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Trends in Premature Deaths From Alcoholic Liver Disease in the U.S., 1999–2018

      Introduction

      So-called deaths of despair—those involving drug overdoses, alcohol-related liver disease, and suicide—have been rising in the U.S. among middle-aged white, non-Hispanic adults without a college degree. Premature deaths (ages 25–69) from alcoholic liver disease were examined specifically in this study from 1999 to 2018, by sex, race/Hispanic origin, and age group.

      Methods

      Data were drawn from the 1999–2018 Multiple Cause of Death database and bridged-race estimates of the U.S. resident population, including 281,243 alcoholic liver disease deaths or an average of 8 deaths per 100,000 population. Analyses examined alcoholic liver disease death rates for sex differences among 3 age groups (25–49, 50–59, and 60–69 years), by race and Hispanic origin, from 1999 to 2018; age-adjusted and age-specific annual percentage changes (accounted for cohorts); years of potential life lost; and age of death for sociodemographic backgrounds, alcoholic liver disease clinical courses, and comortalities.

      Results

      White non-Hispanics increasingly experienced greater alcoholic liver disease mortality than black non-Hispanics and Hispanics, confirming the racial and ethnic crossover observed in previous studies. Although men consistently had higher rates of mortality, male-to-female ratios decreased in the past 2 decades and were the lowest among ages 25–49 years and especially among ages 25–34 years. Although women generally had longer life expectancies, women died of alcoholic liver disease on average about 2–3 years earlier than men.

      Conclusions

      Prevention and intervention efforts are imperative to address the narrowing sex gap and widening racial disparities in alcoholic liver disease premature deaths.
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