Trends in Alcohol-Induced Deaths in the United States, 2000-2016.
paper
Cited
Public
- Authors
- Spillane, Susan; Shiels, Meredith S; Best, Ana F; Haozous, Emily A; Withrow, Diana R; Chen, Yingxi; Berrington de González, Amy; Freedman, Neal D
- Year
- 2020
- Journal
- JAMA network open
- PMID
- 32083687
- DOI
- 10.1001/jamanetworkopen.2019.21451
- PMCID
- PMC7043198
IMPORTANCE: Notable increases in mortality from alcohol-induced causes over the past 2 decades in the United States have been reported. However, comprehensive assessments of trends in alcohol-induced mortality by sex, age, race/ethnicity, and social and geographic factors are lacking. OBJECTIVE: To examine trends in alcohol-induced mortality rates from 2000 to 2016, comparing results by demographic characteristics including sex, race/ethnicity, age, county-level socioeconomic status, and geographic location. DESIGN, SETTING, AND PARTICIPANTS: This serial cross-sectional study used US national vital statistics data for years 2000 to 2016 for all US residents older than 15 years. Data analysis was conducted from January to September 2019. EXPOSURES: Trends in alcohol-induced mortality by sex, race/ethnicity, age, county-level socioeconomic status (ie, median income, percentage of unemployed residents, percentage of residents with a bachelor's degree), rurality level, and US state. MAIN OUTCOMES AND MEASURES: Alcohol-induced mortality, ie, deaths for which alcohol holds a population-attributable fraction of 1. Deaths were expressed per 100 000 residents as absolute and age-standardized rates. Mortality trends were measured as average annual percentage changes (AAPCs) for the entire period (ie, 2000-2016) and annual percentage changes (APCs) for individual periods of change within the study period. RESULTS: A total of 425 045 alcohol-induced deaths were identified from 2000 to 2016 (2000: 19 627 deaths; 14 979 [76.3%] men; 2016: 34 857 deaths; 25 213 [73.3%] men). The rate of alcohol-induced deaths increased substantially among men (AAPC, 1.4%; 95% CI, 1.0% to 1.8%) and women (AAPC, 3.1%; 95% CI, 2.6% to 3.6%) and accelerated recently (men, 2012-2016: APC, 4.2%; 95% CI, 3.1% to 5.3%; women, 2013-2016: APC, 7.1%; 95% CI, 5.1% to 9.1%). The largest increases by race/ethnicity were observed among American Indian and Alaska Native men (AAPC, 3.3%; 95% CI, 2.6% to 4.0%), American Indian and Alaska Native women (AAPC, 4.2%; 95% CI, 3.8% to 4.6%), and white women (AAPC, 4.1%; 95% CI, 3.6% to 4.7%). Despite initial declines among black women, black men, and Latino men (eg, Latino men, 2000-2003: APC, -5.1%; 95% CI, -9.8% to -0.1%; 2003-2013: APC, -0.6%; 95% CI, -1.4% to 0.2%), increases occurred later in the study period (eg, Latino men, 2013-2016: APC, 4.1%; 95% CI, 0.3% to 8.1%). The rates of increase varied by age group and in turn by racial/ethnic group. Among white individuals, large absolute increases occurred in midlife (eg, men aged 55-59 years, 2000-2003: 25.5 deaths per 100 000 residents; 2013-2016: 43.3 deaths per 100 000 residents; women aged 50-54 years, 2000-2003: 7.4 deaths per 100 000 residents; 2013-2016: 16.5 deaths per 100 000 residents), although APCs were also large for ages 25 to 34 years, ranging from 4.6% to 6.9% per year among men and from 7.3% to 12.0% among women. Among American Indian and Alaska Native individuals, increases throughout the age range were observed, with the largest absolute increase occurring for ages 45 to 49 years among men (2000-2013: 113.6 deaths per 100 000 residents; 2013-2016: 193.1 deaths per 100 000 residents) and for ages 50 to 54 among women (2000-2013: from 56.1 deaths per 100 000 residents; 2013-2016: 105.1 deaths per 100 000 residents). CONCLUSIONS AND RELEVANCE: This study found large increases in alcohol-induced death rates across age and racial/ethnic subgroups of the US population, which have accelerated over recent years. Large increases in alcohol-induced deaths among younger age groups may be associated with future increases in alcohol-related disease.
Age-Standardized Rates of Alcohol-Induced Death, 2000-2016Observed age-standardized rates for each year are plotted using dotted markers. Solid lines are plotted from joinpoint analysis and indicate periods of change, with shaded areas indicating 95% CIs. Dotted vertical lines indicate time interval boundaries.
Comparison of Absolute Mortality Rates of Alcohol-Induced Deaths in 2013 to 2016 With Rates in 2000 to 2003
Estimated Annual Percentage Change in Rates of Alcohol-Induced Deaths From 2000 to 2016 by AgeShaded areas indicate 95% CIs.
