Effects of chronic disease diagnoses on alcohol consumption among elderly individuals: longitudinal evidence from China

OBJECTIVES: This study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals' alcohol consumption behaviour. SUBJECTS AND PARTICIPANTS: Our analysis was applied to a publicly available dataset that covers 5724 individuals aged 50 or above and spans 15 years (2000-2015: six waves) from the China Health and Nutrition Survey. DESIGN: The outcome variables are elderly individuals' weekly consumption of alcoholic beverages: beer, red wine, Chinese spirits and total alcohol intake. The explanatory variable of primary interest is the number of chronic diseases diagnosed (including hypertension, diabetes, stroke and myocardial infarction). Other covariates concern sample individuals' sociodemographic and health-related characteristics. A Chamberlain-Mundlak correlated random-effect Tobit model is adopted to simultaneously account for the clustering of 'zeros' in the outcome variable and endogeneity issues such as omitted variables and reverse causality. RESULTS: Our estimation suggests that, on average, an additional chronic disease diagnosed by medical doctors reduced an elderly Chinese individual's weekly consumption of beer, red wine and Chinese spirits, respectively, by 1.49 (95% CI -2.85 to -0.13), 0.93 (95% CI -1.63 to -0.23) and 0.89 (95% CI -1.23 to -0.54) ounces. These effects translate into a reduction of 0.95 (95% CI -1.29 to -0.60) ounces in total weekly alcohol consumption and a reduction of 24% (95% CI -0.35 to -0.14) in the incidence of excessive drinking. Further explorations suggest that elderly Chinese individuals' alcohol consumption is most responsive to diabetes and stroke diagnoses, but the effects vary across different beverages. Moreover, males, rural residents, smokers and those living with non-drinkers respond to CDDs more strongly than their respective counterparts. CONCLUSION: While CDDs reduced alcohol consumption among elderly Chinese individuals, they failed to stop all heavy drinkers from excessive drinking. Relevant policies and measures are thus needed to urge heavy drinking patients to quit excessive drinking.