Increasing socioeconomic inequalities in male cirrhosis of the liver mortality: Australia 1981–2002

Abstract

Liver cirrhosis mortality is an indicator of harms associated with high levels of alcohol consumption. There is good evidence that changes in political and economic systems can lead to changing patterns of liver cirrhosis mortality. Socioeconomic inequalities in liver cirrhosis mortality have been periodically reported but there are few studies of changes in socioeconomic inequalities in liver cirrhosis mortality over time. This paper examines changes in socioeconomic inequalities in liver cirrhosis mortality in Australia for the period 1981 - 2002. Age standardised, liver cirrhosis mortality rates were calculated for occupational groupings for Australia 1981 - 2002. Occupations were grouped into non-manual and manual categories, and there was imputation for missing data. Despite decreasing overall liver cirrhosis mortality rates over time, liver cirrhosis mortality continues to account for about 3% of all deaths. Manual workers have consistently experienced liver cirrhosis mortality rates which are twice or more the rate experienced by non-manual workers. These inequalities appear to have increased in recent years and currently appear to be at historic highs (manual workers have mortality rates of about 2.5 times those of non-manual workers). Increasing socioeconomic inequalities in liver cirrhosis mortality in Australia suggest that lower SES groups have, over time, increased their level of harmful alcohol consumption relative to middle and higher SES groups. It is suggested that this might be attributed to a relative improvement in the affordability of alcohol over time.