Academic journal article Canadian Journal of Public Health

Alcohol Consumption and Alcohol-Related Mortality in Canada, 1950-2000

Academic journal article Canadian Journal of Public Health

Alcohol Consumption and Alcohol-Related Mortality in Canada, 1950-2000

Article excerpt

ABSTRACT

Objective: To describe trends in overall alcohol consumption and alcohol-related mortality in Canada, and to test regional associations between per capita alcohol consumption and alcohol-related mortality.

Method: Alcohol sales for 1950-2000 were used to measure total alcohol consumption; alcohol-related mortality consisted of nine different alcohol-related causes of death for 1950-1998. Alcohol consumption and alcohol-related mortality were described for 1950-2000, and measures of dispersion were calculated to assess the homogeneity across regions.

Findings: Both alcohol consumption and alcohol-related mortality increased in all regions up to 1975-80 and then underwent a decline until the 1990s. Since 1996, consumption began to increase. Beer represented more than half of the total consumption throughout the study period, although overall, the share of wine increased, particularly in the larger provinces. Over time there have been fewer differences in per capita consumption and alcohol-related mortality rates across the regions. A strong positive cross-regional relationship was observed between explicitly alcohol-related mortality and per capita consumption, whereas cirrhosis showed only a weak geographical association with consumption.

Conclusions: Since 1950, there has been a general trend toward national homogenization, especially with respect to drinking levels but also to alcohol-related mortality. A strikingly close regional relationship between alcohol consumption and alcohol-related mortality suggests that consumption is an important marker of alcohol-related harm in Canada.

It is well established that there are regional differences in drinking and alcohol-related problems in Canada, e.g., with more excessive drinking in the North and more wine drinking in Quebec.1 Still, to what extent alcohol consumption, beverage preferences and alcohol-related mortality differ among Canadian regions, and whether regional differences have increased or decreased since 1950, have not been carefully studied. This paper aims to fill this gap.

Considering that the temporal link between alcohol consumption and alcohol-related mortality is well documented in Canada,2-4 we should expect that regions with high consumption also have high rates of alcohol-related mortality. Though this has been suggested in some studies of cirrhosis mortality,5 no previous study has taken other alcohol-related causes of death into account. If mortality from alcohol dependence or alcohol poisoning, for example, is more common in some provinces than in others, a more reliable cross-regional pattern should be obtained by including them in a regional comparison. Whether this is the case is also examined.

DATA AND METHOD

Official sales of alcohol for the years 1950-2000 were used as a measure of alcohol consumption and were calculated as sales (litres 100% alcohol) per year per inhabitant over 14 years of age. These sales figures were obtained from Statistics Canada and include sales from government-run liquor stores, agency stores, cold beer stores, wine shops and venues where wine is sold, as well as sales in grocery stores and corner stores in those provinces where this is available. On-premise sales are also included in these figures. Mortality data were also compiled from Statistics Canada. Two measures of alcohol-related mortality were used: liver cirrhosis mortality (whole category, e.g., 571 in ICD-8 and 9) and a collapsed measure of causes of death with explicit mention of alcohol, including the alcohol-specific liver cirrhosis deaths (see Table I). all mortality rates were age-adjusted using a direct method.

In order to measure if there is more or less regional variation in drinking and mortality, two measures of dispersion were used. The first was the coefficient of variation (CV), which expresses the relative dispersion in terms of the standard deviation relative to the mean. …

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