Premature death from alcoholic liver disease increases as the gap between men and women narrows

Ann Arbor, August 27, 2020-A New research In American Journal of Preventive MedicineIdentifies the prevalence and prevalence patterns of premature death from alcoholic (alcohol-related) liver disease (ALD) in the United States over the past 20 years published by Elsevier. Importantly, the study shows that ALD mortality in non-Hispanic whites, especially women, has increased more rapidly than non-Hispanic blacks since the early 2000s. Findings show that mortality is significantly affected by socioeconomic and sociodemographic factors, ALD clinical course, and coexistence.

“Empirical evidence from our study adds to the growing literature suggesting that the large gap between previous women and men in alcohol-related harm, including mortality, is narrowing,” said the collaborators. Dr Aaron M. White, who was the Director’s Senior Scientific Advisor, described the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA. “Of particular concern is the largest increase that has occurred among young women between the ages of 25 and 34. To develop liver disease usually requires more than 10 years of drinking, so it’s too early to age 35. Deaths are very uncommon and cause serious public health concerns.”

Investigators derived death certificate data from multiple cause-of-death databases compiled by the National Center for Health Statistics 1999-2018. Each death certificate contains a single underlying cause of death, up to 20 additional causes, and sociodemographic data. From 1999 to 2018, 281,243 people between the ages of 25 and 69 died of early ALD. The researchers looked at other factors that were reported to contribute to the cause of death. Demographic characteristics (eg, gender, race/Hispanic origin, marital status, education); ALD type (eg, alcoholic fatty liver, alcoholic hepatitis, alcoholic cirrhosis of the liver); For example, alcohol use disorder, tobacco use disorder, hepatitis C infection, diabetes, high blood pressure, injury).

The highlights of the survey results are:

-Although male ALD mortality rates are consistently high, the gender gap in ALD mortality has narrowed over the past 20 years, especially among people aged 25 to 34 years. The ratio of men to women fell from about 3:1 in 1999 to 2:1 in 2018.

-Women died of ALD approximately 2-3 years earlier than men. This is probably due to the relatively high incidence of alcohol abuse and alcoholic hepatitis in young women, and the high prevalence of severe obesity in women.

-The number of years of latent loss of life (YPLL), an indicator of premature death, increased sharply in women than in men, especially after the 2008 recession. Since then, individuals irrespective of gender, who have not been educated at university, have a higher mortality rate for ALD than those who have been educated at university.

-Age-adjusted ALD mortality in non-Hispanic blacks compared to non-Hispanic whites has declined or stagnated during this period or has increased slowly since 2008.

-Alcohol’s involvement in liver disease remained highest among Hispanics. Historically, gender differences in alcohol drinking were more pronounced in Hispanics than in other racial/ethnic groups. The authors suggest that a high rate among Hispanic women may be due to increased female drinking driven by cultural change.

The authors conclude that the study supports policies to reduce population-level interventions and alcohol consumption, and improve access and quality of ALD treatment. Their findings help raise public awareness of rising levels of mortality by ALD and the highest risk groups, and encourage both physicians and patients to participate more often in discussions about alcohol consumption. To address the narrowing of the disparity in premature mortality from ALD, greater emphasis should be placed on implementing abstinence programs, early detection of ALD, and education on women’s dangerous drinking levels.

Dr. White warned: “Alcohol consumption tends to increase during periods of economic uncertainty, which could lead to a surge in ALD mortality if the current economic crisis continues. In addition, interruption of quality care delivery can increase mortality in end-stage ALD patients.Discontinuation of treatment and recovery programs for alcohol use disorders can lead to relapse and worsening of ALD.”