Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017

Background Alcohol consumption, alcohol‐related emergency department visits, and hospitalizations have all increased in the last 2 decades, particularly among women and people middle‐aged and older. The purpose of this study was to explore data from death certificates to assess whether parallel chan...

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Veröffentlicht in:Alcoholism, clinical and experimental research clinical and experimental research, 2020-01, Vol.44 (1), p.178-187
Hauptverfasser: White, Aaron M., Castle, I‐Jen P., Hingson, Ralph W., Powell, Patricia A.
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description Background Alcohol consumption, alcohol‐related emergency department visits, and hospitalizations have all increased in the last 2 decades, particularly among women and people middle‐aged and older. The purpose of this study was to explore data from death certificates to assess whether parallel changes in alcohol‐related mortality occurred in the United States in recent years. Methods U.S. mortality data from the National Center for Health Statistics were analyzed to estimate the annual number and rate of alcohol‐related deaths by age, sex, race, and ethnicity between 1999 and 2017 among people aged 16+. Mortality data contained details from all death certificates filed nationally. For each death, an underlying cause and up to 20 multiple or contributing causes were indicated. Deaths were identified as alcohol‐related if an alcohol‐induced cause was listed as either an underlying or multiple cause. Joinpoint analyses were performed to assess temporal trends. Results The number of alcohol‐related deaths per year among people aged 16+ doubled from 35,914 to 72,558, and the rate increased 50.9% from 16.9 to 25.5 per 100,000. Nearly 1 million alcohol‐related deaths (944,880) were recorded between 1999 and 2017. In 2017, 2.6% of roughly 2.8 million deaths in the United States involved alcohol. Nearly half of alcohol‐related deaths resulted from liver disease (30.7%; 22,245) or overdoses on alcohol alone or with other drugs (17.9%; 12,954). Rates of alcohol‐related deaths were highest among males, people in age‐groups spanning 45 to 74 years, and among non‐Hispanic (NH) American Indians or Alaska Natives. Rates increased for all age‐groups except 16 to 20 and 75+ and for all racial and ethnic groups except for initial decreases among Hispanic males and NH Blacks followed by increases. The largest annual increase occurred among NH White females. Rates of acute alcohol‐related deaths increased more for people aged 55 to 64, but rates of chronic alcohol‐related deaths, which accounted for the majority of alcohol‐related deaths, increased more for younger adults aged 25 to 34. Conclusions Death certificates suggest that alcohol‐related mortality increased in the United States between 1999 and 2017. Given previous reports that death certificates often fail to indicate the contribution of alcohol, the scope of alcohol‐related mortality in the United States is likely higher than suggested from death certificates alone. Findings confirm an increasing burden of alcohol o
doi_str_mv 10.1111/acer.14239
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The purpose of this study was to explore data from death certificates to assess whether parallel changes in alcohol‐related mortality occurred in the United States in recent years. Methods U.S. mortality data from the National Center for Health Statistics were analyzed to estimate the annual number and rate of alcohol‐related deaths by age, sex, race, and ethnicity between 1999 and 2017 among people aged 16+. Mortality data contained details from all death certificates filed nationally. For each death, an underlying cause and up to 20 multiple or contributing causes were indicated. Deaths were identified as alcohol‐related if an alcohol‐induced cause was listed as either an underlying or multiple cause. Joinpoint analyses were performed to assess temporal trends. Results The number of alcohol‐related deaths per year among people aged 16+ doubled from 35,914 to 72,558, and the rate increased 50.9% from 16.9 to 25.5 per 100,000. Nearly 1 million alcohol‐related deaths (944,880) were recorded between 1999 and 2017. In 2017, 2.6% of roughly 2.8 million deaths in the United States involved alcohol. Nearly half of alcohol‐related deaths resulted from liver disease (30.7%; 22,245) or overdoses on alcohol alone or with other drugs (17.9%; 12,954). Rates of alcohol‐related deaths were highest among males, people