National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study

Shield, Kevin D.; Manthey, Jakob; Rylett, Margaret; Probst, Charlotte; Wettlaufer, Ashley; Parry, Charles; Rehm, Jürgen

doi:10.1016/s2468-2667(19)30231-2

Cited by 381 publications

(402 citation statements)

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“…For both prevalence and attributable burden, we relied on data from the WHO Global Status Report on Alcohol and Health [4], as slightly updated by Shield and colleagues [5]. As both authors undertook the burden calculations and were authors for the Global Status Report and subsequent publications, we report not only previously published data, but also our own calculations based on the underlying data.…”

Section: Data Sourcesmentioning

confidence: 99%

“…By definition, all health harms caused by AUDs were initially caused by alcohol use. In those aged 15 years or older, these harms amounted to about 145,000 AUDs deaths in 2016 (145,600; no 95% CI is available as the Global Health Estimates do not estimate CIs for cause of death or disease burden; [5,35]). A significant gender disparity exists for AUDs, due to the higher level and more detrimental patterns of drinking in men.…”

Section: Alcohol Use Disordersmentioning

confidence: 99%

“…Alcohol consumption caused almost half of the deaths attributed to chronic liver disease [5,36]. In the age group of 15 years and up, nearly 50% of the 1,254,000 liver disease deaths in 2016 were estimated to be alcohol-attributable (588,100; 95% CI: 531,700-683,400; 46.9% of all liver disease, 95% CI: 42.4-54.5%) [5]. This proportion is similar to previous estimates [15,32].…”

Section: Alcoholic Liver Diseasementioning

confidence: 99%

“…Alcohol use is a major risk factor for mortality and morbidity, playing a role in more than 200 diseases and injury outcomes [1,2]. However, for most regions, it can be shown that a few of the larger disease and injury categories capture more than 90% of alcohol-attributable mortality and burden of disease (the latter usually measured in disability-adjusted life-years DALYs [3]), namely alcohol use disorders (AUDs), cancer, cardiovascular disease, liver disease, and injury [4,5]. This contribution will focus on two of these major contributors to alcohol-attributable burden of disease: AUDs and alcoholic liver disease (ALD).…”

Section: Introductionmentioning

confidence: 99%

“…The burden for ALD is clearly larger than for AUDs in terms of DALYs and particularly for mortality (but see previous point). ALD is the single most important health harm caused by alcohol use [4,5]. The estimation methodology used is consistent with the definition of ALD (i.e., without alcohol use, these cases of ALD deaths or disease would not have existed).…”

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confidence: 99%

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Global Burden of Alcohol Use Disorders and Alcohol Liver Disease

2019

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Alcohol use is a major risk factor for burden of mortality and morbidity. Alcoholic liver disease (ALD) and alcohol use disorders (AUDs) are important disease outcomes caused by alcohol use. We will describe the global mortality and burden of disease in disability-adjusted life years for ALD and AUDs, based on data from the comparative risk assessment of the World Health Organization for 2016. AUDs have a limited impact on mortality in this assessment, since alcohol poisonings are almost the only disease category directly attributable to AUDs; most other alcohol-related deaths are indirect, and the cause which directly led to the death, such as liver cirrhosis, is the one recorded on the death certificate. Burden of disease for AUDs is thus mainly due to disability resulting from alcohol use. In contrast to AUDs, ALD is one of the major lethal outcomes of alcohol use, and burden of disease is mainly due to (premature) years of life lost. Many of the negative outcomes attributable to both AUDs and ALD are due to their interactions with other factors, most notably economic wealth. To avoid alcohol-attributable morbidity and mortality, measures should be taken to reduce the AUDs and ALD burden globally, especially among the poor.

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Section: Data Sourcesmentioning

confidence: 99%

Section: Alcohol Use Disordersmentioning

confidence: 99%

Section: Alcoholic Liver Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Global Burden of Alcohol Use Disorders and Alcohol Liver Disease

2019

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Estimated Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 64 Years, 2015 to 2019

et al. 2022

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ImportanceAlcohol consumption is a leading preventable cause of death in the US, and death rates from fully alcohol-attributable causes (eg, alcoholic liver disease) have increased in the past decade, including among adults aged 20 to 64 years. However, a comprehensive assessment of alcohol-attributable deaths among this population, including from partially alcohol-attributable causes, is lacking.ObjectiveTo estimate the mean annual number of deaths from excessive alcohol use relative to total deaths among adults aged 20 to 64 years overall; by sex, age group, and state; and as a proportion of total deaths.Design, Setting, and ParticipantsThis population-based cross-sectional study of mean annual alcohol-attributable deaths among US residents between January 1, 2015, and December 31, 2019, used population-attributable fractions. Data were analyzed from January 6, 2021, to May 2, 2022.ExposuresMean daily alcohol consumption among the 2 089 287 respondents to the 2015-2019 Behavioral Risk Factor Surveillance System was adjusted using national per capita alcohol sales to correct for underreporting. Adjusted mean daily alcohol consumption prevalence estimates were applied to relative risks to generate alcohol-attributable fractions for chronic partially alcohol-attributable conditions. Alcohol-attributable fractions based on blood alcohol concentrations were used to assess acute partially alcohol-attributable deaths.Main Outcomes and MeasuresAlcohol-attributable deaths for 58 causes of death, as defined in the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application. Mortality data were from the National Vital Statistics System.ResultsDuring the 2015-2019 study period, of 694 660 mean deaths per year among adults aged 20 to 64 years (men: 432 575 [66.3%]; women: 262 085 [37.7%]), an estimated 12.9% (89 697 per year) were attributable to excessive alcohol consumption. This percentage was higher among men (15.0%) than women (9.4%). By state, alcohol-attributable deaths ranged from 9.3% of total deaths in Mississippi to 21.7% in New Mexico. Among adults aged 20 to 49 years, alcohol-attributable deaths (44 981 mean annual deaths) accounted for an estimated 20.3% of total deaths.Conclusions And RelevanceThe findings of this cross-sectional study suggest that an estimated 1 in 8 total deaths among US adults aged 20 to 64 years were attributable to excessive alcohol use, including 1 in 5 deaths among adults aged 20 to 49 years. The number of premature deaths could be reduced with increased implementation of evidenced-based, population-level alcohol policies, such as increasing alcohol taxes or regulating alcohol outlet density.

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et al. 2021

Cochrane Database of Systematic Reviews

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Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year.Methods For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0•603 (0•400-1•00) standard drinks per day, and the NDE varied between 0•002 (0-0) and 1•75 (0•698-4•30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0•114 (0-0•403) to 1•87 (0•500-3•30) standard drinks per day and an NDE that ranged between 0•193 (0-0•900) and 6•94 (3•40-8•30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59•1% (54•3-65•4) were aged 15-39 years and 76•9% (73•0-81•3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding Bill & Melinda Gates Foundation.

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National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study

Cited by 381 publications

References 27 publications

Global Burden of Alcohol Use Disorders and Alcohol Liver Disease

Global Burden of Alcohol Use Disorders and Alcohol Liver Disease

Estimated Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 64 Years, 2015 to 2019

Information provision for stroke survivors and their carers

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