College of Economics and Management, China Agricultural University, Beijing, China.
College of Economics and Management, China Agricultural University, Beijing, China
BMJ Open. 2022 Oct 11;12(10):e062920. doi: 10.1136/bmjopen-2022-062920.
This study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals' alcohol consumption behaviour.
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.
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.
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.
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.
本研究估计慢性病诊断对中国老年个体饮酒行为的影响。
我们的分析应用于一个公开可用的数据集，该数据集涵盖了来自中国健康与营养调查的 5724 名 50 岁及以上的个体，涵盖了 15 年（2000-2015 年：六波）。
因变量是老年个体每周饮酒量：啤酒、红酒、白酒和总饮酒量。主要感兴趣的解释变量是诊断出的慢性病数量（包括高血压、糖尿病、中风和心肌梗死）。其他协变量涉及样本个体的社会人口统计学和健康相关特征。采用 Chamberlain-Mundlak 相关随机效应 Tobit 模型，同时考虑到因变量中的“零”聚类和遗漏变量、反向因果关系等内生性问题。
我们的估计表明，平均而言，医生诊断出的额外慢性病分别使中国老年个体每周的啤酒、红酒和白酒消费量减少了 1.49 盎司（95%CI-2.85 至-0.13）、0.93 盎司（95%CI-1.63 至-0.23）和 0.89 盎司（95%CI-1.23 至-0.54）。这些影响相当于每周总饮酒量减少了 0.95 盎司（95%CI-1.29 至-0.60），过量饮酒的发生率降低了 24%（95%CI-0.35 至-0.14）。进一步的探索表明，中国老年个体的饮酒行为对糖尿病和中风诊断最为敏感，但不同饮料的影响不同。此外，男性、农村居民、吸烟者和与不饮酒者同住的人对慢性病诊断的反应比各自的对照更强烈。
虽然慢性病诊断降低了中国老年个体的饮酒量，但未能阻止所有重度饮酒者过量饮酒。因此，需要相关政策和措施来敦促重度饮酒患者戒酒。
