National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study.
Level 4 - case-series / case-control
Level 4 by design analogy (global comparative risk assessment and epidemiological modeling study using aggregate secondary data).
PubMed 31910980 · doi:10.1016/S2468-2667(19)30231-2
What was done
This comparative risk assessment study modeled national, regional, and global disease burdens attributable to alcohol from 2000 to 2016 across gender, age, and geography. Population-attributable fractions (PAFs) were calculated by combining alcohol exposure data (from national production, taxation records, and surveys) with relative risks from published cohort studies and meta-analyses. Morbidity and mortality estimates came from WHO Global Health Estimates, population data from the UN Population Division, and Human Development Index (HDI) data from the UN Development Programme. Uncertainty intervals (95% UIs) were computed using a Monte Carlo-like approach.
What was found
Globally in 2016, alcohol use accounted for an estimated 3.0 million (95% UI 2.6–3.6) deaths and 131.4 million (119.4–154.4) disability-adjusted life-years (DALYs), representing 5.3% (4.6–6.3) of all deaths and 5.0% (4.6–5.9) of all DALYs. Alcohol-attributable mortality PAFs were 17.7% (14.3–23.0) for injury, 4.3% (3.6–5.1) for non-communicable diseases, and 3.3% (1.9–5.6) for communicable, maternal, perinatal, and nutritional diseases. The disease burden was higher in men than women, and the age-standardised burden was highest in eastern Europe, western, southern, and central sub-Saharan Africa, and low-HDI countries. People younger than 60 years accounted for 52.4% of all alcohol-attributable deaths.
Why it matters
This study quantifies the substantial mortality and disability burden of alcohol worldwide, showing that it disproportionately affects low-income nations and working-age adults under 60. These findings help pinpoint demographic and geographic priorities for targeted taxation and alcohol policy interventions.
Limits
The findings derive from epidemiological modeling and aggregate data synthesis rather than direct prospective observation. Exposure measurements rely on taxation and production statistics as well as self-reported surveys, which may overlook illicit or unrecorded alcohol and suffer from reporting bias or sparse data in low-income regions.
Cited by
- supports Harmful use of alcohol is responsible for more than 200 disease and injury conditions, causing 3 million deaths (5.3% of all deaths worldwide) and 131 million disability-adjusted life years lost in 2016.
- supports Approximately 13.5% of all deaths in adults aged 20 to 39 are attributable to alcohol, and more than 50% of all alcohol-related deaths occur in adults younger than 60.