Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
Drug Alcohol Rev. 2024 Sep;43(6):1338-1348. doi: 10.1111/dar.13901. Epub 2024 Jul 15.
Alcohol remains a significant contributor to mortality and morbidity in Finland and the Baltic countries, particularly among men. This study aimed to assess alcohol policy restrictiveness in this region from 1995 to 2019 using a modified version of the Bridging the Gap (BtG-M) policy scale and examine its association with alcohol-related disease burden.
The study utilised national laws to score policy restrictiveness (higher BtG-M scores mean stricter policies) and age-standardised rates of disability-adjusted life years (DALY), years of life lost, years lived with disability and deaths per 100,000 from the 2019 Global Burden of Disease Study (GBD). Spearman correlation tests and panel data regression models were applied to assess the association between policy score and burden of disease.
Finland maintained a high BtG-M score, while the Baltic countries experienced recent increases from initially lower scores. Alcohol-related disease burden showed an inverse association with policy changes in these countries. Strongest association was seen between the BtG-M score and DALY rates attributed to injuries. Premature mortality among men constituted the largest proportion of disease burden.
Despite challenges in accessing and comparing policy data over time, we showed a strong association between alcohol policy and alcohol-related harm in Finland and the Baltic countries. This study is one of the first to use the BtG-M scale to monitor changes in alcohol policies over time and their relationship to alcohol-related harm using GBD methodology. The study highlights the effects of national alcohol policies on levels of alcohol-related harm.
在芬兰和波罗的海国家，酒精仍然是导致死亡率和发病率的一个重要因素，尤其是在男性中。本研究旨在使用改进后的“弥合差距”（BtG-M）政策量表评估该地区 1995 年至 2019 年期间的酒精政策限制程度，并研究其与酒精相关疾病负担的关系。
本研究利用国家法律对政策限制程度进行评分（BtG-M 评分越高表示政策越严格），并使用 2019 年全球疾病负担研究（GBD）的年龄标准化残疾调整生命年（DALY）、损失生命年、残疾生活年和每 10 万人死亡人数来评估疾病负担。采用 Spearman 相关检验和面板数据回归模型来评估政策评分与疾病负担之间的关系。
芬兰保持了较高的 BtG-M 评分，而波罗的海国家则经历了最近的政策变化，其评分从最初较低的水平上升。这些国家的酒精相关疾病负担与政策变化呈负相关。在 BtG-M 评分与归因于损伤的 DALY 率之间观察到最强的关联。男性的过早死亡构成了疾病负担的最大比例。
尽管在不同时间获取和比较政策数据方面存在挑战，但我们在芬兰和波罗的海国家的酒精政策与酒精相关危害之间显示出很强的关联。本研究是使用 BtG-M 量表来监测随着时间的推移酒精政策变化及其与酒精相关危害之间关系的首批研究之一，使用 GBD 方法。该研究强调了国家酒精政策对酒精相关危害水平的影响。
