THE DISADVANTAGE OF BEING ADVANTAGED - ON A SOCIAL GRADIENT IN EXCESSMORTALITY AMONG ALCOHOL ABUSERS

Do alcohol abusers fr om upper social classes have a more elevated exc ess mortality than alcohol abusers from lower social classes? This que stion was empirically assessed by analyses on data from a 40-year pros pective study of more than 40 000 Norwegian conscripts on whom data on social class (i.e. educational level), alcohol abuse (admission to tr eatment) and cause specific mortality before the age of 60 years were available. The results demonstrated a social gradient in excess mortal ity: relative risk of premature death was 2.7 among those with the low est educational level (primary school only) increasing to 6.2 among th ose with the highest educational level at conscription (grammar school ). Among the alcohol abusers the risk of premature death was slightly, but not significantly higher among those highly educated as compared to those with less education. Thus, alcohol abuse was not only found t o elevate the individual's risk of premature death, but it also appear ed to outweigh the advantages of those more socially privileged with r espect to health and mortality. The question as to whether social clas s differences in selection to treatment could account for the observed social gradient in excess mortality is focused in the discussion.