in age‐groups spanning 45 to 74 years, and among non‐Hispanic (NH) American Indians or Alaska Natives. Rates increased for all age‐groups except 16 to 20 and 75+ and for all racial and ethnic groups except for initial decreases among Hispanic males and NH Blacks followed by increases. The largest annual increase occurred among NH White females. Rates of acute alcohol‐related deaths increased more for people aged 55 to 64, but rates of chronic alcohol‐related deaths, which accounted for the majority of alcohol‐related deaths, increased more for younger adults aged 25 to 34. Conclusions Death certificates suggest that alcohol‐related mortality increased in the United States between 1999 and 2017. Given previous reports that death certificates often fail to indicate the contribution of alcohol, the scope of alcohol‐related mortality in the United States is likely higher than suggested from death certificates alone. Findings confirm an increasing burden of alcohol on public health and support the need for improving surveillance of alcohol‐involved mortality. Death certificates documented nearly 1 million (944,880) alcohol‐related deaths in the United States between 1999 and 2017. The rate increased 51% across the study period. Women experienced larger annual increases than men. Increases were larger for non‐Hispanic whites. Deaths related to acute causes (e.g., injuries, overdoses) increased more for people aged 55–64, while deaths related to chronic causes (e.g., liver disease) increased more for people aged 25–34. Alcohol was a factor in 2.6% of all deaths in the United States in 2017.</description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1111/acer.14239</identifier><identifier>PMID: 31912524</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Alcohol ; Alcohol Drinking - mortality ; Alcohol Drinking - trends ; Alcohol use ; Alcohols ; Cause of Death ; Cause of Death - trends ; Certificates ; Death ; Death Certificates ; Emergency medical care ; Emergency medical services ; Fatalities ; Female ; Females ; Humans ; Liver diseases ; Male ; Males ; Middle Aged ; Minority &amp; ethnic groups ; Mortality ; Overdose ; Population Surveillance - methods ; Public health ; Trend ; United States - epidemiology ; Young Adult</subject><ispartof>Alcoholism, clinical and experimental research, 2020-01, Vol.44 (1), p.178-187</ispartof><rights>Published 2020. This article is a U.S. Government work and is in the public domain in the USA.</rights><rights>2020 Research Society on Alcoholism</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3579-2effd8409b86b6266a1d6972ee1db51c43fd230fcf2759354595633a60ad06763</citedby><cites>FETCH-LOGICAL-c3579-2effd8409b86b6266a1d6972ee1db51c43fd230fcf2759354595633a60ad06763</cites><orcidid>0000-0002-8469-004X ; 0000-0002-1610-6040</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Facer.14239$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Facer.14239$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31912524$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>White, Aaron M.</creatorcontrib><creatorcontrib>Castle, I‐Jen P.</creatorcontrib><creatorcontrib>Hingson, Ralph W.</creatorcontrib><creatorcontrib>Powell, Patricia A.</creatorcontrib><title>Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description>Background Alcohol consumption, alcohol‐related emergency department visits, and hospitalizations have all increased in the last 2 decades, particularly among women and people middle‐aged and older. The purpose of this study was to explore data from death certificates to assess whether parallel changes in alcohol‐related mortality occurred in the United States in recent years. Methods U.S. mortality data from the National Center for Health Statistics were analyzed to estimate the annual number and rate of alcohol‐related deaths by age, sex, race, and ethnicity between 1999 and 2017 among people aged 16+. Mortality data contained details from all death certificates filed nationally. For each death, an underlying cause and up to 20 multiple or contributing causes were indicated. Deaths were identified as alcohol‐related if an alcohol‐induced cause was listed as either an underlying or multiple cause. Joinpoint analyses were performed to assess temporal trends. Results The number of alcohol‐related deaths per year among people aged 16+ doubled from 35,914 to 72,558, and the rate increased 50.9% from 16.9 to 25.5 per 100,000. Nearly 1 million alcohol‐related deaths (944,880) were recorded between 1999 and 2017. In 2017, 2.6% of roughly 2.8 million deaths in the United States involved