Background: Alcohol poses a significant public health concern, contributing to acute and chronic health complications, including organ damage, neurological impairments, and increased mortality. Excessive alcohol consumption can result in poisoning. This study analyzed trends and disparities in mortality rates due to toxic effects of alcohol among different demographics and geographical regions from 1999 to 2020 for adults aged ≥25 and older.
Methods: Analysis of Alcohol-related deaths in the US from 1999-2020 was conducted using death certificate data from the CDC WONDER database, utilizing the ICD-10 code T51. Age-adjusted mortality rates (AAMR) per 100,000 population were extracted, and trends were analyzed using Joinpoint regression to calculate the Average Annual Percent Change (AAPC) with p value for statistical significance. Data were stratified using year, gender, race/ethnicity and geographical regions.
Results: Toxic Effects of Alcohol accounted for 179,492 deaths in the USA in the last two decades. The AAMR exhibited an increasing trend from 1999 (1.04) to 2020 (8.76) with a significant AAPC of 10.04 (p< 0.01). AAMR for Toxic Effects of Alcohol was 6.22 in males and 1.97 in females. An increase of AAMR in both genders occurred with a greater increase in female population (AAPC; F: 10.8, M: 10.2). American Indian had the highest AAMR (15.13), and Asian or Pacific Islander with the lowest (0.70). Over the study period, NH Black had the highest AAPC (11.5, p< 0.01). Deaths were highest in decedents home (84,812, 47.25%), followed by Other/Unknown Locations (50,381, 28.1%). Regional stratification shows Midwest had the highest AAMR (4.6) while South had the lowest AAMR (3.5). Significant increase of AAMR was seen in all regions with the highest in Midwest (AAPC: 14.2, p< 0.01). Urbanization-wise, metropolitan areas had a higher AAMR (4.06) than nonmetropolitan areas (4.05). States in the top 90th percentile included: New Mexico (11.7), West Virginia (10.5), Alaska (9.9), Rhode Island (9.2), and District of Columbia (8.6).
Conclusions: Alcohol-related mortality in the USA has significantly increased over the past two decades, with an alarming rise in AAMR across all demographics. While males had higher mortality rates, females experienced a steeper increase. Disparities were evident across racial groups, regions, and urbanization levels, with the Midwest and American Indian populations most affected. These findings highlight the urgent need for targeted interventions to address alcohol-related harm.
