Abstract
There has been a growing consensus that moderate consumption of alcohol is associated with a lower risk of mortality and that this association is probably causal. However, a recent review article has raised a serious challenge to this consensus. In short, it determined that most prior research in this area committed serious misclassification errors; furthermore, among those studies that were free of these misclassification errors, no support for a protective role of alcohol consumption was found. This article reexamines the issue using prospective data for more than 124,000 persons interviewed in the U.S. National Health Interview Surveys of 1997 through 2000 with mortality follow-up through 2002 using the Linked Mortality File. The study involves about 488,000 person-years. Controlling for a variety of covariates, this study finds that compared with nondrinkers, those who consume a moderate amount of alcohol have lower all-cause and CHD mortality. The fact that the current study has taken care to avoid the pitfalls of some earlier studies and still finds that those who consume a moderate amount of alcohol have lower all-cause mortality and CHD mortality lends credence to the argument that the relationship is causal.
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Notes
I use the restricted-use data set. There is a corresponding public-use data set. With the public-use data set, an analyst can obtain the data set to be analyzed at his or her own institution. Owing to confidentiality concerns, however, there are some disadvantages to using the public-use data set. First, the NCHS used “standard data perturbation techniques that introduce statistical noise into the data set” (Lochner et al. 2007:2). Second, “synthetic data were substituted for the actual date and underlying cause-of-death data for selected decedent records” (Lochner et al. 2007:2). Third, while the restricted-use data set reports date of death, the public-use data set reports quarter of death. Given the limitations of the public-use data set, I opted to use the restricted-use data set. For more details, see Lochner et al. (2007).
Not all families reported their income. To deal with missing data, the National Center for Health Statistics (NCHS) used multiple-imputation methodology to create five imputed estimates of family income for each family. As recommended in NCHS documentation, each of the analyses reported in this article was replicated five times, once using each imputation of family income, and the results were then combined. More details are provided by NCHS at http://www.cdc.gov/nchs/about/major/nhis/2000imputedincome.htm and the Technical Documentation linked to that site.
These are found in the document titled “Underlying and Multiple Causes of Death September 2006” located at http://www.cdc.gov/nchs/data/datalinkage/h1_underlying_and_multiple_causes_of_death.pdf.
Former drinkers who rarely binge drink are the same group as all former drinkers; however, the comparison groups are different (i.e., occasional moderate who rarely binge drink versus all occasional moderate binge drinkers).
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Acknowledgment
I would like to thank Margaret Gaines for computational assistance on this paper.
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Fuller, T.D. Moderate Alcohol Consumption and the Risk of Mortality. Demography 48, 1105–1125 (2011). https://doi.org/10.1007/s13524-011-0035-2
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DOI: https://doi.org/10.1007/s13524-011-0035-2