Weekly / July 31, 2020 / 69(30);981–987
Marissa B. Esser, PhD1; Adam Sherk,
PhD2; Yong Liu, MD1; Timothy S. Naimi, MD3,4;
Timothy Stockwell, PhD2; Mandy Stahre, PhD5; Dafna Kanny,
PhD1; Michael Landen, MD6; Richard Saitz, MD3,4;
Robert D. Brewer, MD1 (View author
affiliations)
Summary
What is already known about this topic?
Excessive drinking is a leading cause of
preventable death in the United States and is associated with numerous health
and social problems.
What is added by this report?
During 2011–2015, excessive drinking was
responsible for an average of 93,296 deaths (255 per day) and 2.7 million years
of potential life lost (29 years lost per death, on average) in the United
States each year.
What are the implications for public health
practice?
Widespread implementation of prevention
strategies, including those recommended by the Community Preventive Services
Task Force (e.g., increasing alcohol taxes and regulating the number and
concentration of places that sell alcohol) could help reduce deaths and years
of potential life lost from excessive drinking.
Excessive alcohol use is a leading cause of
preventable death in the United States (1) and costs associated with it,
such as those from losses in workplace productivity, health care expenditures,
and criminal justice, were $249 billion in 2010 (2). CDC used the
Alcohol-Related Disease Impact (ARDI) application* to estimate national and state
average annual alcohol-attributable deaths and years of potential life lost
(YPLL) during 2011–2015, including deaths from one’s own excessive drinking
(e.g., liver disease) and from others’ drinking (e.g., passengers killed in
alcohol-related motor vehicle crashes). This study found an average of 93,296
alcohol-attributable deaths (255 deaths per day) and 2.7 million YPLL (29 years
of life lost per death, on average) in the United States each year. Of all
alcohol-attributable deaths, 51,078 (54.7%) were caused by chronic conditions,
and 52,361 (56.0%) involved adults aged 35–64 years. Age-adjusted
alcohol-attributable deaths per 100,000 population ranged from 20.3 in New
Jersey and New York to 52.3 in New Mexico. YPLL per 100,000 population ranged
from 613.8 in New York to 1,651.7 in New Mexico. Implementation of effective
strategies for preventing excessive drinking, including those recommended by
the Community Preventive Services Task Force (e.g., increasing alcohol taxes
and regulating the number and concentration of alcohol outlets), could reduce
alcohol-attributable deaths and YPLL.†
CDC has updated the ARDI application, including
the causes of alcohol-attributable death, International Classification
of Diseases, Tenth Revision codes,§ and alcohol-attributable
fractions.¶ CDC used ARDI to estimate the average number of
annual national and state alcohol-attributable deaths and YPLL caused by
excessive drinking (i.e., deaths from conditions that are 100%
alcohol-attributable, acute conditions that involved binge drinking, and
chronic conditions that involved medium or high average daily alcohol
consumption). ARDI estimates alcohol-attributable deaths by multiplying the
total number of deaths (based on vital statistics) with an underlying cause
corresponding to any of the 58 alcohol-related conditions in the ARDI
application by its alcohol-attributable fraction. Some conditions (e.g.,
alcoholic liver cirrhosis) are wholly (100%) attributable to alcohol
(alcohol-attributable fraction = 1.0), whereas others are partially
attributable (alcohol-attributable fraction <1.0) to alcohol (e.g., breast
cancer and hypertension). Deaths are assessed by age group and sex and averaged
over a 5-year period. The alcohol-attributable fractions for chronic conditions
are generally calculated using relative risks from published meta-analyses and
the prevalence of low, medium, and high average daily alcohol consumption among
U.S. adults, based on data from the Behavioral Risk Factor Surveillance
System.** The prevalence estimates are adjusted to account for underreporting
of alcohol use during binge drinking episodes (3). Alcohol-attributable
fractions for acute causes (e.g., injuries) are generally based on studies that
measured the proportion of decedents who had a blood alcohol concentration
≥0.10 g/dL (4). Alcohol-attributable fractions for motor vehicle crash
deaths are based on the proportion of crash deaths that involved a blood
alcohol concentration ≥0.08 g/dL.†† For 100%
alcohol-attributable conditions, deaths are summed without adjustment.§§ YPLL,
a commonly used measure of premature death, are calculated by multiplying the
age-specific and sex-specific alcohol-attributable deaths by the corresponding
reduction in years of life potentially remaining for decedents relative to
average life expectancies.¶¶ Chronic causes of death are
calculated for decedents aged ≥20 years, and acute causes are generally
calculated for decedents aged ≥15 years. Deaths involving children that were
caused by someone else’s drinking (e.g., deaths caused by a pregnant mother’s
drinking and passengers killed in alcohol-related motor vehicle crashes) are
also included.
