Temporal changes in geographical disparities in alcohol-attributed disease mortality before and after implementation of the alcohol tax policy in Taiwan

BACKGROUND: Taxation of alcohol-containing products may effectively reduce alcohol consumption. However, whether alcohol taxation may lead to a decrease in alcohol-attributed disease mortality (ADM) remains unclear. The objective of this study was to assess the effect of alcohol tax policy in 2002 in Taiwan on temporal changes in geographical disparities in ADM before and after implementation of the policy. METHODS: Local spatial statistical methods were used to explore the geographic variations in ADM rates and identify statistically significant clusters among townships. RESULTS: Our results indicate that the areas with the highest rates of ADM (127-235 deaths per 100,000 people) were located in mountainous regions, and the areas with the lowest rates of ADM (less than 26 deaths per 100,000 people) were clustered in the most populated areas. The areas where the rates of ADM significantly declined after alcohol taxation was initiated were clustered in the central, southwest and northeast parts of the country. CONCLUSIONS: This study provides evidence of a township-level relationship between the reduction of ADM and alcohol taxation in Taiwan.