Alcohol-related outcomes and all-cause mortality in the Health 2000 Survey by participation status and compared with the Finnish population

McMinn, M. A. , Gray, L. , Härkänen, T., Tolonen, H., Pitkänen, J., Molaodi, O. R., Leyland, A. H. and Martikainen, P. (2020) Alcohol-related outcomes and all-cause mortality in the Health 2000 Survey by participation status and compared with the Finnish population. Epidemiology, 31(4), pp. 534-541. (doi: 10.1097/EDE.0000000000001200) (PMID:32483066) (PMCID:PMC7269017)

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Abstract

Background: In the context of declining levels of participation, understanding differences between participants and non-participants in health surveys is increasingly important for reliable measurement of health-related behaviors and their social differentials. This study compared participants and non-participants of the Finnish Health 2000 survey, and participants and a representative sample of the target population, in terms of alcohol-related harms (hospitalizations and deaths) and all-cause mortality. Methods: We individually linked 6,127 survey participants and 1,040 non-participants, aged 30–79, and a register-based population sample (n = 496,079) to 12 years of subsequent administrative hospital discharge and mortality data. We estimated age-standardized rates and rate ratios for each outcome for non-participants and the population sample relative to participants with and without sampling weights by sex and educational attainment. Results: Harms and mortality were higher in non-participants, relative to participants for both men (rate ratios = 1.5 [95% confidence interval = 1.2, 1.9] for harms; 1.6 [1.3, 2.0] for mortality) and women (2.7 [1.6, 4.4] harms; 1.7 [1.4, 2.0] mortality). Non-participation bias in harms estimates in women increased with education and in all-cause mortality overall. Age-adjusted comparisons between the population sample and sampling weighted participants were inconclusive for differences by sex; however, there were some large differences by educational attainment level. Conclusions: Rates of harms and mortality in non-participants exceed those in participants. Weighted participants’ rates reflected those in the population well by age and sex, but insufficiently by educational attainment. Despite relatively high participation levels (85%), social differentiating factors and levels of harm and mortality were underestimated in the participants.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMinn, Dr Megan and Gray, Dr Linsay and Leyland, Professor Alastair and Molaodi, Dr Oarabile
Authors: McMinn, M. A., Gray, L., Härkänen, T., Tolonen, H., Pitkänen, J., Molaodi, O. R., Leyland, A. H., and Martikainen, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Epidemiology
Publisher:Lippincott, Williams & Wilkins
ISSN:1044-3983
ISSN (Online):1531-5487
Published Online:05 June 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published Epidemiology 31(4):534-541
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
SPHSU13