@article{ref1,
title="Social determinants of drug-related mortality in a general population",
journal="Drug and alcohol dependence",
year="2017",
author="Rönkä, Sanna and Karjalainen, Karoliina and Martikainen, Pekka and Makela, Pia",
volume="181",
number="",
pages="37-43",
abstract="BACKGROUND: We investigated the association between social determinants and a broad selection of drug-related deaths in a general population. <br><br>METHODS: We conducted a follow-up of an 11% random sample of working-age Finnish residents for 1996-2007 linked with an oversampling of deaths and population registration data on social characteristics. We defined total drug-related deaths as those from psychoactive substance use disorders and drug-induced poisonings (drug-induced deaths) as well as drug-related accidents, homicides, illnesses, and suicides. <br><br>RESULTS: The number of drug-related deaths was three times that of drug-induced deaths. We found the highest hazard ratios (HRs) for total drug-related mortality for long-term unemployment (4.9; 95% confidence interval [CI], 4.3-5.6), short-term unemployment (3.9; 95% CI, 3.5-4.4), and retirement (5.8; 95% CI, 5.1-6.8). The HRs were highest for mortality related to psychoactive substance use disorders and lowest for mortality related to drug-related suicides. The differences were large for both sexes. <br><br>CONCLUSIONS: Drug-related mortality was associated with social disadvantage; however, the strength of the association varied by drug-related cause of death. Primary and secondary prevention of drug use should particularly target disadvantaged groups.<br><br>Copyright © 2017 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2017.09.005",
url="http://dx.doi.org/10.1016/j.drugalcdep.2017.09.005"
}