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Pia Mäkelä

Publications and source records attributed to Pia Mäkelä.

9 recordsLinked to original sources
PubMed2005

Temporal variation in deaths related to alcohol intoxication and drinking.

BACKGROUND: Temporal variation in deaths related to alcohol intoxication is examined using two approaches. First, we examine the risk of these deaths during festivals, on the day preceding them, and on the three days that immediately follow them. Second, we assess the weekday variation in deaths, and compare this with survey-based data on weekday variations in drinking. Previously no data existed on the temporal association between intoxication-related deaths and drinking occasions according to the severity of intoxication. METHODS: We used population registration data on 15-69-year-old men and women, linked with the national cause of death register for the years 1987-2001, and the Finnish Drinking Habits Survey carried out in 2000. Intoxication-related deaths were defined on the basis of underlying and contributory causes of death. RESULTS: The largest increased risk of intoxication-related deaths was observed for Midsummer Day [Observed deaths/Expected deaths (O/E) = 2.88 (95% confidence interval 2.48-3.31) for men and O/E = 2.21 (1.43-3.27) for women respectively], Midsummer Eve [O/E = 2.70 (2.32-3.12) and 3.18 (2.23-4.41)], May Day [O/E = 1.80 (1.50-2.16) and 2.65 (1.79-3.79)], Christmas Eve [O/E = 1.58 (1.29-1.91) and 2.21 (1.43-3.27)], and New Year's Day [O/E = 1.48 (1.20-1.80) and 1.77 (1.08-2.74)]. Among men, the increased risk at Midsummer lasted for three consecutive days. The weekday distribution of different levels of intoxication and of intoxication-related deaths was similar, with a clear increase observed on Friday, Sunday, and, particularly, Saturday. CONCLUSIONS: Intoxication-related deaths peak during weekends and around festival days when alcohol is widely consumed in excess. Public awareness of the risks attached to binge drinking should be increased.

Adolescent↗
PubMed2005

Difficulty in demonstrating a risk from drinking pattern in fourteen years of coronary heart disease morbidity and mortality: the Lung Health Study.

The health effects of a binge pattern of alcohol consumption have not been widely investigated. The objective of this study is to evaluate cardiovascular consequences of drinking eight or more drinks at a sitting and of usual drinking of alcohol among 3702 men in the Lung Health Study (LHS), a clinical trial where heavy drinkers were excluded from enrollment. Using a 14-year follow-up period, survival graphs were examined. Cox proportional hazards regressions were performed on time to first event for documented hospitalizations and deaths due to coronary heart disease (CHD). The upper two quartiles of usual drinking were protective against CHD in men [hazard ratios (HRs) 0.76 and 0.69] in adjusted models. When eight or more drinks per occasion was combined with models of usual drinking quartiles, its effect was not significant. The measure of eight or more drinks in these data appears to act as a surrogate for heavy drinking, and does not provide a suitable test of the effect of drinking pattern in men, due primarily to the exclusion of heavier drinkers at baseline. The alcohol effects in women in this study were not significant.

Adult↗
PubMed2005

Pattern of drinking and fatal injury: a population-based follow-up study of Finnish men.

AIM: To find out how the frequency of drinking one to two drinks, three to four drinks and five or more drinks of alcohol per drinking occasion predicts injury mortality in 16 years of follow-up among the Finnish 15-69-year-old male population. DESIGN: Three alcohol surveys conducted in 1969, 1976 and 1984 were pooled and linked with mortality information from the national cause of death register. METHOD: Cox proportional hazard models were used for analysing the survival time data. FINDINGS: Drinking at the level of one to two drinks, regardless of frequency, did not elevate the risk of fatal injury, nor did drinking at the level of three to four drinks. Drinking five or more drinks at a time significantly increased the risk of fatal injury in graded relation, compared with those who never drank at that level. The risk was highest for those who drank five or more drinks at a time at least weekly (RR = 5.78, 95% CI = 2.80-11.94), when adjusted for possible confounders. CONCLUSIONS: We found that besides the total volume of consumption, a drinking pattern that involves drinking occasions when consumption exceeds four drinks of alcohol at a time leads to a significant increase in the risk of fatal injury among Finnish men. The risk is highest among those who have the highest annual number of heavy drinking occasions. The finding does not support the hypothesis that alcohol tolerance would lower the risk of fatal injuries among frequent heavy drinkers.

Adult↗
PubMed2004

The effects of regional characteristics on alcohol-related mortality-a register-based multilevel analysis of 1.1 million men.

The aim of this study is to assess to what extent selected characteristics of functional regions affect alcohol-related mortality among men in Finland after adjusting for individual-level characteristics. The study was conducted as a multilevel Poisson regression analysis, with individuals (n = 1.1 million) as the first level and functional regions of Finland (n = 84) as the second level. The analysis covered men aged 25-64. The data are based on the 1990 census records, which were linked to death records in 1991-1996. The outcome measure was alcohol-related mortality, which was defined using information on the underlying and contributory causes of death. The individual-level covariates included age, education, socioeconomic status, marital status and mother tongue. The area-level variables considered were the proportion of manual workers, unemployment level, median household income, Gini coefficient of income, family cohesion, voting turnout, level of urbanisation and proportion of Swedish-speaking inhabitants. A high proportion of manual workers and of unemployed and low social cohesion (family cohesion and voting turnout) were found to produce adverse effects on alcohol-related mortality, and the independent effects of these variables remained after adjustment for all individual-level and area-level characteristics. The protective effect of high level of urbanisation was revealed after adjustment for other individual- and area-level characteristics. Neither mean income nor income inequality were related to alcohol-related mortality. Adjusting for individual-level variables diminished the average relative deviation of alcohol-related mortality among the functional regions by 41%. The inclusion of area-level characteristics in the model resulted in a total diminution of variation of 79%. The area characteristics considered in this study had a notable effect on alcohol-related mortality, although these effects were smaller than those of the individual-level characteristics. Fuller understanding of the mechanisms underlying the effects of area measures of social structure and cohesion on risky alcohol consumption and alcohol-related mortality is needed.