CDC used the data available in ARDI to estimate
the average annual national and state alcohol-attributable deaths and YPLL
associated with excessive drinking and national estimates of
alcohol-attributable deaths and YPLL by cause of death, sex, and age group.
National and state alcohol-attributable deaths and YPLL per 100,000 population
were calculated by dividing the average annual alcohol-attributable death and
YPLL estimates, respectively, by average annual population estimates from the
U.S. Census for 2011–2015, and then multiplying by 100,000. The
alcohol-attributable death rates were then age-adjusted to the 2000 U.S.
population.*** The number of YPLL per alcohol-attributable death was calculated
by dividing total YPLL by total alcohol-attributable deaths in the United
States and in states.
During 2011–2015 in the United States, an
average of 93,296 alcohol-attributable deaths occurred, and 2.7 million years
of potential life were lost annually (28.8 YPLL per alcohol-attributable death)
(Table 1) (Table 2). Among the 93,296 deaths, 51,078
(54.7%) were caused by chronic conditions and 42,218 (45.2%) by acute
conditions. Of the 2.7 million YPLL, 1.1 million (41.1%) were because of
chronic conditions, and 1.6 million (58.8%) were because of acute conditions.
Overall, 66,519 (71.3%) alcohol-attributable deaths and 1.9 million (70.8%)
YPLL involved males. Among all alcohol-attributable deaths, 52,361 (56.1%)
involved adults aged 35–64 years, 24,766 (26.5%) involved adults aged ≥65, and
13,910 (14.9%) involved young adults aged 20–34 years (Figure).
Alcoholic liver disease was the leading chronic
cause of alcohol-attributable deaths overall (18,164) and among males (12,887)
and females (5,277) (Table 1). Poisonings that involved another substance in
addition to alcohol (e.g., drug overdoses) were the leading acute cause of
alcohol-attributable deaths overall (11,839) and among females (4,315); suicide
associated with excessive alcohol use was the leading acute cause of
alcohol-attributable deaths among males (7,711). Conditions wholly attributable
to alcohol accounted for 29,068 (31.2%) of all alcohol-attributable deaths and
762,241 (28.4%) of all YPLL.
The national average annual age-adjusted
alcohol-attributable death rate was 27.4 per 100,000, and the YPLL per 100,000
was 847.7 (Table 2). The average annual number of alcohol-attributable deaths
and YPLL varied across states, ranging from 203 alcohol-attributable deaths in
Vermont to 10,811 in California, and from 5,074 YPLL in Vermont to 299,336 in
California. Age-adjusted alcohol-attributable death rates among the 40 states
with reliable estimates (excluding those with suppressed data where estimates might
not account for all the alcohol-attributable deaths in the state) ranged from
20.3 per 100,000 in New Jersey and New York to 52.3 in New Mexico. YPLL per
100,000 ranged from 613.8 in New York to 1,651.7 in New Mexico.
Discussion
Excessive alcohol use was responsible for
approximately 93,000 deaths and 2.7 million YPLL annually in the United States
during 2011–2015. This means that an average of 255 Americans die from
excessive drinking every day, shortening their lives by an average of 29 years.
The majority of these alcohol-attributable deaths involved males, and
approximately four in five deaths involved adults aged ≥35 years. The number of
alcohol-attributable deaths among adults aged ≥65 years was nearly double that
among adults aged 20–34 years. Approximately one half of alcohol-attributable
deaths were caused by chronic conditions, but acute alcohol-attributable
deaths, all of which were caused by binge drinking, accounted for the majority
of the YPLL from excessive drinking.
