcohol consumption (98% partially)
o Disease categories: abdominal/liver, cancers, heart (16%), nervous system/mental disorder,
others-conditions; none.
Data (ctd.)Data (ctd.)
Methods (2): ApproachMethods (2): Approach
o Latent class analysis (LCA) approach statistical method used to identify homogenous, mutually exclusive
groups (classes) existing within a heterogeneous population. Widely used in health care research to analyse behavioural patterns.
o Latent class regression model A single model for LCA for polytomous responses + regression
(Linzer and Lewis 2011) Item-response probabilities are obtained from LCA based on self-
reported drinking status and related diseases/conditions Characteristics associated with class membership are then obtained
from regression.
o Separate analysis for females and males.
Results (1): Latent class profilesResults (1): Latent class profiles
Females Males
C 1 C 2 C 3 C 1 C 2 C 3
Pr (class membership) 0.47 0.30 0.23 0.42 0.29 0.29
Alc. consumption: Never drk 0.031 0.061 0.178 0.014 0.043 0.042
Ex-drinker 0.014 0.091 0.099 0.014 0.041 0.102
Occ. or < 7 0.481 0.602 0.564 0.278 0.243 0.325
Over 7-14 0.214 0.157 0.106 0.215 0.101 0.146
Over 14 -28 0.193 0.059 0.04 0.277 0.272 0.197
Over 28 0.067 0.03 0.013 0.202 0.30 0.188
SMR post survey: None 0.942 0.802 0.395 0.962 0.884 0.307
Abdominal/liver 0.021 0.071 0.066 0.01 0.021 0.077
Cancers 0.015 0.014 0.041 0.004 0 0.021
Heart 0.01 0.067 0.489 0.022 0.017 0.567
Nervous/mental 0.006 0.027 0.006 0 0.054 0.016
Other (conditions) 0.006 0.018 0.003 0.002 0.024 0.012
Profiles continued (notes only)
Results (2): Graphical displaysResults (2): Graphical displaysFig.1. Females Fig.2. Males
Characteristics of class membershipCharacteristics of class membership
Females Males
Variables: (2/1) (2/1)
Age: No clear age effect Clear age effect (increasing)
Marital status: Lower for divwidsep Lower for married or cohabiting
Education qual: Decreasing progressively Significant only at degree level
Occ. soc. class: Decreasing progressively No association
Deprivation: Increasing progressively Significant only for most deprived.
Gtr. Glasgow: No association Positive association
(3/1) (3/1)
Age: Increasing progressively Similar
Marital status: Married/cohabiting positive Similar
Education qual: Decreasing progressively Similar, but lower in magnitude
Occ. soc. class: Decreasing progressively Similar
Deprivation: Increasing progressively Similar
Gtr. Glasgow: No association Positive association
Preliminary conclusionsPreliminary conclusions
o Given their patterns of alcohol and related diseases/conditions: Important gender differences at moderate level of risk (2/1) (age,
education qualification, social class, health board).• Women with better education and social class are at a lower risk of
alcohol-related diseases/conditions than men of similar characteristic. No clear gender differences in characteristics at highest level of
risk (3/1).
o Some indication of under-reporting: objective measures of alcohol consumption may reduce under-reporting.
o Diseases are largely partially related to alcohol.
o Further work: policy implications of findings