Adult↗
PubMed2004

Contribution of deaths related to alcohol or smoking to the gender difference in life expectancy: Finland in the early 1990s.

BACKGROUND: In comparison to most other countries in Western Europe, Finland ranks high with regard to male excess mortality. This study examined the contribution of smoking and alcohol to the gender difference in mortality in Finland during 1991-93 among the population aged 15 or over. METHODS: The study is based on data from linked registers. The number of alcohol-related deaths was assessed on the basis of information included in the death certificate, while the conventional method of population attributable fraction was applied to estimate the aggregated contribution of smoking. In combining the effects of alcohol and smoking, three alternative assumptions of their overlap were used. RESULTS: Approximately 51-56% of the gender difference of 7.6 years in the life expectancy at age 15 was estimated to be attributable to alcohol or smoking, depending on the assumption about the overlap of the contribution of alcohol and smoking. CONCLUSIONS: The study confirms the important role of alcohol and smoking as a mechanism contributing to the difference in mortality between men and women in Finland.

Adolescent↗
PubMed2003

Impact of correcting for nonresponse by weighting on estimates of alcohol consumption.

OBJECTIVE: This study describes the characteristics of nonrespondents and assesses the impact of unit nonresponse on estimates of central alcohol consumption variables by examining the impact of corrective weighting. METHOD: The data came from a Finnish general population random sample of 1,932 respondents (987 women) (response rate: 78.1%). The survey was carried out in the year 2000 using face-to-face interviews. The impact of unit nonresponse was assessed by comparing results using (1) no weighting; (2) poststratified weights adjusted for age, gender and region; (3) weights obtained from a statistical model predicting response propensity; and (4) weights from the model, adjusted to match the population distribution for age, gender and region. Extensive auxiliary information used to predict response propensity came from administrative registers. RESULTS: Compared with respondents, both male and female nonrespondents had fewer children, lived in urban areas and lived in southern Finland. Male nonrespondents were also older; female nonrespondents more often had only a basic education and were less often in the second-highest income quartile. The change in alcohol variables resulting from the adjustment for nonresponse was small, however, and the difference between the different weighting schemes was even smaller. CONCLUSIONS: If nonrespondents' drinking differs considerably from that of respondents, this difference cannot be captured even by using extensive auxiliary information and an elaborate model predicting propensity of nonresponse.

Adolescent↗
PubMed2002

Whose drinking does the liberalization of alcohol policy increase? Change in alcohol consumption by the initial level in the Finnish panel survey in 1968 and 1969.

AIMS: To study how the annual volume of alcohol consumed changed among population groups in different categories of initial consumption in a situation where per capita consumption strongly increased due to a new alcohol law. DESIGN: A post-hoc quasi-experiment with a two-wave panel study. The regression to the mean effect was accounted for by using reference data from two auxiliary panel studies. SETTING: Finland in 1968 and 1969, when per capita consumption increased by 46% in a year. Reference data come from Norway in 1975 and 1976, and the United States in 1993 and 1994. PARTICIPANTS: General population sample of 1720 (1292 men) aged 15-69 (response rate 91.4%). REFERENCE DATA: General population surveys in a Norwegian town (n=254) and in the United States (n=658). MEASUREMENTS: Annual volume of alcohol consumed. FINDINGS: In Finland, the greatest change in observed consumption levels occurred among those with moderate consumption levels, but the same phenomenon was observed in the reference data. A comparison between the Finnish and the reference data indicated that in Finland consumption increased at all levels, and the higher the initial consumption level, the greater the increase. CONCLUSIONS: A best estimate for the differential impact of future increases in alcohol consumption is that moderate and particularly heavy drinkers will be affected to a greater extent than will light drinkers or abstainers.

Adolescent↗
PubMedDate not supplied

Drinking patterns and their gender differences in Europe.

AIMS: To compare drinking habits and to examine differences between drinking cultures in different regions and countries in Europe; to examine gender differences in drinking habits and to compare them over countries. METHODS: Data consisted of independently conducted, centrally analysed surveys in the general population aged 20-64 years in 14 European countries. Central measures were abstention, frequency and volume of drinking overall and by beverage type, amounts drunk per drinking day, and heavy episodic drinking. RESULTS: There were clear gender differences in all drinking measures, except for wine drinking. Differences between genders were often smaller than average in northern Europe. Gender ratios did not show systematic changes by age, with the exception that young men and women differed less than older men and women in the frequency of heavy episodic drinking. The results on beverage preferences indicate that the distinction among wine/beer/spirits cultures have implicitly been based on male drinking. Our expectation was for more daily light drinking integrated in everyday life in the Mediterranean countries, more heavy episodic drinking associated with weekends and celebrations in the North, with the traditional beer countries somewhere in between. The differences observed were usually in the direction expected. However, no country represented an ideal type of drinking culture, i.e. drinking for 'mood-changing effects' only or for 'nutritional purposes' only; all countries were mixtures of these two extremes. CONCLUSIONS: There were clear and consistent gender differences in all countries, while the differences in drinking between countries and regions were not as obvious.

Adult↗