Little progress has been made in preventing
deaths caused by excessive drinking; the average annual estimates of
alcohol-attributable deaths and YPLL in this report are slightly higher than
estimates for 2006–2010, and the age-adjusted alcohol-attributable death rates
are similar (5), suggesting that excessive drinking remains a leading
preventable cause of death and disability (1). From 2006–2010 (5)
to 2011–2015, average annual deaths caused by alcohol dependence increased
14.2%, from 3,728 to 4,258, and deaths caused by alcoholic liver disease
increased 23.6%, from 14,695 to 18,164. These findings are consistent with
reported increasing trends in alcohol-induced deaths (e.g., deaths from
conditions wholly attributable to alcohol) among adults aged ≥25 years,††† including
alcoholic liver disease,§§§ as well as with increases in per
capita alcohol consumption during the past 2 decades.¶¶¶
Age-adjusted alcohol-attributable death rates
varied approximately twofold across states, but deaths caused by excessive
drinking were common across the country. The differences in
alcohol-attributable death and YPLL rates in states might be partially explained
by varying patterns of excessive alcohol use, particularly binge drinking,
which is affected by state-level alcohol pricing and availability strategies (6)
and differential access to medical care.
The findings in this report are subject to at
least five limitations. First, the prevalence of alcohol consumption
ascertained through the Behavioral Risk Factor Surveillance System is based on
self-reported data, which substantially underestimates alcohol consumption (7).
Second, these estimates are conservative, because former drinkers, some of whom
might have died from alcohol-related conditions, are not included in the
estimates of alcohol-attributable deaths and YPLL for partially
alcohol-attributable causes of death. Third, direct alcohol-attributable fraction
estimates for some chronic and acute conditions rely on data older than that of
2011–2015 (4) and might not accurately represent the proportion of
excessive drinkers among persons who died of some conditions (e.g., drug
overdoses) during that period. This emphasizes the importance of more timely
information on alcohol involvement and various health conditions. Fourth,
several conditions partially related to alcohol (e.g., tuberculosis, human
immunodeficiency virus, and acquired immunodeficiency syndrome)**** are not
included because published risk estimates were not available. Finally, the
alcohol-attributable deaths and YPLL are based on alcohol-related conditions
that were listed as the underlying (i.e., primary) cause of death, and not as a
multiple cause of death, yielding conservative estimates.
The implementation of effective population-based
strategies for preventing excessive drinking, such as those recommended by the
Community Preventive Services Task Force (e.g., increasing alcohol taxes and
regulating the number and concentration of alcohol outlets), could reduce
alcohol-attributable deaths and YPLL. These strategies can complement other
population-based prevention strategies that focus on health risk behaviors
associated with excessive alcohol use, such as safer prescribing practices to
reduce opioid misuse and overdoses (8,9) and alcohol-impaired
driving interventions (10).
Corresponding author: Marissa B. Esser, messer@cdc.gov,
770-488-5463.
1Division of Population Health, National Center for Chronic Disease
Prevention and Health Promotion, CDC; 2Canadian Institute for
Substance Use Research, University of Victoria, British Columbia, Canada; 3Boston
Medical Center, Boston, Massachusetts; 4Boston University
Schools of Medicine and Public Health, Boston, Massachusetts; 5Forecasting
and Research, State of Washington Office of Financial Management; 6New
Mexico Department of Health.
All authors have completed and submitted the
International Committee of Medical Journal Editors form for disclosure of
potential conflicts of interest. Timothy Stockwell reports grants and personal
fees from Alko, Finland, outside the submitted work. Richard Saitz reports
nonfinancial support from Alkermes; personal fees from UpToDate and
Massachusetts Medical Society; support and consulting fees from the National
Institute on Drug Abuse, the National Institute on Alcohol Abuse and
Alcoholism, and the Patient-Centered Outcomes Research Institute; travel
support and consulting fees from the American Medical Association, the American
Society of Addiction Medicine, Wolters Kluwer, National Council on Behavioral
Healthcare, the International Network on Brief Intervention for Alcohol and
other drugs, Systembolaget, Kaiser Permanente, RAND, the Institute for Research
and Training in the Addictions, the National Council on Behavioral Healthcare,
Charles University (Czech Republic), National Committee on Quality Assurance,
and the University of Oregon; and salary support from Burroughs Wellcome Fund.
No other potential conflicts of interest were disclosed.
