Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: a systematic review and meta-analysis.

Charlotte Probst, Michael Roerecke, Silke Behrendt, Jürgen Rehm

Abstract readMeta-AnalysisSystematic Review

In one paragraph

Synthesis in International journal of epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it

0cells of the map it votes in

115citing papers in PubMed, 9 pooled it

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 9 syntheses or guidelines pooled it.

A systematic review of the association between alcohol-related deaths and area-level socioeconomic deprivation and other geographic characteristics in high-income countries.BMC public health · 2026
Pooled it
Associations Between Employment and Health Outcomes: A Systematic Review of Reviews.Journal of occupational rehabilitation · 2026
Pooled it
The Role of Socioeconomic Position in the Association Between Mental Disorders and Mortality: A Systematic Review and Meta-Analysis.JAMA psychiatry · 2024
Pooled it
Employment Status and Alcohol-Attributable Mortality Risk-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022
Pooled it
Causal mechanisms proposed for the alcohol harm paradox-a systematic review.Addiction (Abingdon, England) · 2022
Pooled it
The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk-a systematic review and meta-analysis.BMC medicine · 2021
Pooled it
Socioeconomic inequalities in hospitalizations for chronic ambulatory care sensitive conditions: a systematic review of peer-reviewed literature, 1990-2018.International journal for equity in health · 2020
Pooled it
Socio-economic inequalities in fragility fracture outcomes: a systematic review and meta-analysis of prognostic observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
Pooled it
Genome-Wide Association Study Meta-Analysis of the Alcohol Use Disorders Identification Test (AUDIT) in Two Population-Based Cohorts.The American journal of psychiatry · 2019
Pooled it
The Moderating Effect of Educational Background on the Efficacy of a Computer-Based Brief Intervention Addressing the Full Spectrum of Alcohol Use: Randomized Controlled Trial.JMIR public health and surveillance · 2022
Trial
Testing Alcohol Labels as a Tool to Communicate Cancer Risk to Drinkers: A Real-World Quasi-Experimental Study.Journal of studies on alcohol and drugs · 2020
Trial
Association between Adverse Childhood Experiences and Binge Drinking among Adults: The Moderating Effect of Race/Ethnicity.Journal of racial and ethnic health disparities · 2026
Article
A Data-Driven Exploratory Analysis of the Alcohol-Harm Paradox in South-East Wales.International journal of environmental research and public health · 2026
Article
Perceived risk of substance use and associations with early experimentation: A latent profile analysis using ABCD study data.Drug and alcohol dependence reports · 2026
Article
Implementation of a Hospital-Based Screening and Treatment Program for Unhealthy Alcohol Use.Journal of general internal medicine · 2026
Article
Health's influence on alcohol use-a longitudinal study of working adults in Sweden.European journal of public health · 2026
Article
Socioeconomic differences in dementia risk, lifestyle, and relevant determinants of behavior.Journal of Alzheimer's disease : JAD · 2026
Article
Describing the alcohol harm paradox: 20 years of data from Victoria, Australia.Addiction (Abingdon, England) · 2026
Article
Past-month alcohol use in relation to the COVID-19 lockdown in 13 Indian states and union territories: gender, socioeconomic status, and state alcohol policy differences.Frontiers in public health · 2026
Article
Level of education, labor-market marginalization, and alcohol-related mortality: a cohort study of Swedish men.European journal of public health · 2025
Article

55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Charlotte ProbstInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, Canada c.probst@psychologie.tu-dresden.de.

Michael RoereckeInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, Canada.

Silke BehrendtInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, Canada.

Jürgen RehmInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Institute of Medical Science, University of Toronto, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, CanadaInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canad

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFactors underlying socioeconomic inequalities in mortality are not well understood. This study contributes to our understanding of potential pathways to result in socioeconomic inequalities, by examining alcohol consumption as one potential explanation via comparing socioeconomic inequalities in alcohol-attributable mortality and all-cause mortality.

methodsWeb of Science, MEDLINE, PsycINFO and ETOH were searched systematically from their inception to second week of February 2013 for articles reporting alcohol-attributable mortality by socioeconomic status, operationalized by using information on education, occupation, employment status or income. The sex-specific ratios of relative risks (RRRs) of alcohol-attributable mortality to all-cause mortality were pooled for different operationalizations of socioeconomic status using inverse-variance weighted random effects models. These RRRs were then combined to a single estimate.

resultsWe identified 15 unique papers suitable for a meta-analysis; capturing about 133 million people, 3 741 334 deaths from all causes and 167 652 alcohol-attributable deaths. The overall RRRs amounted to RRR = 1.78 (95% confidence interval (CI) 1.43 to 2.22) and RRR = 1.66 (95% CI 1.20 to 2.31), for women and men, respectively. In other words: lower socioeconomic status leads to 1.5-2-fold higher mortality for alcohol-attributable causes compared with all causes.

conclusionsAlcohol was identified as a factor underlying higher mortality risks in more disadvantaged populations. All alcohol-attributable mortality is in principle avoidable, and future alcohol policies must take into consideration any differential effect on socioeconomic groups.

Indexed as

Social ClassAlcohol-Related DisordersEducational StatusHumansIncomeMortalitySocioeconomic FactorsalcoholAlcohol-attributable mortalityall-cause mortalityeducationincomemeta-analysisoccupationSESsocioeconomic differencessocioeconomic inequalitysocioeconomic status

Identifiers

PMID24618188

DOI10.1093/ije/dyu043

PMCPMC4258771

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.