Background: This article is the first analysis of the social inequalities in adult alcohol-related mortality in England and Wales at the start of the 21st century, using the National Statistics Socio-economic Classification (NS-SEC). It presents the socio-economic patterns of alcohol-related mortality by gender, age and region, for England and Wales as a whole, Wales and the regions of England.
Methods: Death registrations provided the number of deaths for working age adults, using the National Statistics definition of alcohol-related mortality. Population estimates for England and Wales in 2001-03 were used to estimate alcohol-related mortality rates by sex, five-year age group, NS-SEC and region. Inequalities were measured using ratios of alcohol-related mortality rates between the least and most advantaged classes.
Results: There were substantial socio-economic variations in adult alcohol-related mortality, with the inequalities being greater for women than for men. The mortality rate of men in the Routine class was 3.5 times those of men in Higher and Managerial occupations, while for women the corresponding figure was 5.7 times. Greater socio-economic inequalities in mortality were observed for men aged 25-49 than for men aged 50-64; however the highest mortality rate of men occurred for Routine workers aged 50-54. Women in the Routine class experienced mortality rates markedly higher than other classes. The highest mortality rate of women also occurred for Routine workers, but at a younger age than for men (45-49). Within England, the North-West showed the largest inequalities, with particularly high rates in the Routine class for both sexes. In general, there was no association between levels of mortality and socio-economic gradients in mortality across the English regions and Wales.
Conclusions: Rates of alcohol-related mortality in England and Wales increased significantly for people between the early 1990s and early 21st century, and were substantially greater for those in more disadvantaged socio-economic classes. There is also evidence that these socio-economic differences were greater at younger ages, especially for men at ages 25-49.