§§ Conditions that that are 100% alcohol-attributable include
13 chronic conditions (alcoholic psychosis, alcohol abuse, alcohol dependence
syndrome, alcohol polyneuropathy, degeneration of the nervous system caused by
alcohol use, alcoholic myopathy, alcohol cardiomyopathy, alcoholic gastritis,
alcoholic liver disease, alcohol-induced acute pancreatitis, alcohol-induced
chronic pancreatitis, fetal alcohol syndrome, and fetus and newborn affected by
maternal use of alcohol) and two acute conditions (suicide by and exposure to
alcohol and alcohol poisoning).
References
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2018.
|
TABLE 1. Average annual number of deaths and years of
potential life lost attributable to excessive alcohol use,* by condition and
sex — United States, 2011–201
|
||||||
|
Cause
|
Alcohol-attributable deaths
|
Years of potential life lost
|
||||
|
Total†
|
Males
no. (%) |
Females
no. (%) |
Total†
|
Males
no. (%) |
Females
no. (%) |
|
|
Total†
|
93,296
|
66,519
(71.3)
|
26,778
(28.7)
|
2,683,211
|
1,899,089
(70.8)
|
784,121
(29.2)
|
|
Chronic causes
|
51,078
|
35,583
(69.7)
|
15,495
(30.3)
|
1,105,190
|
752,936
(68.1)
|
352,253
(31.9)
|
|
Alcohol abuse
|
2,591
|
1,986
(76.6)
|
605
(23.4)
|
66,839
|
49,129
(73.5)
|
17,710
(26.5)
|
|
Alcohol
cardiomyopathy
|
510
|
432
(84.7)
|
78
(15.3)
|
12,235
|
10,136
(82.8)
|
2,099
(17.2)
|
|
Alcohol dependence
syndrome
|
4,258
|
3,269
(76.8)
|
989
(23.2)
|
109,911
|
81,192
(73.9)
|
28,719
(26.1)
|
|
Alcohol
polyneuropathy
|
3
|
3
(100.0)
|
0
(—)
|
54
|
54
(100.0)
|
0
(—)
|
|
Alcoholic gastritis
|
33
|
26
(78.8)
|
7
(21.2)
|
890
|
696
(78.2)
|
194
(21.8)
|
|
Alcoholic liver
disease
|
18,164
|
12,887
(70.9)
|
5,277
(29.1)
|
467,996
|
313,897
(67.1)
|
154,099
(32.9)
|
|
Alcoholic myopathy
|
0
|
0
(—)
|
0
(—)
|
0
|
0
(—)
|
0
(—)
|
|
Alcoholic psychosis
|
703
|
549
(78.1)
|
154
(21.9)
|
14,129
|
10,799
(76.4)
|
3,330
(23.6)
|
|
Alcohol-induced
acute pancreatitis
|
278
|
214
(77.0)
|
64
(23.0)
|
8,284
|
6,247
(75.4)
|
2,037
(24.6)
|
|
Alcohol-induced
chronic pancreatitis
|
52
|
38
(73.1)
|
14
(26.9)
|
1,507
|
1,046
(69.4)
|
461
(30.6)
|
|
Atrial fibrillation
|
329
|
228
(69.3)
|
100
(30.4)
|
2,943
|
2,084
(70.8)
|
860
(29.2)
|
|
Cancer, breast
(females only)
|
584
|
NA
|
584
(NA)
|
11,203
|
NA
|
11,203
(NA)
|
|
Cancer, colorectal
|
996
|
898
(90.2)
|
98
(9.8)
|
15,540
|
14,016
(90.2)
|
1,524
(9.8)
|
|
Cancer, esophageal§
|
494
|
430
(87.0)
|
64
(13.0)
|
8,038
|
7,007
(87.2)
|
1,031
(12.8)
|
|
Cancer, laryngeal
|
248
|
233
(94.0)
|
15
(6.0)
|
4,002
|
3,737
(93.4)
|
265
(6.6)
|
|
Cancer, liver
|
1,609
|
1,545
(96.0)
|
64
(4.0)
|
28,191
|
27,129
(96.2)
|
1,061
(3.8)
|
|
Cancer, oral cavity
and pharyngeal
|
909
|
830
(91.3)
|
79
(8.7)
|
16,034
|
14,715
(91.8)
|
1,319
(8.2)
|
|
