Trends and Inequalities in Alcohol Related Harm – a Birth Cohort Comparison of Finnish Adolescents Born between 1978 and 2001

Anna Leuwer , Helsinki Institute for Demography and Population Health
Joonas Pitkänen, Max Planck – University of Helsinki Center for Social Inequalities in Population Health
Lauren Bishop, University of Helsinki
Pekka Martikainen, University of Helsinki

Background: Recent evidence indicates a decline in adolescent alcohol use (AU), raising expectations of a corresponding reduction in alcohol-related harms. However, research on trends in these outcomes is limited, and some findings challenge this assumption. Potential explanations for this inconsistency include variations in AU across sex and socioeconomic groups, which may contribute to both increased incidence rates of alcohol-related harm and widening social inequalities. Aim: The present study aims to enhance our comprehension of temporal trends and social disparities in alcohol-related harm in the youth population. To this end, it will examine birth-cohort patterns in alcohol-related inpatient admissions and mortality among Finnish adolescents born between 1978 and 2001, stratified by sex and socioeconomic background. Method: We utilized Finnish register-based data to estimate trends in alcohol-related intoxication and alcohol use disorder (AUD) incidence rates among adolescents, modelling birth cohorts employing restricted cubic splines. To evaluate temporal variability in the relative risk among different socioeconomic groups, we compared incidence rate ratios across cohorts based on information about parental education, income and unemployment. Results: Alcohol-related harms showed distinct birth cohort trends by sex and socioeconomic status. Initially, acute intoxication increased in both female and male adolescents, but this increase eventually leveled off among females and stabilized among males. In contrast, AUD rose sharply in older cohorts before declining among later-born adolescents. Socioeconomic disparities remained evident across cohorts, with widening gaps among females, attributable to a marked rise in incidence rates among girls from lower socioeconomic backgrounds, and stable or narrowing inequalities among males.

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 Presented in Session 86. Health Behaviours and Lifestyke Determinants of Wellbeing