Petrie Dennis, Doran Chris, Shakeshaft Anthony, Sanson-Fisher Rob
Economic Studies, University of Dundee, Scotland, United Kingdom.
Soc Sci Med. 2008 Dec;67(11):1717-26. doi: 10.1016/j.socscimed.2008.09.017. Epub 2008 Oct 20.
Alcohol misuse represents one of the leading causes of preventable death, illness and injury in Australia. Extensive research exists estimating the effect of risky alcohol use on mortality, but little research quantifies the impact of risky alcohol consumption on morbidity. Such estimates are required to more precisely measure the benefit of interventions aimed at reducing risky alcohol use. Ordered probit and tobit models are used in this research to analyse the impact of risky drinking on self-reported health status using questionnaire data from an age and gender stratified sample drawn from 20 rural communities in New South Wales which are part of a large randomised controlled trial of community based alcohol interventions. It is found that risky alcohol use is associated with lower self-reported health; however, the average effect is small apart for those drinking at very-high risk. The effect of alcohol on morbidity, derived from the current analyses, is lower than that commonly used in current economics analyses. If this is accurate for geographical regions other than rural Australia, then from a policy viewpoint, these economic analyses may tend to overemphasise interventions which are morbidity reducing, such as taxation, and place undue focus on alcohol as a risk factor and consequently adversely impact resource allocation decisions.
酒精滥用是澳大利亚可预防的死亡、疾病和伤害的主要原因之一。已有大量研究估算了危险饮酒对死亡率的影响，但很少有研究对危险饮酒对发病率的影响进行量化。需要此类估算来更精确地衡量旨在减少危险饮酒的干预措施的益处。本研究使用有序概率模型和托比特模型，利用新南威尔士州20个农村社区年龄和性别分层样本的问卷调查数据，分析危险饮酒对自我报告健康状况的影响，这些社区是一项基于社区的酒精干预大型随机对照试验的一部分。研究发现，危险饮酒与较低的自我报告健康状况相关；然而，除了那些饮酒风险极高的人之外，平均影响较小。从当前分析得出的酒精对发病率的影响低于当前经济学分析中常用的影响。如果这对于澳大利亚农村以外的地理区域也是准确的，那么从政策角度来看，这些经济分析可能倾向于过度强调降低发病率的干预措施，如税收，并过度关注酒精作为一个风险因素，从而对资源分配决策产生不利影响。
