Using death certificate data from the National Center for Health Statistics, the study’s authors identified 425,045 alcohol-induced deaths in the United States between 2000 and 2016. Those deaths climbed from 19,627 in 2000 to 34,847 in 2016.
After adjusting for increases in the country’s population, the study’s authors calculated that the rate of alcohol-induced deaths in the U.S. jumped from 8.9 per 100,000 people in 2000 to 12 per 100,000 in 2016 — a 34 percent increase.
Three out of four of those deaths were among men. But women saw their rate climb the quickest — by an average of 3.1 percent per year compared to an average of 1.4 percent per year for men.
And those rates have accelerated in recent years. Between 2012 and 2016, alcohol-induced deaths increased an average of 4.2 percent per year for men and a startling 7.2 percent per year for women.
The study’s findings reflect, however, only a subset of alcohol-related fatalities in the U.S. — just the ones that would not have occurred if alcoholic consumption had been avoided, such as alcohol-caused liver disease, alcohol poisoning (overdosing) and mental and behavioral problems related to liquor.
“We excluded causes known to be alcohol-related but not 100 percent alcohol-attributable, such as road traffic accidents, alcohol-associated cancers, and infections and organ system diseases known to be associated with alcohol use,” said Susan Spillane, the study’s lead author and an epidemiologist at the National Cancer Institute, in an interview with HealthDay.
“Rates of alcohol-induced deaths, as documented in our study, are bellwethers of a far larger public health problem, as these rates capture only a portion of all alcohol-related deaths and say nothing of alcohol-related morbidities,” she added.
The magnitude of the problem is “huge,” agrees Dr. Frederick Rivara, editor-in-chief of JAMA Network Open and a professor of pediatrics at the University of Washington in Seattle, in an audio discussion about the study. “Particularly, if we’re not including a big portion of it. You’re actually in the same order of magnitude as opioid-related deaths.”
Here are some of the other trends uncovered in the study:
Race/ethnicity. The largest increases in alcohol-induced deaths by race and ethnicity during the study period occurred among American Indian and Alaska Native women (4.2 percent per year), white women (4.1 percent) and American Indian and Alaska Native men (3.3 percent). Alcohol-induced deaths declined among black men and Latino men until 2013, when the rates started climbing. Until 2007, they had also been declining for black women.
“Within the [American Indian and Alaska Native] population, alcohol misuse should be considered within the context of historical trauma and exposure to other risk factors, which include poverty, family history of alcohol use disorder, availability of alcohol at a younger age through peer groupings that include older relatives, and acculturation stress,” the researchers write. “Additionally, available treatment and testing interventions have largely developed for other populations and are poorly suited to the [American Indian and Alaska Native] populations.”
Age. The peak age period for alcohol-induced deaths among people of all groups in the study was 55 to 64, except for the American Indian and Alaska Native group. They were most likely to die as a result of alcohol between the ages of 45 and 49. Younger people are becoming increasingly at risk, however. Among whites, the steepest increase in alcohol-induced mortality occurred among adults aged 25 to 34 years — particularly women.
Geography. Rates of alcohol-induced deaths tended to be higher in western states, although increases occurred across the country.
The study doesn’t provide individual state statistics, but the Minnesota Department of Health reported last year that the number of alcohol-related deaths in the state has increased significantly over the past 15 years, from an annual average rate of 18.6 per 100,000 during 2001-2005 to a rate of 28.9 per 100,000 during 2013-2017. Those figures include all types of alcohol-related deaths, however, including motor vehicle crashes, suicides and homicides.
Limitations and implications
As already noted, this study restricted its definition of alcohol-induced deaths to ones that are 100 percent attributable to alcohol consumption.
“Thus, although our analysis of trends in alcohol-induced deaths provides an important indicator of the consequences of alcohol on population health, our findings substantially underestimate the full mortality burden,” Spillane and her co-authors write.
The researchers also relied on death certificate information, which may or may not have been entirely accurate about the cause of death — or about other demographic data.
Still, the findings are deeply troubling, particularly as alcohol-induced deaths are entirely preventable.
Also, the findings suggest the problem will only worsen in the coming years.
“Because many of the consequences of alcohol consumption occur later in life, large increases in alcohol-induced deaths among younger age groups portend substantial future increase in alcohol-related disease,” explain Spillane and her co-authors. “Thus, narratives regarding increasing deaths among white US residents at midlife should be extended to note large increases in rates of alcohol-induced death among women and younger groups as well as among minority populations.”
“Reflecting on the consequences of alcohol-related morbidity and mortality throughout the age range, our findings document an urgent public health crisis calling for concerted public health action,” they add.
FMI: You can read the study in full on the JAMA Network Open website.