Gauffin Karl, Vinnerljung Bo, Hjern Anders
Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden,
Department of Social Work, Stockholm University, Stockholm, Sweden and.
Int J Epidemiol. 2015 Jun;44(3):919-27. doi: 10.1093/ije/dyv006. Epub 2015 Mar 22.
Alcohol misuse is an important global health determinant and a major contributor to health inequalities. We aimed to investigate the association between school performance and alcohol-related disorders in early adulthood in a longitudinal register-based national cohort study.
We followed a register-based national cohort of Swedish citizens born 1973-1984 (N = 948,440) from compulsory school graduation at age 15-16 to 2009. We divided the population into five groups: high school marks (> mean + 1 SD); high average (between mean and mean + 1 SD); low average (between mean and mean - 1 SD); low (< mean - 1SD); and missing. Cox proportional hazard models were used to investigate the relation between school marks at time of graduation and hospital care for alcohol-related disorders in early adulthood.
There was a steep gradient in the risk of alcohol-related disorders related to school performance. In comparison with peers in the top category of school marks, students with low marks had adjusted hazard ratios of 8.02 [95% confidence interval (CI) 7.20 to 8.91], low average 3.02 (2.72 to 3.35) and high average 1.55 (1.39 to 1.73). The risk associated with low school marks was stronger in the male population and in the group from high socioeconomic background.
The study demonstrated a strong graded relation between low school performance and alcohol-related disorders in young adulthood. School performance should be taken into account when developing prevention programmes/policies targeting alcohol misuse among teenagers and young adults, especially if the aim is to reach high-risk groups.
酒精滥用是一个重要的全球健康决定因素，也是健康不平等的主要促成因素。我们旨在通过一项基于纵向登记的全国队列研究，调查成年早期学业成绩与酒精相关障碍之间的关联。
我们追踪了一个基于登记的瑞典公民全国队列，这些公民出生于1973年至1984年（N = 948,440），从15 - 16岁义务教育毕业一直到2009年。我们将人群分为五组：高中成绩（>平均成绩 + 1标准差）；高平均分（在平均成绩和平均成绩 + 1标准差之间）；低平均分（在平均成绩和平均成绩 - 1标准差之间）；低成绩（<平均成绩 - 1标准差）；以及缺失成绩。使用Cox比例风险模型来研究毕业时的学业成绩与成年早期酒精相关障碍的住院治疗之间的关系。
与酒精相关障碍的风险与学业成绩之间存在陡峭的梯度关系。与学业成绩最高组的同龄人相比，成绩低的学生调整后的风险比为8.02 [95%置信区间（CI）7.20至8.91]，低平均分的学生为3.02（2.72至3.35），高平均分的学生为1.55（1.39至1.73）。低学业成绩相关的风险在男性人群和高社会经济背景组中更强。
该研究表明，成年早期学业成绩低与酒精相关障碍之间存在强烈的分级关系。在制定针对青少年和年轻人酒精滥用的预防计划/政策时，应考虑学业成绩，特别是如果目标是针对高危人群。
