Abstract
Objective
To describe trends in overall alcohol consumption and alcohol-related mortality in Canada, and to test regional associations between per capita alcohol consumption and alcohol-related mortality.
Method
Alcohol sales for 1950–2000 were used to measure total alcohol consumption; alcohol-related mortality consisted of nine different alcohol-related causes of death for 1950–1998. Alcohol consumption and alcohol-related mortality were described for 1950–2000, and measures of dispersion were calculated to assess the homogeneity across regions.
Findings
Both alcohol consumption and alcohol-related mortality increased in all regions up to 1975–80 and then underwent a decline until the 1990s. Since 1996, consumption began to increase. Beer represented more than half of the total consumption throughout the study period, although overall, the share of wine increased, particularly in the larger provinces. Over time there have been fewer differences in per capita consumption and alcohol-related mortality rates across the regions. A strong positive cross-regional relationship was observed between explicitly alcohol-related mortality and per capita consumption, whereas cirrhosis showed only a weak geographical association with consumption.
Conclusions
Since 1950, there has been a general trend toward national homogenization, especially with respect to drinking levels but also to alcohol-related mortality. A strikingly close regional relationship between alcohol consumption and alcohol-related mortality suggests that consumption is an important marker of alcohol-related harm in Canada.
Résumé
Objectif
Décrire les tendances de la consommation générale d’alcool et de la mortalité liée à l’alcool au Canada et tester les associations régionales entre la consommation d’alcool par habitant et la mortalité liée à l’alcool.
Méthode
Les ventes d’alcool de 1950 à 2000 ont servi à mesurer la consommation totale d’alcool; la mortalité liée à l’alcool comprenait neuf causes de décès attribuables à l’alcool pour la période 1950–1998. La consommation d’alcool et la mortalité liée à l’alcool sont décrites pour la période 1950–2000, et nous en avons mesuré la dispersion pour évaluer l’homogénéité d’une région à l’autre.
Constatations
La consommation d’alcool et la mortalité liée à l’alcool ont toutes deux augmenté dans l’ensemble des régions jusqu’en 1975–1980, puis elles ont baissé jusqu’aux années 1990. Depuis 1996, la consommation augmente de nouveau. La bière représentait plus de la moitié de la consommation totale pendant toute la période à l’étude, mais globalement, la part du vin a augmenté, surtout dans les grandes provinces. Au fil du temps, les différences régionales dans la consommation par habitant et les taux de mortalité liés à l’alcool se sont amoindries. Nous avons observé une forte relation positive transrégionale entre la mortalité explicitement liée à l’alcool et la consommation par habitant, mais seulement une faible association géographique entre les cirrhoses et la consommation d’alcool.
Conclusions
Depuis 1950, la tendance générale est à l’homogénéisation à l’échelle du pays, surtout en ce qui a trait aux niveaux de consommation, mais également à la mortalité liée à l’alcool. La relation régionale étonnamment étroite entre la consommation d’alcool et la mortalité liée à l’alcool porte à croire que la consommation est un important indicateur des méfaits de l’alcool au Canada.
Footnotes
Acknowledgement: The manuscript was written within the framework of the Canadian Alcohol Experiences & Nordic Perspectives project, which has been financially supported by the Swedish Ministry of Health and Social Affairs. I am thankful to Robin Room and Sandra Bullock for comments on an earlier version of this paper.
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