Age-Standardized Rates of Alcohol-Induced Death for Non-Latino White Individuals by State, Comparing 2000-2003 With 2013-2016
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| The Young were not Spared: What Death Certificates Reveal about Non-Covid Excess Deaths. | Mulligan CB et al. | — | 2022 | → |
| Trends in Binge Drinking and Heavy Alcohol Consumption Among Pregnant Women in the US, 2011 to 2020. | Howard JT et al. | — | 2022 | → |
| Trends in Deaths Fully Attributable to Alcohol in Minnesota, 2000-2018. | Braun NJ et al. | — | 2022 | → |
| A cascade of care for alcohol use disorder: Using 2015-2019 National Survey on Drug Use and Health data to identify gaps in past 12-month care. | Mintz CM et al. | — | 2021 | → |
| A Decade of Drinking: Temporal Trends in Apparent Household Beer Intake and Standard Drink Consumption in the United States. | Schiff MD et al. | — | 2021 | → |
| Alcohol policy effects on 100% chronic alcohol-attributable mortality across racial/ethnic subgroups. | Subbaraman MS et al. | — | 2021 | → |
| Corticotropin releasing factor and norepinephrine related circuitry changes in the bed nucleus of the stria terminalis in stress and alcohol and substance use disorders. | Snyder AE et al. | — | 2021 | → |
| Dimensions of Craving Interact with <i>COMT</i> Genotype to Predict Relapse in Individuals with Alcohol Use Disorder Six Months after Treatment. | Padula CB et al. | — | 2021 | → |
| Effect of High-Dose Baclofen on Agitation-Related Events Among Patients With Unhealthy Alcohol Use Receiving Mechanical Ventilation: A Randomized Clinical Trial. | Vourc'h M et al. | — | 2021 | → |
| Efficacy of Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction: A Randomized Clinical Trial. | Ray LA et al. | — | 2021 | → |
| Examining adverse childhood experiences among Native American persons in a nationally representative sample: Differences among racial/ethnic groups and race/ethnicity-sex dyads. | Richards TN et al. | — | 2021 | → |
| Molecular Mechanisms of Alcohol-Induced Colorectal Carcinogenesis. | Johnson CH et al. | — | 2021 | → |
| Multi-omics integration analysis identifies novel genes for alcoholism with potential overlap with neurodegenerative diseases. | Kapoor M et al. | — | 2021 | → |
| Naltrexone Initiation in the Inpatient Setting for Alcohol Use Disorder: A Systematic Review of Clinical Outcomes. | Kirchoff RW et al. | — | 2021 | → |
| Policy Responses to the Addiction Crisis. | Frank RG et al. | — | 2021 | → |
| Risk factors for hyperthermia mortality among emergency department patients. | Hall C et al. | — | 2021 | → |
| The Changing Burden of Alcoholic Hepatitis: Rising Incidence and Associations with Age, Gender, Race, and Geography. | Doshi SD et al. | — | 2021 | → |
| The cultural equivalence of measurement in substance use research. | Lopez-Vergara HI et al. | — | 2021 | → |
| The Need for Biochemical Testing for Alcohol in Integrated Addiction Treatment Settings During the Opioid Epidemic. | Marcovitz D et al. | — | 2021 | → |
| Time to ACT: launching an Addiction Care Team (ACT) in an urban safety-net health system. | Martin M et al. | — | 2021 | → |
| Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016. | Kerr WC et al. | — | 2021 | → |
| What Will it Take to Stem the Tide? Understanding and Addressing the Needs of People With Addiction Involving Multiple Substances. | Lin LA et al. | — | 2021 | → |
| Alcohol-Induced Deaths Among American Indian and Alaska Native Individuals-"Drinking Was What I and Others Just Did". | Manson SM | — | 2020 | → |
| Associations Between Medical Conditions and Alcohol Consumption Levels in an Adult Primary Care Population. | Sterling SA et al. | — | 2020 | → |
| Can Asking Adolescents About Being Drunk and Their Subjective Experience of Intoxication Help in Screening for Risky Drinking? | Wellman RJ et al. | — | 2020 | → |
| Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol. | Frost MC et al. | — | 2020 | → |
| Racial and ethnic differences in alcohol-, opioid-, and co-use-related deaths in Washington State from 2011 to 2017. | Oluwoye O et al. | — | 2020 | → |
| Social Determinants and Differences in Mortality by Race/Ethnicity. | Pérez-Stable EJ et al. | — | 2020 | → |
| Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina. | Santos LP et al. | — | 2020 | → |
| The Kaiser Permanente Northern California Adult Alcohol Registry, an Electronic Health Records-Based Registry of Patients With Alcohol Problems: Development and Implementation. | Palzes VA et al. | — | 2020 | → |
| Trends in Adverse Childhood Experiences (ACEs) in the United States. | Finkelhor D | — | 2020 | → |
| Twenty-Year Observational Study Shows Rising Alcohol-Attributable Death Profiles in the U.S. and Delaware. | D'Souza MJ et al. | — | 2020 | → |