Abstract

BackgroundAlcohol has been linked to health disparities between races in the US; however, race-specific alcohol-attributable mortality has never been estimated. The objective of this article is to estimate premature mortality attributable to alcohol in the US in 2005, differentiated by race, age and sex for people 15 to 64 years of age.Methods and FindingsMortality attributable to alcohol was estimated based on alcohol-attributable fractions using indicators of exposure from the National Epidemiologic Survey on Alcohol and Related Conditions and risk relations from the Comparative Risk Assessment study. Consumption data were corrected for undercoverage (the observed underreporting of alcohol consumption when using survey as compared to sales data) using adult per capita consumption from WHO databases. Mortality data by cause of death were obtained from the US Department of Health and Human Services. For people 15 to 64 years of age in the US in 2005, alcohol was responsible for 55,974 deaths (46,461 for men; 9,513 for women) representing 9.0% of all deaths, and 1,288,700 PYLL (1,087,280 for men; 201,420 for women) representing 10.7% of all PYLL. Per 100,000 people, this represents 29 deaths (29 for White; 40 for Black; 82 for Native Americans; 6 for Asian/Pacific Islander) and 670 PYLL (673 for White; 808 for Black; 1,808 for Native American; 158 for Asian/Pacific Islander). Sensitivity analyses showed a lower but still substantial burden without adjusting for undercoverage.ConclusionsThe burden of mortality attributable to alcohol in the US is unequal among people of different races and between men and women. Racial differences in alcohol consumption and the resulting harms explain in part the observed disparities in the premature mortality burden between races, suggesting the need for interventions for specific subgroups of the population such as Native Americans.

Highlights

  • A consistent gap in measures of mortality has been observed for people of different races in the United States (US)

  • The burden of mortality attributable to alcohol in the US is unequal among people of different races and between men and women

  • Racial differences in alcohol consumption and the resulting harms explain in part the observed disparities in the premature mortality burden between races, suggesting the need for interventions for specific subgroups of the population such as Native Americans

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Summary

Introduction

A consistent gap in measures of mortality has been observed for people of different races in the United States (US). The observed large variations by race in measures of mortality have been hypothesized to be attributable in part to differences in exposure to modifiable risk factors, such as alcohol consumption, tobacco smoking, and being overweight or obese [1]. To lessen the burden of disease and injury attributable to alcohol, a global strategy to reduce the harmful use PLOS ONE | www.plosone.org of alcohol was agreed upon at the World Health Organization’s (WHO) 63rd World Health Assembly [6]. Despite the magnitude of mortality attributable to alcohol consumption, alcohol-attributable burden estimates have yet to be calculated by race for any country. The objective of this article is to estimate premature mortality attributable to alcohol in the US in 2005, differentiated by race, age and sex for people 15 to 64 years of age

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