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. 2022 Nov 1;5(11):e2239485.
doi: 10.1001/jamanetworkopen.2022.39485.

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

Marissa B Esser  1 , Gregory Leung  1 , Adam Sherk  2 , Michele K Bohm  1 , Yong Liu  1 , Hua Lu  1 , Timothy S Naimi  2
Affiliations

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

Marissa B Esser et al. JAMA Netw Open. .

Abstract

Importance: Alcohol 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.

Objective: To 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 participants: This 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.

Exposures: Mean 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 measures: Alcohol-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.

Results: During 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 relevance: The 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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Conflict of interest statement

Conflict of Interest Disclosures: Dr Sherk reported receiving grant funding from the Centers for Disease Control and Prevention (CDC) of the Department of Health and Human Services (HHS), during the conduct of the study. Dr Naimi reported grant funding from the CDC/HHS, during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Estimated Percentage of Total Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 49 Years, 2015 to 2019
See this image and copyright information in PMC

References

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    1. Centers for Disease Control and Prevention . Alcohol-Related Disease Impact (ARDI) application. Updated April 25, 2022. Accessed August 25, 2022. https://www.cdc.gov/ardi
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