ArticleAddiction (Abingdon, England)2025
Educational attainment as a potential effect modifier of alcohol use and 100% alcohol-attributable mortality in the United States-A longitudinal analysis of mortality linked survey data from 1997 to 2018.
Article in Addiction (Abingdon, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed.
- Socioeconomic Status, Alcohol Use, and Mortality: Results From a Prospective Cohort Study.Alcohol, clinical & experimental research · 2026Article
- Higher amyloid deposition and lower white matter volume in cognitively healthy seniors exceeding French alcohol recommendations.EBioMedicine · 2026Article
- Comparisons of Risk Behaviors and Factors Associated with Poor Knowledge and Attitudes Toward Zoonotic Infection Among Hill Tribe People in Northern Thailand.Journal of racial and ethnic health disparities · 2026Article
- Sex‑specific trends and demographic vs. epidemiologic drivers of alcohol‑related cirrhosis in United States, 2021-2040: Letter to the editor on "Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the United States".Clinical and molecular hepatology · 2026Article
- Can alcohol use explain the increase in educational inequalities in all-cause mortality after 2010 in the USA? A three-way interaction analysis.Addiction (Abingdon, England) · 2026Article
- Swedish women with alcohol dependence: survival and cause-specific mortality compared with matched controls.Frontiers in public health · 2026Article
- Educational attainment as a potential effect modifier of alcohol use and 100% alcohol-attributable mortality in the United States-A longitudinal analysis of mortality linked survey data from 1997 to 2018.Addiction (Abingdon, England) · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo measure effects between educational attainment and alcohol use as a driver of unequal alcohol-attributable mortality.
designNation-wide cohort study using a longitudinal design, linking data from the 1997-2018 National Health Interview Survey to mortality data of the National Death Index in 2019. The study has an average follow-up time of 10.7 years (SD = 6.4).
settingUnited States.
participantsNationally representative sample of adults aged 25 years and older. MEASUREMENTS: The outcome was time to 100% alcohol-attributable mortality, censored or last presumed alive by 31 December 2019. Socioeconomic status was operationalized via educational attainment; alcohol use was self-reported and operationalized using a categorical measure with lifetime abstainers as reference category.
findingsOf a total of 562 632 adults, 901 (635 men and 266 women) died during follow-up from a 100% alcohol-attributable cause of death [15 per 100 000 person years (PY)]. We found a strong interaction effect between low education and Category III alcohol use (>60 g and >40 g per day for men and women, respectively), which was of additive nature as shown by the Aalen's additive hazards model, with 83.68 additional deaths per 100 000 PY (95% confidence interval = 16.48-150.87) found in individuals with low education with Category III drinking compared with a situation when there was no interaction between the two risk factors. A large and statistically significant relative excess risk due to interaction (RERI) of 32.05 from the Cox model supported the interaction. For individuals with low education, the risk associated with Category III drinking was double that for those with high education.
conclusionsIn the United States, people with combined low education and high alcohol consumption (>60 g/day for men, >40 g/day for women) appear to have a higher risk of 100% alcohol-attributable mortality compared with other combinations of educational attainment and drinking.
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