Cancer, pancreatic¶
|
186
|
151
(81.2)
|
35
(18.8)
|
2,827
|
2,301
(81.4)
|
526
(18.6)
|
|
Cancer, prostate
(males only)
|
188
|
188
(NA)
|
NA
|
1,952
|
1,952
(NA)
|
NA
|
|
Cancer, stomach¶
|
58
|
56
(96.6)
|
3
(5.2)
|
943
|
897
(95.1)
|
46
(4.9)
|
|
Chronic hepatitis
|
2
|
2
(100.0)
|
0
(0.0)
|
42
|
36
(85.7)
|
6
(14.3)
|
|
Coronary heart
disease
|
3,537
|
2,971
(84.0)
|
567
(16.0)
|
46,698
|
40,183
(86.0)
|
6,515
(14.0)
|
|
Degeneration of
nervous system attributable to alcohol
|
145
|
118
(81.4)
|
27
(18.6)
|
2,617
|
2,030
(77.6)
|
587
(22.4)
|
|
Esophageal varices
|
112
|
77
(68.8)
|
34
(30.4)
|
2,414
|
1,711
(70.9)
|
703
(29.1)
|
|
Fetal alcohol
syndrome
|
4
|
2
(50.0)
|
2
(50.0)
|
212
|
122
(57.5)
|
90
(42.5)
|
|
Fetus and newborn affected by maternal use
of alcohol
|
1
|
1 (100.0)
|
0 (0.0)
|
76
|
76 (100.0)
|
0 (—)
|
|
Gallbladder disease
|
0
|
0 (—)
|
0 (—)
|
0
|
0 (—)
|
0 (—)
|
|
Gastroesophageal hemorrhage
|
31
|
20 (64.5)
|
10 (32.3)
|
517
|
359 (69.4)
|
157 (30.4)
|
|
Hypertension
|
3,584
|
1,638 (45.7)
|
1,946 (54.3)
|
50,016
|
26,021 (52.0)
|
23,994 (48.0)
|
|
Infant death, low birthweight**
|
2
|
1 (50.0)
|
1 (50.0)
|
133
|
69 (51.9)
|
65 (48.9)
|
|
Infant death, preterm birth**
|
44
|
24 (54.5)
|
19 (43.2)
|
3,410
|
1,845 (54.1)
|
1,565 (45.9)
|
|
Infant death, small for gestational age**
|
0
|
0 (—)
|
0 (—)
|
13
|
5 (38.5)
|
7 (53.8)
|
|
Liver cirrhosis, unspecified
|
9,801
|
5,696 (58.1)
|
4,105 (41.9)
|
197,875
|
114,580 (57.9)
|
83,295 (42.1)
|
|
Pancreatitis, acute
|
0
|
0 (—)
|
0 (—)
|
0
|
0 (—)
|
0 (—)
|
|
Pancreatitis, chronic
|
15
|
12 (80.0)
|
3 (20.0)
|
317
|
252 (79.5)
|
65 (20.5)
|
|
Pneumonia††
|
133
|
105 (78.9)
|
29 (21.8)
|
3,714
|
2,839 (76.4)
|
875 (23.6)
|
|
Portal hypertension
|
61
|
34 (55.7)
|
26 (42.6)
|
1,267
|
729 (57.5)
|
538 (42.5)
|
|
Stroke, hemorrhagic
|
938
|
565 (60.2)
|
374 (39.9)
|
14,497
|
8,856 (61.1)
|
5,641 (38.9)
|
|
Stroke, ischemic
|
342
|
243 (71.1)
|
100 (29.2)
|
3,867
|
2,837 (73.4)
|
1,030 (26.6)
|
|
Unprovoked seizures, epilepsy, or seizure
disorder
|
134
|
112 (83.6)
|
22 (16.4)
|
3,987
|
3,352 (84.1
|
635 (15.9)
|
|
Acute causes
|
42,218
|
30,935 (73.3)
|
11,283 (26.7)
|
1,578,021
|
1,146,153 (72.6)
|
431,868 (27.4)
|
|
Air-space transport
|
75
|
64 (85.3)
|
11 (14.7)
|
2,268
|
1,867 (82.3)
|
401 (17.7)
|
|
Alcohol poisoning
|
2,288
|
1,735 (75.8)
|
553 (24.2)
|
76,224
|
56,511 (74.1)
|
19,713 (25.9)
|
|
Aspiration
|
255
|
141 (55.3)
|
114 (44.7)
|
4,765
|
2,695 (56.6)
|
2,070 (43.4)
|
|
Child maltreatment§§
|
148
|
87 (58.8)
|
61 (41.2)
|
11,000
|
6,294 (57.2)
|
4,706 (42.8)
|
|
Drowning
|
981
|
772 (78.7)
|
210 (21.4)
|
33,853
|
27,108 (80.1)
|
6,745 (19.9)
|
|
Fall injuries¶¶
|
2,645
|
1,873 (70.8)
|
772 (29.2)
|
70,815
|
49,887 (70.4)
|
20,927 (29.6)
|
|
Fire injuries
