Detrimental drinking patterns: Empirical validation of the pattern values score of the Global Burden of Disease 2000 study in 13 countries

Abstract

In addition to volume, patterns of drinking have an effect on disease and injury. Depending on the prevailing way alcohol is coghnsumed (i.e. on drinking patterns), mortality and morbidity should vary across cultures even if per capita consumption is about the same. In a Comparative Risk Analysis (CRA), the WHO estimated for the year 2000 the Global Burden of Disease stemming from alcohol consumption by including both dimensions of intake (volume and patterns). For this purpose, a detrimental drinking pattern scale was developed. This scale used expert ratings of six dimensions of the prevailing drinking patterns in each country. The present study attempts first to replicate the expert ratings based on survey data from 13 countries. Secondly, it compares the scaling of individual level data with the scaling of aggregate level data. For the latter, such survey measures as percentage usually drinking with meals and percentage usually getting drunk when drinking to approximate the pattern scoring system used in CRA were constructed. Aggregate and individual level analyses resulted in similar orderings of countries on a one‐dimensional scale. There was a good correspondence between the orderings and country's values on the CRA detrimental drinking pattern scale. The ordering of countries varied if men and women were scaled separately. The results indicated a bias of expert ratings towards focusing on male drinking patterns. From analysis of the survey data, the patterns in Nigeria appeared relatively more detrimental than the CRA score based on expert ratings, while the patterns in Finland appeared less detrimental. Future attempts to include drinking patterns in addition to volume should take gender differences into account.

• Drinking patterns
• heavy drinking
• consequences

Acknowledgments

These data are part of the project, Gender, Alcohol and Culture: An International Study (GenACIS). GenACIS is a collaborative international project affiliated with the Kettil Bruun Society for Social and Epidemiological Research on Alcohol and coordinated by GenACIS partners from the University of North Dakota, the University of Southern Denmark, the Free University of Berlin, the World Health Organization, and the Swiss Institute for the Prevention of Alcohol and Drug Problems. Support for aspects of the project comes from the U.S. National Institute on Alcohol Abuse and Alcoholism/National Institutes of Health (Grant Numbers R01 AA04610 and R21 AA12941, Sharon C. Wilsnack, principal investigator), the European Union's Fifth Framework Research Programme (Kim Bloomfield, coordinator), the World Health Organization (Maristela Monteiro and Isidore Obot, coordinators), the German Federal Ministry of Health, and Swiss national funds (BBW 01.0366). Support for individual country surveys was provided by government agencies and other national sources. Data coordinator for the GENACIS project is Gerhard Gmel, Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne, Switzerland. The authors acknowledge the cooperation of Myriam Munné, Argentina; Julio Bejarano, Costa Rica; Ladislav Csémy, Czech Republic; Kim Bloomfield, Denmark; Pia Mäkela, Finland; Zsuzsanna Elekes, Hungary; Hildigunnur Ólafsdóttir, Iceland; Shinji Shimizu, Japan; Akanidomo Ibanga; Nigeria; Siri Hettige, Sri Lanka; Karin Helmersson‐Bergmark, Sweden; Nazarius Tumwesigye, Uganda; Raquel Magri, Uruguay.