Alcohol Causing ‘Urgent Public Health Crisis’ in U.S., Study Says

Alcohol has been increasingly responsible for deaths across racial, ethnic and gender lines in the U.S. in recent years, according to a new study, and surging death rates among younger whites are helping fuel what researchers call “an urgent public health crisis.”

“Many of the diseases that are caused by alcohol occur among people who consume alcohol for many years, so we think this is concerning if the rates of alcohol-induced deaths are going up among people in their 20s or 30s,” says Neal Freedman, senior investigator in the National Cancer Institute’s cancer epidemiology and genetics division and senior author of the study. “When that group of people are in their 50s and 60s … they’ll have very high rates of alcohol-induced deaths as they age.”

“These increases are concerning, but the ultimate impact of alcohol on the population maybe even larger going into the future,” he says.

For the study – published Friday in JAMA Network Open – Freedman and colleagues examined data on alcohol-induced deaths that occurred between 2000 and 2016 among members of the U.S. population older than 15. These deaths are “due to alcohol consumption” and are tied to causes such as alcoholic liver disease and alcohol poisoning, according to the study, but exclude deaths potentially related to alcohol, such as traffic accidents.

Researchers identified 425,045 alcohol-induced deaths within the study’s time frame. In 2016 alone, 34,857 deaths occurred at a rate of 12 deaths per 100,000 residents – an increase from the nearly 20,000 deaths that occurred at a rate of 8.9 per 100,000 in 2000.

“On the one hand, we document nearly 35,000 deaths from alcohol-induced causes in 2016. and that’s by itself a substantial number of people,” Freedman says. But “this number is an underestimate because we very conservatively classified alcohol-induced deaths. … We’re really underestimating the full impact of alcohol on the population.”

About 72% of those who died in 2016 were men; alcoholic liver disease was responsible for about 60% of those deaths and for nearly 70% of alcohol-induced deaths among women.

Researchers also found that the alcohol-induced death rate for women increased at a faster pace from 2000 to 2016, with a 3.1% average rate of annual change for women compared with 1.4% for men.

Rates for both genders accelerated closer to 2016: Men saw an annual change of 4.2% between 2012 and 2016, while the rate stood at 7.1% among women from 2013 to 2016.

Broken down by race and ethnicity, researchers found that alcohol-induced death rates increased over the study’s time frame among both white men – at an average rate of 2.3% – and white women, at an average rate of 4.1%. Though death rates initially declined for Latino men and black men and women, the trends reversed later in the study period, and mortality rates increased from 2013 to 2016 in all examined racial and ethnic groups, which also included Asians and Pacific Islanders and American Indians/Alaska Natives.

The largest average annual percentage increases in alcohol-induced deaths occurred among American Indian and Alaska Native men, at 3.3%; American Indian and Alaska Native women at 4.2%; and white women.

“It’s known that alcohol induced deaths are happening at a higher rate among American Indians and Alaska Natives … I think that’s a really important concern in those communities,” Freedman says. “But I think it’s very concerning because not only do we see very high rates within that racial-ethnic group, but also the rates increased quite a lot over the time period that we examined.”

In the most recent period covered by the study – from 2013 to 2016 – the results showed that peak alcohol-induced mortality occurred between the ages of 55 and 64 across all racial and ethnic groups except American Indians and Alaska Natives, who experienced peak mortality among those 45 to 49 years old.

The study also showed large increases in mortality among white men and women between the ages of 25 to 34, and notes that “the steepest increases in the rates of alcohol-induced deaths among white individuals in our study population occurred among younger adults, particularly women.”

From 2000 to 2016, death rates in the 25-to-34 age group increased between 4.6% and 6.9% per year for white men and between 7.3% and 12% per year for white women, according to the study.

“If you wanted to look at the absolute number of deaths, like what group of people (had) the most number of people dying within the U.S. population, it’s among the older people,” Freedman says. “But if we think about where is the increase in this trend happening most, it’s the younger people.”

“That’s why we think it’s important that there’s research that’s done to understand at an individual level what are the trends in alcohol use and what kind of policies maybe could be developed to reduce these trends and to reduce the number of deaths caused by alcohol in the population,” Freedman says.

In the study, researchers said their findings are generally supported by other studies showing recent increases in alcohol use, high-risk drinking and alcohol use disorders “particularly among women and other population subgroups not traditionally recognized as being at high risk.”

They also noted that the exclusion of deaths known to be tied to alcohol but not “100% attributable to alcohol” – such as car accidents and certain types of cancer – means their findings “substantially underestimate the full mortality burden.”

They said the results serve as concerning indicators of a dire public health issue.

“Narratives regarding increasing deaths among white U.S. 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,” the study says.

“Our findings document an urgent public health crisis calling for concerted public health action.”

[Read More…]