|
457
|
274 (60.0)
|
183 (40.0)
|
10,950
|
6,491 (59.3)
|
4,459 (40.7)
|
|
Firearm injuries
|
337
|
284 (84.3)
|
53 (15.7)
|
12,917
|
10,768 (83.4)
|
2,149 (16.6)
|
|
Homicide
|
5,306
|
4,267 (80.4)
|
1,039 (19.6)
|
230,047
|
187,052 (81.3)
|
42,995 (18.7)
|
|
Hypothermia
|
296
|
194 (65.5)
|
102 (34.5)
|
6,199
|
4,354 (70.2)
|
1,845 (29.8)
|
|
Motor-vehicle nontraffic crashes
|
190
|
144 (75.8)
|
47 (24.7)
|
5,588
|
4,249 (76.0)
|
1,339 (24.0)
|
|
Motor-vehicle traffic crashes***
|
7,092
|
5,522 (77.9)
|
1,570 (22.1)
|
323,610
|
245,447 (75.8)
|
78,163 (24.2)
|
|
Occupational and machine injuries
|
126
|
117 (92.9)
|
9 (7.1)
|
3,294
|
3,060 (92.9)
|
234 (7.1)
|
|
Other road vehicle crashes
|
170
|
137 (80.6)
|
33 (19.4)
|
5,632
|
4,473 (79.4)
|
1,159 (20.6)
|
|
Poisoning (not alcohol)
|
11,839
|
7,524 (63.6)
|
4,315 (36.4)
|
444,235
|
280,270 (63.1)
|
163,965 (36.9)
|
|
Suicide
|
9,899
|
7,711 (77.9)
|
2,189 (22.1)
|
332,791
|
252,674 (75.9)
|
80,117 (24.1)
|
|
Suicide by and exposure to alcohol
|
38
|
24 (63.2)
|
14 (36.8)
|
1,267
|
764 (60.3)
|
503 (39.7)
|
|
Water transport
|
75
|
65 (86.7)
|
9 (12.0)
|
2,566
|
2,189 (85.3)
|
377 (14.7)
|
Abbreviation: NA = not
applicable.
* In the Alcohol-Related Disease Impact application (https://www.cdc.gov/ARDI), deaths attributable to excessive alcohol use include deaths from 1) conditions that are 100% alcohol-attributable, 2) deaths caused by acute conditions that involved binge drinking, and 3) deaths caused by chronic conditions that involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks [men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels of average daily alcohol consumption.
† Numbers might not sum to totals, and row percentages might not sum to 100% because of rounding.
§ Deaths calculated for the proportion of esophageal cancer deaths caused by squamous cell carcinoma only, based on the Surveillance, Epidemiology, and End Results data in 18 states (SEER18). https://seer.cancer.gov/external icon.
¶ Deaths among those consuming high average daily levels of alcohol only.
** Alcohol consumption prevalence estimates calculated among women aged 18–44 years only.
†† Deaths among persons aged 20–64 years only because of the high number of deaths from pneumonia among persons aged ≥65 years that are not alcohol-related and the lack of relative risks that differ by age.
§§ Deaths among persons aged 0–14 years.
¶¶ Deaths among persons aged 15–69 years only because of the high number of deaths from falls among persons aged ≥70 years that are not alcohol-attributable and the lack of alcohol-attributable fractions that differ by age.
*** Deaths among persons of all ages. A blood alcohol concentration level of ≥0.08 g/dL is used for defining alcohol attribution for this condition.