alcohol. Nearly half of alcohol‐related deaths resulted from liver disease (30.7%; 22,245) or overdoses on alcohol alone or with other drugs (17.9%; 12,954). Rates of alcohol‐related deaths were highest among males, people in age‐groups spanning 45 to 74 years, and among non‐Hispanic (NH) American Indians or Alaska Natives. Rates increased for all age‐groups except 16 to 20 and 75+ and for all racial and ethnic groups except for initial decreases among Hispanic males and NH Blacks followed by increases. The largest annual increase occurred among NH White females. Rates of acute alcohol‐related deaths increased more for people aged 55 to 64, but rates of chronic alcohol‐related deaths, which accounted for the majority of alcohol‐related deaths, increased more for younger adults aged 25 to 34. Conclusions Death certificates suggest that alcohol‐related mortality increased in the United States between 1999 and 2017. Given previous reports that death certificates often fail to indicate the contribution of alcohol, the scope of alcohol‐related mortality in the United States is likely higher than suggested from death certificates alone. Findings confirm an increasing burden of alcohol on public health and support the need for improving surveillance of alcohol‐involved mortality. Death certificates documented nearly 1 million (944,880) alcohol‐related deaths in the United States between 1999 and 2017. The rate increased 51% across the study period. Women experienced larger annual increases than men. Increases were larger for non‐Hispanic whites. Deaths related to acute causes (e.g., injuries, overdoses) increased more for people aged 55–64, while deaths related to chronic causes (e.g., liver disease) increased more for people aged 25–34. Alcohol was a factor in 2.6% of all deaths in the United States in 2017.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Alcohol</subject><subject>Alcohol Drinking - mortality</subject><subject>Alcohol Drinking - trends</subject><subject>Alcohol use</subject><subject>Alcohols</subject><subject>Cause of Death</subject><subject>Cause of Death - trends</subject><subject>Certificates</subject><subject>Death</subject><subject>Death Certificates</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Fatalities</subject><subject>Female</subject><subject>Females</subject><subject>Humans</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Males</subject><subject>Middle Aged</subject><subject>Minority &amp; ethnic groups</subject><subject>Mortality</subject><subject>Overdose</subject><subject>Population Surveillance - methods</subject><subject>Public health</subject><subject>Trend</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9uEzEQhy0EoqFw4QGQJS4VYsv478bHaAkUqQipkPPK2Z1tXDnrYDuC3HgEnpEnwduUHjh0LiPNfPo0mh8hLxmcs1LvbIfxnEkuzCMyY0pABbyuH5MZMKkqDTA_Ic9SugEAOdf6KTkRzDCuuJyR7Sq58Zq-R5s3tMGY3eA6mzHRHOjy586HiLTZ2PG6jNxIF74Lm-D__Pp9hb5wPf0cYrbe5cO0zhukq9FN86950rylzBgzyTiw-jl5Mlif8MVdPyWrD8tvzUV1-eXjp2ZxWXVC1abiOAz9XIJZz_Vac60t67WpOSLr14p1Ugw9FzB0A6-VEUoqo7QQVoPtQddanJKzo3cXw_c9ptxuXerQezti2KeWCyFrmP5R0Nf_oTdhH8dyXaGkAK2ZhEK9OVJdDClFHNpddFsbDy2DdgqhnUJob0Mo8Ks75X69xf4e_ff1ArAj8MN5PDygahfN8uoo_QuuLY8q</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>White, Aaron M.</creator><creator>Castle, I‐Jen P.</creator><creator>Hingson, Ralph W.</creator><creator>Powell, Patricia A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K7.</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8469-004X</orcidid><orcidid>https://orcid.org/0000-0002-1610-6040</orcidid></search><sort><creationdate>202001</creationdate><title>Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017</title><author>White, Aaron M. ; Castle, I‐Jen P. ; Hingson, Ralph W. ; Powell, Patricia A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3579-2effd8409b86b6266a1d6972ee1db51c43fd230fcf2759354595633a60ad06763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Alcohol</topic><topic>Alcohol Drinking - mortality</topic><topic>Alcohol Drinking - trends</topic><topic>Alcohol use</topic><topic>Alcohols</topic><topic>Cause of Death</topic><topic>Cause of Death - trends</topic><topic>Certificates</topic><topic>Death</topic><topic>Death Certificates</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Fatalities</topic><topic>Female</topic><topic>Females</topic><topic>Humans</topic><topic>Liver diseases</topic><topic>Male</topic><topic>Males</topic><topic>Middle Aged</topic><topic>Minority &amp; ethnic groups</topic><topic>Mortality</topic><topic>Overdose</topic><topic>Population Surveillance - methods</topic><topic>Public health</topic><topic>Trend</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>White, Aaron M.