Alcohol-related mortality following the loss of a child: a register-based follow-up study from Norway
Solveig Glestad Christiansen1, Anne Reneflot2, Kim Stene-Larsen2
1Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway solveig.christiansen@fhi.no.
Objectives:
The death of one's child is one of the most stressful events a person can experience. Research has shown that bereaved parents have a higher mortality than non-bereaved parents. This increased mortality might partly be caused directly by long-term stress. However, changes in health behaviour such as an increase in alcohol consumption might also play a role. This study examines the association between losing a child and alcohol-related mortality. In addition to Cox regression models using data covering the entire Norwegian adult population, we employ sibling fixed-effect models in order to partly control for genes and childhood experiences that might be associated with both losing a child and alcohol-related mortality.
Design:
A follow-up study between 1986 and 2014 based on Norwegian register data.
Setting:
Norway.
Participants:
The entire Norwegian adult population.
Primary Outcome Measure:
Alcohol-related mortality.
Results:
An increased alcohol-related mortality was found among parents who had experienced the death of a child. The HR of alcohol-related mortality among those bereaved of a child was 1.59 (95% CI 1.48 to 1.71) compared with non-bereaved parents, for women 2.03 (95% CI 1.78 to 2.32) and for men 1.46 (95% CI 1.34 to 1.59). After including sibling fixed effects, the HR of alcohol-related mortality among parents who had lost a child was 1.30 (95% CI 1.03 to 1.64).
Conclusions:
This study provides evidence of an elevated alcohol-related mortality among parents who have lost a child compared with non-bereaved parents. Although strongly attenuated, there is still an association when adjusting for genetic predisposition for alcohol problems as well as childhood environment using sibling fixed-effect models.
