Browsing by Author "Reile, Rainer"

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    Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020
    (2023-12) Vaitkevičiūtė, Justina; Gobiņa, Inese; Janik-Koncewicz, Kinga; Lange, Shannon; Miščikienė, Laura; Petkevičienė, Janina; Radišauskas, Ričardas; Reile, Rainer; Štelemėkas, Mindaugas; Stoppel, Relika; Telksnys, Tadas; Tran, Alexander; Rehm, Jürgen; Zatoński, Witold A; Jiang, Huan; Department of Public Health and Epidemiology; Institute of Public Health
    Alcohol consumption in the Baltic countries and Poland is among the highest globally, causing high all-cause mortality rates. Contrary to Poland, the Baltic countries have adopted many alcohol control policies, including the World Health Organization (WHO) "best buys". The aim of this study was to evaluate the impact of these policies, which were implemented between 2001 and 2020, on all-cause mortality. Monthly mortality data for men and women aged 20+ years of age in Estonia, Latvia, Lithuania, and Poland were analysed for 2001 to 2020. A total of 19 alcohol control policies, fulfilling an a-priori defined definition, were implemented between 2001 and 2020 in the countries of interest, and 18 of them could be tested. Interrupted time-series analyses were conducted by employing a generalized additive mixed model (GAMM) for men and women separately. The age-standardized all-cause mortality rate was lowest in Poland and highest in Latvia and had decreased in all countries over the time period. Taxation increases and availability restrictions had short-term effects in all countries, on average reducing the age-standardized all-cause mortality rate among men significantly (a reduction of 2.31% (95% CI 0.71%, 3.93%; p = 0.0045)). All-cause mortality rates among women were not significantly reduced (a reduction of 1.09% (95% CI - 0.02%, 2.20%; p = 0.0554)). In conclusion, the alcohol control policies implemented between 2001 and 2020 reduced all-cause mortality among men 20+ years of age in Baltic countries and Poland, and thus, the practice should be continued.
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    Alcohol-attributable mortality and alcohol control policy in the Baltic Countries and Poland in 2001–2020 : an interrupted time-series analysis
    (2023-11-09) Radišauskas, Ričardas; Štelemėkas, Mindaugas; Petkevičienė, Janina; Trišauskė, Justina; Telksnys, Tadas; Miščikienė, Laura; Gobina, Inese; Stoppel, Relika; Reile, Rainer; Janik-Koncewicz, Kinga; Zatonski, Witold; Lange, Shannon; Tran, Alexander; Rehm, Jürgen; Jiang, Huan; Department of Public Health and Epidemiology; Institute of Public Health
    Background: The Baltic countries–Lithuania, Latvia and Estonia–are characterized by a high rate of fully alcohol-attributable mortality, compared with Poland. Alcohol control policy measures implemented since 2001 in the Baltic countries included a restriction on availability and an increase in excise taxation, among others. The aim of the current study was to evaluate the relationship between alcohol control policy implementation and alcohol-attributable mortality in the Baltic countries and Poland. Methods: Alcohol-attributable mortality data for 2001–2020 was defined by codes 100% alcohol-attributable for persons aged 15 years and older in the Baltic countries and Poland. Alcohol control policies implemented between 2001 and 2020 were identified, and their impact on alcohol-attributable mortality was evaluated using an interrupted time-series methodology by employing a generalized additive model. Results: Alcohol-attributable mortality was significantly higher in the Baltic countries, compared with Poland, for both males and females. In the final reduced model, alcohol control policy significantly reduced male alcohol-attributable mortality by 7.60% in the 12 months post-policy implementation. For females, the alcohol control policy mean-shift effect was higher, resulting in a significant reduction of alcohol-attributable mortality by 10.77% in the 12 months post-policy implementation. The interaction effects of countries and policy tested in the full model were not statistically significant, which indicated that the impact of alcohol control policy on alcohol-attributable mortality did not differ across countries for both males and females. Conclusions: Based on the findings of the current study, alcohol control policy in the form of reduced availability and increased taxation was associated with a reduction in alcohol-attributable mortality among both males and females.
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    Impact of health spending on hospitalization rates in Baltic countries : a comparative analysis
    (2024-01) Jiang, Huan; Tran, Alexander; Gobiņa, Inese; Petkevičienė, Janina; Reile, Rainer; Štelemėkas, Mindaugas; Radisauskas, Ricardas; Lange, Shannon; Rehm, Jürgen; Department of Public Health and Epidemiology
    Introduction: This study examines the association between healthcare indicators and hospitalization rates in three high-income European countries, namely Estonia, Latvia, and Lithuania, from 2015 to 2020. Method: We used a sex-stratified generalized additive model (GAM) to investigate the impact of select healthcare indicators on hospitalization rates, adjusted by general economic status—i.e., gross domestic product (GDP) per capita. Results: Our findings indicate a consistent decline in hospitalization rates over time for all three countries. The proportion of health expenditure spent on hospitals, the number of physicians and nurses, and hospital beds were not statistically significantly associated with hospitalization rates. However, changes in the number of employed medical doctors per 10,000 population were statistically significantly associated with changes of hospitalization rates in the same direction, with the effect being stronger for males. Additionally, higher GDP per capita was associated with increased hospitalization rates for both males and females in all three countries and in all models. Conclusions: The relationship between healthcare spending and declining hospitalization rates was not statistically significant, suggesting that the healthcare systems may be shifting towards primary care, outpatient care, and on prevention efforts.
