Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
PLoS One. 2013;8(1):e51923. doi: 10.1371/journal.pone.0051923. Epub 2013 Jan 2.
Alcohol has been linked to health disparities between races in the US; however, race-specific alcohol-attributable mortality has never been estimated. The objective of this article is to estimate premature mortality attributable to alcohol in the US in 2005, differentiated by race, age and sex for people 15 to 64 years of age.
Mortality attributable to alcohol was estimated based on alcohol-attributable fractions using indicators of exposure from the National Epidemiologic Survey on Alcohol and Related Conditions and risk relations from the Comparative Risk Assessment study. Consumption data were corrected for undercoverage (the observed underreporting of alcohol consumption when using survey as compared to sales data) using adult per capita consumption from WHO databases. Mortality data by cause of death were obtained from the US Department of Health and Human Services. For people 15 to 64 years of age in the US in 2005, alcohol was responsible for 55,974 deaths (46,461 for men; 9,513 for women) representing 9.0% of all deaths, and 1,288,700 PYLL (1,087,280 for men; 201,420 for women) representing 10.7% of all PYLL. Per 100,000 people, this represents 29 deaths (29 for White; 40 for Black; 82 for Native Americans; 6 for Asian/Pacific Islander) and 670 PYLL (673 for White; 808 for Black; 1,808 for Native American; 158 for Asian/Pacific Islander). Sensitivity analyses showed a lower but still substantial burden without adjusting for undercoverage.
The burden of mortality attributable to alcohol in the US is unequal among people of different races and between men and women. Racial differences in alcohol consumption and the resulting harms explain in part the observed disparities in the premature mortality burden between races, suggesting the need for interventions for specific subgroups of the population such as Native Americans.
酒精已被证明与美国不同种族之间的健康差异有关;然而,种族特异性的酒精相关死亡率从未被估计过。本文的目的是估计 2005 年美国 15 至 64 岁人群中因酒精导致的过早死亡人数,并按种族、年龄和性别进行区分。
根据《国家酒精流行病学调查和相关情况》中的酒精归因分数和《比较风险评估研究》中的风险关系,利用暴露指标来估计酒精导致的死亡率。使用世界卫生组织数据库中的成人人均消费数据,对饮酒数据进行了未覆盖的校正(与销售数据相比,使用调查时酒精消费的观察性漏报)。通过美国卫生与公众服务部获得按死因分类的死亡率数据。2005 年,美国 15 至 64 岁人群中,酒精导致 55974 人死亡(男性 46461 人,女性 9513 人),占总死亡人数的 9.0%,导致 1288700 人减寿年数(男性 1087280 人,女性 201420 人),占总减寿年数的 10.7%。每 10 万人中,这代表 29 人死亡(白人 29 人,黑人 40 人,美国原住民 82 人,亚太裔 6 人)和 670 人减寿年数(白人 673 人,黑人 808 人,美国原住民 1808 人,亚太裔 158 人)。敏感性分析表明,如果不调整未覆盖范围,负担会降低,但仍然很大。
美国因酒精导致的死亡率负担在不同种族和男女之间不平等。酒精消费的种族差异以及由此产生的危害部分解释了不同种族之间过早死亡负担的差异,这表明需要针对特定人群群体(如美国原住民)采取干预措施。