</creatorcontrib><creatorcontrib>Castle, I‐Jen P.</creatorcontrib><creatorcontrib>Hingson, Ralph W.</creatorcontrib><creatorcontrib>Powell, Patricia A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>White, Aaron M.</au><au>Castle, I‐Jen P.</au><au>Hingson, Ralph W.</au><au>Powell, Patricia A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2020-01</date><risdate>2020</risdate><volume>44</volume><issue>1</issue><spage>178</spage><epage>187</epage><pages>178-187</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><abstract>Background Alcohol consumption, alcohol‐related emergency department visits, and hospitalizations have all increased in the last 2 decades, particularly among women and people middle‐aged and older. The purpose of this study was to explore data from death certificates to assess whether parallel changes in alcohol‐related mortality occurred in the United States in recent years. Methods U.S. mortality data from the National Center for Health Statistics were analyzed to estimate the annual number and rate of alcohol‐related deaths by age, sex, race, and ethnicity between 1999 and 2017 among people aged 16+. Mortality data contained details from all death certificates filed nationally. For each death, an underlying cause and up to 20 multiple or contributing causes were indicated. Deaths were identified as alcohol‐related if an alcohol‐induced cause was listed as either an underlying or multiple cause. Joinpoint analyses were performed to assess temporal trends. Results The number of alcohol‐related deaths per year among people aged 16+ doubled from 35,914 to 72,558, and the rate increased 50.9% from 16.9 to 25.5 per 100,000. Nearly 1 million alcohol‐related deaths (944,880) were recorded between 1999 and 2017. In 2017, 2.6% of roughly 2.8 million deaths in the United States involved alcohol. Nearly half of alcohol‐related deaths resulted from liver disease (30.7%; 22,245) or overdoses on alcohol alone or with other drugs (17.9%; 12,954). Rates of alcohol‐related deaths were highest among males, people in age‐groups spanning 45 to 74 years, and among non‐Hispanic (NH) American Indians or Alaska Natives. Rates increased for all age‐groups except 16 to 20 and 75+ and for all racial and ethnic groups except for initial decreases among Hispanic males and NH Blacks followed by increases. The largest annual increase occurred among NH White females. Rates of acute alcohol‐related deaths increased more for people aged 55 to 64, but rates of chronic alcohol‐related deaths, which accounted for the majority of alcohol‐related deaths, increased more for younger adults aged 25 to 34. Conclusions Death certificates suggest that alcohol‐related mortality increased in the United States between 1999 and 2017. Given previous reports that death certificates often fail to indicate the contribution of alcohol, the scope of alcohol‐related mortality in the United States is likely higher than suggested from death certificates alone. Findings confirm an increasing burden of alcohol on public health and support the need for improving surveillance of alcohol‐involved mortality. Death certificates documented nearly 1 million (944,880) alcohol‐related deaths in the United States between 1999 and 2017. The rate increased 51% across the study period. Women experienced larger annual increases than men. Increases were larger for non‐Hispanic whites. Deaths related to acute causes (e.g., injuries, overdoses) increased more for people aged 55–64, while deaths related to chronic causes (e.g., liver disease) increased more for people aged 25–34. Alcohol was a factor in 2.6% of all deaths in the United States in 2017.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31912524</pmid><doi>10.1111/acer.14239</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8469-004X</orcidid><orcidid>https://orcid.org/0000-0002-1610-6040</orcidid></addata></record>
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subjects Adolescent
Adult
Age
Aged
Alcohol
Alcohol Drinking - mortality
Alcohol Drinking - trends
Alcohol use
Alcohols
Cause of Death
Cause of Death - trends
Certificates
Death
Death Certificates
Emergency medical care
Emergency medical services
Fatalities
Female
Females
Humans
Liver diseases
Male
Males
Middle Aged
Minority & ethnic groups
Mortality
Overdose
Population Surveillance - methods
Public health
Trend
United States - epidemiology
Young Adult
title Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017
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