Effects of Chronic Disease Diagnoses on Alcohol Consumption Among Elderly Individuals: Longitudinal Evidence from China

Overview

Journal BMJ Open

Specialty General Medicine

Date 2022 Oct 11

PMID 36220320

Authors

Yue Hu

Qihui Chen

Bo Zhang

Affiliations

Soon will be listed here.

Abstract

Objectives: This study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals' alcohol consumption behaviour.

Subjects And Participants: Our analysis was applied to a publicly available dataset that covers 5724 individuals aged 50 or above and spans 15 years (2000-2015: six waves) from the China Health and Nutrition Survey.

Design: The outcome variables are elderly individuals' weekly consumption of alcoholic beverages: beer, red wine, Chinese spirits and total alcohol intake. The explanatory variable of primary interest is the number of chronic diseases diagnosed (including hypertension, diabetes, stroke and myocardial infarction). Other covariates concern sample individuals' sociodemographic and health-related characteristics. A Chamberlain-Mundlak correlated random-effect Tobit model is adopted to simultaneously account for the clustering of 'zeros' in the outcome variable and endogeneity issues such as omitted variables and reverse causality.

Results: Our estimation suggests that, on average, an additional chronic disease diagnosed by medical doctors reduced an elderly Chinese individual's weekly consumption of beer, red wine and Chinese spirits, respectively, by 1.49 (95% CI -2.85 to -0.13), 0.93 (95% CI -1.63 to -0.23) and 0.89 (95% CI -1.23 to -0.54) ounces. These effects translate into a reduction of 0.95 (95% CI -1.29 to -0.60) ounces in total weekly alcohol consumption and a reduction of 24% (95% CI -0.35 to -0.14) in the incidence of excessive drinking. Further explorations suggest that elderly Chinese individuals' alcohol consumption is most responsive to diabetes and stroke diagnoses, but the effects vary across different beverages. Moreover, males, rural residents, smokers and those living with non-drinkers respond to CDDs more strongly than their respective counterparts.

Conclusion: While CDDs reduced alcohol consumption among elderly Chinese individuals, they failed to stop all heavy drinkers from excessive drinking. Relevant policies and measures are thus needed to urge heavy drinking patients to quit excessive drinking.

References

Jiang H, Room R, Hao W . Alcohol and related health issues in China: action needed. Lancet Glob Health. 2015; 3(4):e190-1. DOI: 10.1016/S2214-109X(15)70017-3. View

Gronbaek M, Mortensen E, Mygind K, Andersen A, Becker U, Gluud C . Beer, wine, spirits and subjective health. J Epidemiol Community Health. 2000; 53(11):721-4. PMC: 1756800. DOI: 10.1136/jech.53.11.721. View

Idalsoaga F, Kulkarni A, Mousa O, Arrese M, Arab J . Non-alcoholic Fatty Liver Disease and Alcohol-Related Liver Disease: Two Intertwined Entities. Front Med (Lausanne). 2020; 7:448. PMC: 7468507. DOI: 10.3389/fmed.2020.00448. View

Cahill P, Redmond E . Alcohol and cardiovascular disease--modulation of vascular cell function. Nutrients. 2012; 4(4):297-318. PMC: 3347010. DOI: 10.3390/nu4040297. View

Rosoff D, Clarke T, Adams M, McIntosh A, Davey Smith G, Jung J . Educational attainment impacts drinking behaviors and risk for alcohol dependence: results from a two-sample Mendelian randomization study with ~780,000 participants. Mol Psychiatry. 2019; 26(4):1119-1132. PMC: 7182503. DOI: 10.1038/s41380-019-0535-9. View

Hu Y, Chen Q, Zhang B . Can Chronic Disease Diagnosis Urge the Patients to Quit Smoking? - Evidence from the China Health and Nutrition Survey. Risk Manag Healthc Policy. 2021; 14:3059-3077. PMC: 8313401. DOI: 10.2147/RMHP.S315358. View

Briasoulis A, Agarwal V, Messerli F . Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2012; 14(11):792-8. PMC: 8108791. DOI: 10.1111/jch.12008. View

Cutler D, Lleras-Muney A . Understanding differences in health behaviors by education. J Health Econ. 2009; 29(1):1-28. PMC: 2824018. DOI: 10.1016/j.jhealeco.2009.10.003. View

Holmes M, Dale C, Zuccolo L, Silverwood R, Guo Y, Ye Z . Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ. 2014; 349:g4164. PMC: 4091648. DOI: 10.1136/bmj.g4164. View

10.

Carpenter C, Dobkin C . The Effect of Alcohol Consumption on Mortality: Regression Discontinuity Evidence from the Minimum Drinking Age. Am Econ J Appl Econ. 2010; 1(1):164-182. PMC: 2846371. DOI: 10.1257/app.1.1.164. View

11.

Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q . Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. JAMA. 2017; 317(24):2515-2523. PMC: 5815077. DOI: 10.1001/jama.2017.7596. View

12.

Chen Q, Chu X, Wang S, Zhang B . A Triple-Difference Approach to Re-Evaluating the Impact of China's New Cooperative Medical Scheme on Incidences of Chronic Diseases Among Older Adults in Rural Communities. Risk Manag Healthc Policy. 2020; 13:643-659. PMC: 7325006. DOI: 10.2147/RMHP.S244021. View

13.

Carpenter C, Dobkin C . The Minimum Legal Drinking Age and Crime. Rev Econ Stat. 2015; 97(2):521-524. PMC: 4477871. DOI: 10.1162/REST_a_00489. View

14.

Shankar A, Klein R, Klein B . The association among smoking, heavy drinking, and chronic kidney disease. Am J Epidemiol. 2006; 164(3):263-71. DOI: 10.1093/aje/kwj173. View

15.

Fletcher J, Marksteiner R . Causal Spousal Health Spillover Effects and Implications for Program Evaluation. Am Econ J Econ Policy. 2018; 9(4):144-166. PMC: 6063372. DOI: 10.1257/pol.20150573. View

16.

Zhang S, Chen Q, Zhang B . Understanding Healthcare Utilization In China Through The Andersen Behavioral Model: Review Of Evidence From The China Health And Nutrition Survey. Risk Manag Healthc Policy. 2019; 12:209-224. PMC: 6857654. DOI: 10.2147/RMHP.S218661. View

17.

Falba T, Sindelar J . Spousal concordance in health behavior change. Health Serv Res. 2008; 43(1 Pt 1):96-116. PMC: 2323137. DOI: 10.1111/j.1475-6773.2007.00754.x. View

18.

Meyler D, Stimpson J, Peek M . Health concordance within couples: a systematic review. Soc Sci Med. 2007; 64(11):2297-310. DOI: 10.1016/j.socscimed.2007.02.007. View

19.

Zhao Y, Zhao G, Chen Z, She Z, Cai J, Li H . Nonalcoholic Fatty Liver Disease: An Emerging Driver of Hypertension. Hypertension. 2019; 75(2):275-284. DOI: 10.1161/HYPERTENSIONAHA.119.13419. View

20.

Veracruz N, Hameed B, Saab S, Wong R . The Association Between Nonalcoholic Fatty Liver Disease and Risk of Cardiovascular Disease, Stroke, and Extrahepatic Cancers. J Clin Exp Hepatol. 2021; 11(1):45-81. PMC: 7897860. DOI: 10.1016/j.jceh.2020.04.018. View