Search resultsSocial epidemiology of chronic liver disease and cirrhosis mortality in the United States, 1935-1997: Trends and differentials by ethnicity, socioeconomic status, and alcohol consumption
Title
Social epidemiology of chronic liver disease and cirrhosis mortality in the United States, 1935-1997: Trends and differentials by ethnicity, socioeconomic status, and alcohol consumption
Publication type
Journal Article
Year of Publication
2000
Authors
Journal
Human Biology
Volume
72
Issue
5
Pagination
801 - 820
Date published
2000
ISBN
00187143 (ISSN)
Keywords
Adult, African American, African Americans, age distribution, Aged, alcohol consumption, Alcoholism, American Indian, article, Caucasian, cause of death, Chronic Disease, Cirrhosis, comparative study, Cross-Sectional Studies, cross-sectional study, Educational Status, ethnicity, ethnology, European Continental Ancestry Group, Female, health survey, Hispanic, Hispanic Americans, human, Humans, Indians, North American, Least-Squares Analysis, Liver Cirrhosis, liver disease, Liver Diseases, Longitudinal Studies, longitudinal study, male, Middle Aged, mortality, Multivariate Analysis, Population Surveillance, poverty, proportional hazards model, Proportional Hazards Models, Regression Analysis, Sex Distribution, sex ratio, socioeconomic status, statistics, Survival regression, Time series, Trend, unemployment, United States
Abstract
This study examines trends and ethnic and socioeconomic differentials in chronic liver disease and cirrhosis mortality in the United States. Age-adjusted death rates from the National Vital Statistics System were used to analyze race and sex-specific mortality trends from 1968 through 1997. Age-adjusted liver cirrhosis mortality and per capita alcohol consumption data from 1935 through 1996 were modeled using time-series regression. Moreover, the Cox hazards regression was applied to the National Longitudinal Mortality Study, 1979-1989, to examine socioeconomic differentials at the individual level, whereas multivariate ordinary least squares regression was used to model state-specific cirrhosis mortality from 1990 to 1992 as a function of socioeconomic variables and alcohol consumption at the ecological level. Chronic liver disease and cirrhosis continues to be an important cause of death in the United States, even after three decades of consistently declining mortality rates. For both men and women aged 25 years and older, significant mortality differentials were found by age, race/ethnicity, marital status, family income, and employment status. For men, marked differentials were also found by nativity, rural-urban residence, and education. Unemployment, minority concentration, and alcohol consumption were major predictors of state-specific cirrhosis mortality. Both time-series and cross-sectional data indicate a strong correlation between alcohol consumption and US cirrhosis mortality. Substantial ethnic and socioeconomic differences in cirrhosis mortality suggest the need for social and public health policies: and interventions that target such high-risk groups as American Indians, Hispanic Americans, the socially isolated, and the poor.