Abstract Background and Aims When measuring inequalities in health, public health and addiction research has tended to focus on differences in average life‐span between socio‐economic groups. This does not account for the extent to which age of death varies between individuals within socio‐economic groups or whether this variation differs between groups. This study assesses (1) socio‐economic inequalities in both average life‐span and variation in age at death, (2) the extent to which these inequalities can be attributed to alcohol‐specific causes (i.e. those attributable only to alcohol) and (3) how this contribution has changed over time. Design Cause‐deleted life table analysis of national mortality records. Setting England and Wales, 2001–16. Cases All‐cause and alcohol‐specific deaths for all adults aged 18+, stratified by sex, age and quintiles of the index of multiple deprivation (IMD). Measurements Life expectancy at age 18 yearss and standard deviation in age at death within IMD quintiles and the contribution of alcohol to overall differences in both measures between the highest and lowest IMD quintiles by comparing observed and cause‐deleted inequality ‘gaps’. Findings In 2016, alcohol‐specific causes reduced life expectancy for men and women by 0.26 and 0.14 years, respectively, and increased the standard deviation in age at death. These causes also increased the inequality gap in life expectancy by 0.33 years for men and 0.17 years for women, and variation in age at death by 0.14 years and 0.13 years, respectively. For both measures, the contribution of alcohol to mortality inequalities rose after 2001 and subsequently fell back. For women, alcohol accounted for 3.6% of inequality in age at death and 6.0% of life‐span uncertainty, suggesting that using only the former may underestimate alcohol‐induced inequalities. There was no comparable difference for men. Conclusions Deaths from alcohol‐specific causes increase inequalities in both life expectancy and variation in age of death between socio‐economic groups. Using both measures can provide a fuller picture of overall inequalities in health.

中文翻译：

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评估酒精特定原因对英格兰和威尔士 2001-16 年社会经济不平等死亡率的贡献

摘要 背景和目标 在衡量健康不平等时，公共卫生和成瘾研究倾向于关注社会经济群体之间平均寿命的差异。这并没有考虑社会经济群体内个体之间的死亡年龄差异的程度，或者这种差异在群体之间是否存在差异。本研究评估了 (1) 平均寿命和死亡年龄变化方面的社会经济不平等，(2) 这些不平等在多大程度上可归因于酒精特定原因（即仅归因于酒精的原因）和（ 3) 这种贡献是如何随着时间变化的。国家死亡率记录的设计原因删除生命表分析。设置英格兰和威尔士，2001-16。所有 18 岁以上成年人的全因和酒精特异性死亡，按性别分层，多重剥夺指数 (IMD) 的年龄和五分位数。测量 18 岁时的预期寿命和 IMD 五分位数内死亡年龄的标准偏差，以及酒精对最高和最低 IMD 五分位数之间的总体差异的贡献，通过比较观察到的和原因删除的不平等“差距”。结果 2016 年，酒精特定原因使男性和女性的预期寿命分别减少了 0.26 年和 0.14 年，并增加了死亡年龄的标准差。这些原因还使男性和女性的预期寿命不平等差距分别增加了 0.33 年和 0.17 年，死亡年龄差异分别增加了 0.14 年和 0.13 年。对于这两项措施，酒精对死亡率不平等的贡献在 2001 年之后上升，随后又回落。对女性来说，酒精占死亡年龄不平等的 3.6% 和寿命不确定性的 6.0%，表明仅使用前者可能会低估酒精引起的不平等。男性没有可比性差异。结论 酒精特定原因导致的死亡增加了社会经济群体之间预期寿命和死亡年龄差异的不平等。使用这两种措施可以更全面地了解健康方面的整体不平等。