Alcohol-related mortality rates have risen recently among both men and women, but the rate of increase has been higher among females across different demographic categories, including race/ethnicity, age, cause of death, and region.
In the past, men tended to have more alcohol-related complications, but evidence suggests that the sex gap is narrowing ― a trend attributed partly to an increase in alcohol use, high-risk drinking, and alcohol use disorders among women, but it remains unclear whether this convergence extends to alcohol-related death rates.
Women generally have a higher percentage of body fat and a lower percentage of body water compared with men, resulting in higher alcohol blood concentrations, potentially increasing vulnerability to complications.
The study used national mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) and diagnostic codes to identify alcohol-related deaths in the US between 1999 and 2020.
Researchers abstracted age-adjusted mortality rates (AAMRs) by age, sex, race/ethnicity, cause of death (alcohol poisoning, alcoholic liver disease, mental and behavioral disorders due to use of alcohol, or other), and census region.
Between 1999 and 2020, 605,948 Americans died from alcohol-related causes, resulting in an AAMR of 8.3 per 100,000 persons (95% CI, 8.3 – 8.3 per 100,000 persons).
Men were 2.88 times more likely to die from alcohol-related causes than women. This sex disparity persisted across age, race/ethnicity, census region, and cause of death.
Overall, alcohol-related mortality trends were stable from 1999–2007 but increased by 3.0% per year from 2007–2018 and by 14.1% per year from 2018–2020.
Among males, the trend was stable from 1999–2009, with annual increases of 3.0% from 2009–2018 and 12.5% from 2018–2020. Among females, the trend was slightly different: a 1.0% per year increase from 1999–2007, followed by a 4.3% increase per year from 2007–2018 and an even larger increase of 14.7% per year from 2018–2020.
Alcohol-related mortality increased among males and females across all age groups, but among those younger than 60 years, the rate of increase in the most recent trend was higher among males. Among adults aged 65 years or older, the annual rate of change was higher among females.
Changing patterns of alcohol consumption among women is important to the understanding of related mortality trends, said the authors, who noted that women now drink more alcohol and they do so more frequently than they did in the past, likely because of the normalization of alcohol use by females in society.
The study was conducted by Ibraheem M. Karaye, MD, DrPH, Department of Population Health, Hofstra University, Hempstead, New York, and colleagues. It was published online July 28 in JAMA Network Open.
The study is primarily descriptive and doesn’t explore factors associated with alcohol-related mortality trends. The restricted examination of age-specific trends and of period and cohort effects meant researchers were unable to delve deeply into these dimensions. Insufficient death counts for females aged 15–24 years prevented the researchers from calculating trends for this age group.
The study received support from the National Institute on Alcohol Abuse and Alcoholism. The authors did not report any relevant conflicts of interest.
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