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    The Impact of Raising Alcohol Taxes on Government Tax Revenue : Insights from Five European Countries
    (2024-05) Manthey, Jakob; Gobiņa, Inese; Isajeva, Laura; Neneman, Jarosław; Reile, Rainer; Štelemėkas, Mindaugas; Rehm, Jürgen; Department of Public Health and Epidemiology; Institute of Public Health
    Background and Objective: Reducing the affordability of alcoholic beverages by increasing alcohol excise taxation can lead to a reduction in alcohol consumption but the impact on government alcohol excise tax revenue is poorly understood. This study aimed to (a) describe cross-country tax revenue variations and (b) investigate how changes in taxation were related to changes in government tax revenue, using data from Estonia, Germany, Latvia, Lithuania and Poland. Methods: For the population aged 15 years or older, we calculated the annual per capita alcohol excise tax revenue, total tax revenue, gross domestic product and alcohol consumption. In addition to descriptive analyses, joinpoint regressions were performed to identify whether changes in alcohol excise taxation were linked to changes in alcohol excise revenue since 1999. Results: In 2022, the per capita alcohol excise tax revenue was lowest in Germany (€44.2) and highest in Estonia (€218.4). In all countries, the alcohol excise tax revenue was mostly determined by spirit sales (57–72% of total alcohol tax revenue). During 2010–20, inflation-adjusted per capita alcohol excise tax revenues have declined in Germany (− 22.9%), Poland (− 19.1%) and Estonia (− 4.2%) and increased in Latvia (+ 56.8%) and Lithuania (+ 49.3%). In periods of policy non-action, alcohol consumption and tax revenue showed similar trends, but tax level increases were accompanied by increased revenue and stagnant or decreased consumption. Conclusions: Increasing alcohol taxation was not linked to decreased but increased government revenue. Policymakers can increase revenue and reduce alcohol consumption and harm by increasing alcohol taxes.
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    Impact of the WHO “best buys” for alcohol policy on consumption and health in the Baltic countries and Poland 2000–2020
    (2023-10) Rehm, Jürgen; Badaras, Robertas; Ferreira-Borges, Carina; Galkus, Lukas; Gostautaite Midttun, Nijole; Gobiņa, Inese; Janik-Koncewicz, Kinga; Jasilionis, Domantas; Jiang, Huan; Kim, Kawon Victoria; Lange, Shannon; Liutkutė-Gumarov, Vaida; Manthey, Jakob; Miščikienė, Laura; Neufeld, Maria; Petkevičienė, Janina; Radišauskas, Ričardas; Reile, Rainer; Room, Robin; Stoppel, Relika; Tamutienė, Ilona; Tran, Alexander; Trišauskė, Justina; Zatoński, Mateusz; Zatoński, Witold A.; Zurlytė, Ingrida; Štelemėkas, Mindaugas; Department of Public Health and Epidemiology; Institute of Public Health
    Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.
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    The prevalence of genital warts in the Baltic countries : Findings from national cross-sectional surveys in Estonia, Latvia and Lithuania
    (2015-02-01) Uusküla, Anneli; Reile, Rainer; Rezeberga, Dace; Karnite, Anda; Logminiene, Zeneta; Padaiga, Žilvinas; Nygard, Mari; Department of Obstetrics and Gynaecology; Department of Public Health and Epidemiology
    Objectives: To assess the prevalence and correlates of self-reported genital warts (GWs) among women and men aged 18-45 years in the Baltic countries. Methods: In 2011-2013 we performed a cross-sectional survey using a self-administered questionnaire to collect information on the history of clinically diagnosed GWs, sociodemographic characteristics and sexual behaviour. Probability sampling methods were used to invite 16 959 individuals representing the general population, of whom 7760 (45.8%) participated (Estonia: 1967 women, 1221 men; Latvia: 1525 women, 1525 men; Lithuania: 1522 women). Results: The estimated lifetime prevalence of clinically diagnosed GWs in women was 4.6% (95% CI 3.8 to 5.5) in Estonia, 2.9% (95% CI 2.0 to 3.6) in Latvia and 1.5% (95% CI 1.2 to 2.0) in Lithuania. Among men, the corresponding values were 2.8% (95% CI 1.9 to 4.0) in Estonia and 1.9% (95% CI 1.3 to 2.6) in Latvia. The mean age at first episode of clinically diagnosed GW was 24.6 years (95% CI 23.6 to 25.5) for women and 24.5 years (95% CI 22.9 to 26.0) for men. A lifetime history of clinically diagnosed GW was associated with a history of sexually transmitted infections other than GW (adjusted OR (AOR) 3.0, 95% CI 2.1 to 4.3 for women; AOR 5.3, 95% CI 3.0 to 9.2 for men), and a higher number (5+) of lifetime sexual partners (AOR 2.9, 95% CI 1.9 to 4.2 for women; AOR 2.1, 95% CI 1.2 to 3.9 for men). Men living comfortably within their household income had higher odds for GW (AOR 1.9, 95% CI 1.1 to 3.2). Conclusions: Our estimated prevalence of clinically diagnosed GWs was lower than estimates from the general population of other European countries.