Oldham Melissa, Jackson Sarah, Brown Jamie, Buss Vera, Mehta Gautam, Dowd Jennifer Beam, Holmes John, Angus Colin
Department of Behavioural Science and Health, University College London, London, UK.
Department of Behavioural Science and Health, University College London, London, UK.
Lancet Public Health. 2025 May;10(5):e371-e379. doi: 10.1016/S2468-2667(25)00047-7. Epub 2025 Apr 10.
Following the COVID-19 pandemic, many countries saw large increases in rates of alcohol-specific deaths, including England. This study aimed to examine whether there have been changes in the characteristics of those dying by specific cause of death, age, sex, and area-level deprivation.
Using annual mortality data in England published by the Office for National Statistics, we describe the prevalence and 95% CI of age-standardised rates of alcohol-specific deaths overall and by age, sex, area-level deprivation measured by quintiles of the Index of Multiple Deprivation (IMD), and cause of death between 2001 and 2022. We also compared demographic profiles of those dying before the COVID-19 pandemic (2017-19) and after (2020-22); calculated crude absolute differences in rates and relative rate ratios across age, sex, and IMD; and used a multivariable Poisson regression model to calculate the rate ratio and adjusted absolute differences for deaths by IMD quintile for each period, adjusting for age and sex.
Age-standardised rates of alcohol-specific deaths in England remained largely unchanged until 2019, before rising sharply by 19·4% in 2020 and continuing to rise by a further 13·5% to the highest level on record in 2022: 14·7 (95% CI 14·4-15·0) per 100 000 people. There were few relative demographic changes in alcohol-specific mortality between 2017-19 (pre-pandemic) and 2020-22 (after the start of the COVID-19 pandemic) because the largest absolute increases in alcohol-specific mortality were seen among groups that had the highest pre-pandemic rates, including men (absolute rate increase, 3·87; relative increase, 25·9%) and those from areas of higher deprivation (absolute rate increase, 4·72; relative increase, 22·5%). When examining causes of deaths, the largest absolute increase was in alcohol-related liver disease (2·37; relative increase, 27·2%), with the largest relative increase in acute causes (absolute rate increase, 0·49; relative increase, 35·4%), although these accounted for a smaller proportion of deaths compared to alcohol-related liver disease. There was little to no change in deaths from alcohol dependence syndrome (absolute rate increase, 0·02; relative increase, 5·8%).
Alcohol-specific deaths in England remain high and increased after the COVID-19 pandemic. Policies should aim to reduce rates of alcohol consumption at the population level. Substantial investment is also required to facilitate early detection of liver disease and effective treatment.
Cancer Research UK.
在新冠疫情之后，包括英国在内的许多国家因酒精导致的死亡率大幅上升。本研究旨在探讨特定死因、年龄、性别以及地区层面贫困程度等方面死亡人群的特征是否发生了变化。
利用英国国家统计局公布的英格兰年度死亡率数据，我们描述了2001年至2022年期间总体以及按年龄、性别、以多重剥夺指数（IMD）五分位数衡量的地区层面贫困程度和死因划分的酒精特定死亡率的患病率及95%置信区间。我们还比较了在新冠疫情之前（2017 - 19年）和之后（2020 - 22年）死亡人群的人口统计学特征；计算了不同年龄、性别和IMD水平下的粗绝对率差异和相对率比；并使用多变量泊松回归模型计算每个时期按IMD五分位数划分的死亡的率比和调整后的绝对差异，同时对年龄和性别进行了调整。
在2019年之前，英格兰酒精特定死亡率的年龄标准化率基本保持不变，2020年急剧上升19.4%，并在2022年继续上升13.5%，达到有记录以来的最高水平：每10万人中有14.7例（95%置信区间14.4 - 15.0）。在2017 - 19年（疫情前）和2020 - 22年（新冠疫情开始后）之间，酒精特定死亡率的相对人口统计学变化不大，因为酒精特定死亡率绝对增幅最大的人群是疫情前死亡率最高的群体，包括男性（绝对率增幅为3.87；相对增幅为25.9%）以及来自贫困程度较高地区的人群（绝对率增幅为4.72；相对增幅为22.5%）。在研究死因时，绝对增幅最大的是酒精性肝病（2.37；相对增幅为27.2%），急性病因的相对增幅最大（绝对率增幅为0.49；相对增幅为35.4%），不过与酒精性肝病相比，这些病因导致的死亡占比更小。酒精依赖综合征导致的死亡几乎没有变化（绝对率增幅为0.02；相对增幅为5.8%）。
英国因酒精导致的死亡率仍然很高，且在新冠疫情之后有所上升。政策应致力于在人群层面降低酒精消费率。还需要大量投资以促进肝病的早期检测和有效治疗。
英国癌症研究基金会。
