Alcohol-Associated Liver Disease Mortality Doubles in Two Decades, Highlighting Public Health Crisis

Strategic Insights -

Research published in JAMA Network Open reveals that alcohol-associated liver disease (ALD) mortality has more than doubled between 1999 and 2022, with significant acceleration from 2018 to 2022. This disturbing trend disproportionately affects women, young adults, and American Indian and Alaskan Native populations. The study highlights the need for targeted interventions among high-risk groups and emphasizes the role of socioeconomic inequities, pandemic stressors, and health care disparities in driving ALD mortality.

Key Takeaways:

  • ALD mortality doubled between 1999 and 2022, with the greatest increase occurring from 2018-2022.
  • Women showed more rapid increases in ALD mortality than men, with a 50% increase in alcohol-related liver injury among women from 2009 to 2015, compared with a 30% increase among men.
  • Young adults aged 25-44 years demonstrated concerning upward trends in ALD mortality, with more than 20% of young veterans aged 18 to 39 years reporting high-risk alcohol use in the third year following the pandemic.
  • American Indian and Alaskan Native populations experienced the highest mortality rates and most rapid increase in recent years, with 64% of these populations represented in ALD-related cirrhosis admissions.
  • The study highlights the importance of socioeconomic inequities, pandemic stressors, and health care disparities in driving ALD mortality among minoritized racial and ethnic groups.
  • The researchers recommend targeted interventions for high-risk groups, including enhanced screening for alcohol use disorders, improved addiction treatment access, and targeted campaigns addressing high-risk drinking behaviors.
  • The study notes the limitations of relying on death certificate data and ICD-10 codes, which may not accurately capture the true prevalence of ALD as a cause of death.

Statistics:

  • 76% of ALD deaths were in men, 70% of who were from alcohol-associated hepatitis and alcohol-associated cirrhosis.
  • ALD mortality increased from 6.71 to 12.53 deaths per 100,000 between 1999 and 2022.
  • Women showed a 50% increase in alcohol-related liver injury from 2009 to 2015, compared with a 30% increase among men.
  • More than 20% of young veterans aged 18 to 39 years reported high-risk alcohol use in the third year following the pandemic.
  • American Indian or Alaska Native populations showed the highest mortality rates, with 64% of these populations represented in ALD-related cirrhosis admissions.
  • 436,814 ALD deaths were included in the study.

Sources:

  • "Alcohol-associated liver disease mortality" published in JAMA Network Open on June 11.
  • ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.33385, https://onlinelibrary.wiley.com/doi/10.1002/adaw.33607, https://onlinelibrary.wiley.com/doi/10.1002/adaw.33753.