* In the Alcohol-Related Disease Impact application (https://www.cdc.gov/ARDI), deaths attributable to excessive alcohol use include deaths from 1) conditions that are 100% alcohol-attributable, 2) deaths caused by acute conditions that involved binge drinking, and 3) deaths caused by chronic conditions that involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks [men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels of average daily alcohol consumption.
† Numbers might not sum to totals, and row percentages might not sum to 100% because of rounding.
§ Deaths calculated for the proportion of esophageal cancer deaths caused by squamous cell carcinoma only, based on the Surveillance, Epidemiology, and End Results data in 18 states (SEER18). https://seer.cancer.gov/external icon.
¶ Deaths among those consuming high average daily levels of alcohol only.
** Alcohol consumption prevalence estimates calculated among women aged 18–44 years only.
†† Deaths among persons aged 20–64 years only because of the high number of deaths from pneumonia among persons aged ≥65 years that are not alcohol-related and the lack of relative risks that differ by age.
§§ Deaths among persons aged 0–14 years.
¶¶ Deaths among persons aged 15–69 years only because of the high number of deaths from falls among persons aged ≥70 years that are not alcohol-attributable and the lack of alcohol-attributable fractions that differ by age.
*** Deaths among persons of all ages. A blood alcohol concentration level of ≥0.08 g/dL is used for defining alcohol attribution for this condition.
|
TABLE 2. Annual
average number of deaths and years of potential life lost from excessive
alcohol use,* by state — United States, 2011–2015
|
|||||
|
Location
|
Alcohol-attributable
deaths
|
Age-adjusted
alcohol-attributable deaths per 100,000-population
|
Years of potential
life lost
|
Years of potential
life lost per 100,000-population
|
Years of potential
life lost per alcohol-attributable death
|
|
U.S. total
|
93,296
|
27.4
|
2,683,211
|
847.7
|
28.8
|
|
Alabama
|
1,446
|
28.0
|
44,074
|
912.4
|
30.5
|
|
Alaska
|
292
|
29.4†
|
9,631
|
1,313.2
|
33.0
|
|
Arizona
|
2,594
|
37.0
|
74,450
|
1,120.9
|
28.7
|
|
Arkansas
|
892
|
28.3
|
26,512
|
896.2
|
29.7
|
|
California
|
10,811
|
26.9
|
299,336
|
779.1
|
27.7
|
|
Colorado
|
1,810
|
32.5
|
54,054
|
1,024.0
|
29.9
|
|
Connecticut
|
900
|
22.8
|
25,738
|
716.3
|
28.6
|
|
Delaware
|
271
|
19.3†
|
8,136
|
878.2
|
30.0
|
|
District of Columbia
|
207
|
26.4†
|
5,861
|
905.2
|
28.3
|
|
Florida
|
6,778
|
29.8
|
183,199
|
932.5
|
27.0
|
|
Georgia
|
2,556
|
24.7
|
75,681
|
756.3
|
29.6
|
|
Hawaii
|
348
|
17.1†
|
9,470
|
673.4
|
27.2
|
|
Idaho
|
491
|
29.5
|
14,037
|
868.3
|
28.6
|
|
Illinois
|
3,295
|
24.0
|
95,560
|
742.3
|
29.0
|
|
Indiana
|
1,900
|
27.4
|
56,502
|
860.2
|
29.7
|
|
Iowa
|
834
|
24.5
|
22,014
|
711.6
|
26.4
|
|
Kansas
|
750
|
24.7
|
22,152
|
765.7
|
29.5
|
|
Kentucky
|
1,524
|
32.3
|
45,422
|
1,032.9
|
29.8
|
|
Louisiana
|
1,523
|
31.5
|
47,217
|
1,020.9
|
31.0
|
|
Maine
|
424
|
18.8†
|
11,261
|
847.3
|
26.6
|
|
Maryland
|
1,453
|
22.9
|
43,804
|
738.6
|
30.1
|
|
Massachusetts
|
1,729
|
23.3
|
48,305
|
720.4
|
27.9
|
|
Michigan
|
3,123
|
28.9
|
89,332
|
902.3
|
28.6
|
|
Minnesota
|
1,333
|
22.7
|
36,537
|
674.2
|
27.4
|
|
