Community Health Epidemiology, San Francisco Department of Public Health, San Francisco, California, USA.
BMC Public Health. 2010 Nov 9;10:682. doi: 10.1186/1471-2458-10-682.
In recent years, national and global mortality data have been characterized in terms of well-established risk factors. In this regard, alcohol consumption has been called the third leading "actual cause of death" (modifiable behavioral risk factor) in the United States, after tobacco use and the combination of poor diet and physical inactivity. Globally and in various regions of the world, alcohol use has been established as a leading contributor to the overall burden of disease and as a major determinant of health disparities, but, to our knowledge, no one has characterized alcohol-related harm in such broad terms at the local level. We asked how alcohol-related premature mortality in San Francisco, measured in years of life lost (YLLs), compares with other well-known causes of premature mortality, such as ischemic heart disease or HIV/AIDS.
We applied sex- and cause-specific population-attributable fractions (PAFs) of years of life lost (YLLs) from the Global Burden of Disease Study to 17 comparable outcomes among San Francisco males and females during 2004-2007. We did this in three ways: Method 1 assumed that all San Franciscans drink like populations in developed economies. These estimates were limited to alcohol-related harm. Method 2 modified these estimates by including several beneficial effects. Method 3 assumed that Latino and Asian San Franciscans drink alcohol like populations in the global regions related to their ethnicity.
By any of these three methods, alcohol-related premature mortality accounts for roughly a tenth of all YLLs among males. Alcohol-related YLLs among males are comparable to YLLs for leading causes such as ischemic heart disease and HIV/AIDS, in some instances exceeding them. Latino and black males bear a disproportionate burden of harm. Among females, for whom estimates differed more by method and were smaller than those for males, alcohol-related YLLs are comparable to leading causes which rank somewhere between fifth and fourteenth.
Alcohol consumption is a major contributor to premature mortality in San Francisco, especially among males. Interventions to avert alcohol-related harm in San Francisco should be taken at the population level and deserve the same attention that is given to other major risk factors, such as smoking or obesity.
近年来，人们根据既定的风险因素来描述国家和全球的死亡率数据。在这方面，酒精消费已被称为继烟草使用、不良饮食和缺乏身体活动相结合之后，美国的第三个主要“实际死亡原因”（可改变的行为风险因素）。在全球和世界各地区，酒精使用已被确定为导致疾病总负担的一个主要因素，并成为健康差异的一个主要决定因素，但据我们所知，没有人从地方层面以如此广泛的术语来描述与酒精有关的危害。我们想知道，旧金山因酒精导致的过早死亡（以损失的生命年衡量）与其他导致过早死亡的常见原因（如缺血性心脏病或艾滋病）相比如何。
我们应用全球疾病负担研究中性别和病因特异性损失生命年（YLL）的人群归因分数（PAF），对 2004 年至 2007 年期间旧金山男性和女性的 17 种可比结局进行分析。我们以三种方式进行分析：方法 1 假设所有旧金山人都像发达经济体的人群那样饮酒。这些估计仅限于与酒精有关的危害。方法 2 通过纳入几种有益影响来修改这些估计。方法 3 假设拉丁裔和亚裔旧金山人会像他们所在的全球地区人群一样饮酒。
通过这三种方法中的任何一种方法，酒精相关的过早死亡约占男性所有 YLL 的十分之一。在某些情况下，男性因酒精导致的 YLL 与缺血性心脏病和艾滋病等主要原因的 YLL 相当，在某些情况下甚至超过这些原因。拉丁裔和黑人男性承受着不成比例的伤害负担。对于女性来说，由于估计方法不同，且数值小于男性，因酒精导致的 YLL 与排名在第五至第十四位的主要原因相当。
酒精消费是旧金山过早死亡的一个主要原因，尤其是在男性中。为了避免旧金山的酒精相关危害，应在人群层面采取干预措施，这应与对其他主要风险因素（如吸烟或肥胖）的关注程度相同。
