Introduction: BACKGROUND: 5.1% of the global burden of disease is attributed to alcohol, as quantified by the alcohol-attributable fraction (AAF) (2). Alcoholic liver disease (ALD) is the third highest global cause of death from alcohol use (2). The development and progression of ALD are influenced by the quantity of alcohol consumed, duration, beverage type, gender, ethnicity and other comorbidities (i.e. viral hepatitis)(3). Though consumption varies geographically, no previous studies have examined its correlation with AAF while stratifying to GDP per capita (GDPpc). Aim: Determine if the difference between alcohol consumption (AC) in high-income and very lowincome countries correlates with a respective difference in AAF. Methods: Data from the WHO (2015) and World Bank (2014) for both genders on ALD, AC per capita (liters/year), GDPpc (USD/year), and preferred alcohol type for each country was obtained to conduct a cross-sectional study. Countries with GDPpc greater than $30,000USD were defined as “high-income” (HIC), while countries with less than $1,000USD GDPpc were defined as “very low-income” (VLIC). Differences in total AC were calculated using a paired t-test for the means. Scatterplots were generated to supplement the variance, Pearson correlation, and F-test to assess for differences in ALD between HIC and VLIC. Results: Of the 186 countries listed, 26 and 27 countries met the definition of HIC and VLIC (median GDPpc $50,525 and $605), respectively. AC is significantly higher in HIC (p=0.01). Correlation coefficients for AAF and AC for males in HIC and VLIC were 0.896 and 0.883, respectively, and 0.899 and 0.851 for females in HIC and VLIC, respectively. The F-Test yielded an F value of 1.29 with an F-critical value of 1.96. Correlation coefficients between AAF and beer, wine and spirits were 0.62, 0.55, and 0.57, respectively; showing no statistically-significant difference. Correlation between ALD-related deaths in patients in HIC vs. VLIC and AC was calculated, yielding Pearson correlation coefficients of 0.514 and 0.883, respectively, with p=0.0049. Conclusion: Direct correlation between AAF and AC in HIC and VLIC was observed in both genders and no significant difference was found between them. Though alcohol consumption is greater in HIC, the ALD-related mortality was significantly lower, likely owing to better developed healthcare systems. No difference between type of preferred alcohol ingested and AAF was observed.Figure 1