Mississippi
|
913
|
29.3
|
27,950
|
935.4
|
30.6
|
|
Missouri
|
1,860
|
28.8
|
55,813
|
923.2
|
30.0
|
|
Montana
|
414
|
37.4
|
12,232
|
1,205.5
|
29.5
|
|
Nebraska
|
453
|
23.0
|
12,610
|
674.6
|
27.8
|
|
Nevada
|
1,037
|
34.6
|
29,604
|
1,057.8
|
28.5
|
|
New Hampshire
|
420
|
20.1†
|
11,364
|
858.2
|
27.1
|
|
New Jersey
|
1,967
|
20.3
|
57,455
|
645.2
|
29.2
|
|
New Mexico
|
1,129
|
52.3
|
34,424
|
1,651.7
|
30.5
|
|
New York
|
4,390
|
20.3
|
120,761
|
613.8
|
27.5
|
|
North Carolina
|
2,811
|
26.5
|
82,568
|
838.7
|
29.4
|
|
North Dakota
|
215
|
21.2†
|
6,352
|
880.2
|
29.5
|
|
Ohio
|
3,608
|
28.6
|
103,809
|
896.8
|
28.8
|
|
Oklahoma
|
1,465
|
36.4
|
43,597
|
1,132.5
|
29.8
|
|
Oregon
|
1,498
|
33.5
|
39,310
|
997.9
|
26.2
|
|
Pennsylvania
|
3,768
|
26.5
|
108,168
|
846.4
|
28.7
|
|
Rhode Island
|
337
|
20.5†
|
9,240
|
876.9
|
27.4
|
|
South Carolina
|
1,629
|
31.4
|
48,121
|
1,007.2
|
29.5
|
|
South Dakota
|
282
|
22.0†
|
8,608
|
1,020.9
|
30.5
|
|
Tennessee
|
2,102
|
30.0
|
62,325
|
958.9
|
29.7
|
|
Texas
|
7,097
|
26.9
|
213,553
|
804.7
|
30.1
|
|
Utah
|
68
|
26.1
|
21,803
|
751.0
|
31.9
|
|
Vermont
|
203
|
21.0†
|
5,074
|
809.8
|
25.0
|
|
Virginia
|
1,972
|
22.2
|
56,965
|
689.9
|
28.9
|
|
Washington
|
2,195
|
28.8
|
59,665
|
854.1
|
27.2
|
|
West Virginia
|
725
|
35.3
|
21,621
|
1,167.8
|
29.8
|
|
Wisconsin
|
1,722
|
27.2
|
47,374
|
825.0
|
27.5
|
|
Wyoming
|
236
|
27.1†
|
7,317
|
1,262.3
|
31.0
|
* In the Alcohol-Related Disease Impact
application (https://www.cdc.gov/ARDI),
deaths attributable to excessive alcohol use include deaths from 1) conditions
that are 100% alcohol-attributable, 2) deaths caused by acute conditions that
involved binge drinking, and 3) deaths caused by chronic conditions that
involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks
[men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels
of average daily alcohol consumption.
† The estimate might be unreliable because of suppressed estimates of the number of alcohol-attributable deaths in two or more age groups, and estimates might not account for the total number of alcohol-attributable deaths in the state.
† The estimate might be unreliable because of suppressed estimates of the number of alcohol-attributable deaths in two or more age groups, and estimates might not account for the total number of alcohol-attributable deaths in the state.
FIGURE. Average
annual number of deaths attributable to excessive alcohol use,* by sex and age
group — United States, 2011–2015
* In the Alcohol-Related Disease Impact
application (https://www.cdc.gov/ARDI),
deaths attributable to excessive alcohol use include deaths from 1) conditions
that are 100% alcohol-attributable, 2) deaths caused by acute conditions that
involved binge drinking, and 3) deaths caused by chronic conditions that
involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks
[men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels
of average daily alcohol consumption.
Suggested citation for this article: Esser
MB, Sherk A, Liu Y, et al. Deaths and Years of Potential Life Lost From
Excessive Alcohol Use — United States, 2011–2015. MMWR Morb Mortal Wkly Rep
2020;69:981–987. DOI: http://dx.doi.org/10.15585/mmwr.mm6930a1external icon.
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