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Alcohol-Associated Liver Disease Mortality.

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Alcohol-associated liver disease (ALD) mortality is rising significantly in the US, particularly among women, young adults, and Native American populations. Urgent public health interventions are needed to address these concerning trends.

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Area of Science:

  • Hepatology
  • Public Health
  • Epidemiology

Background:

  • Alcohol-associated liver disease (ALD) is a critical public health issue in the US, contributing significantly to cirrhosis deaths and liver transplantations.
  • Mortality rates for ALD have shown concerning increases, especially following the onset of the COVID-19 pandemic.

Purpose of the Study:

  • To comprehensively analyze national trends in ALD mortality in the US from 1999 to 2022.
  • To investigate disparities in ALD mortality based on sex, race, ethnicity, and age.

Main Methods:

  • A retrospective cross-sectional analysis of the CDC Wide Ranging Online Data for Epidemiologic Research (WONDER) mortality database (1999-2022).
  • Inclusion of death certificates for individuals aged 25 years and older across all 50 states and the District of Columbia.
  • Age-adjusted annual mortality rates were calculated and stratified by demographic factors, with Joinpoint regression used to identify trends.

Main Results:

  • Total ALD deaths exceeded 436,000, with mortality rates increasing from 6.71 to 12.53 per 100,000 population between 1999 and 2022.
  • Significant mortality acceleration was observed from 2018-2022 (APC 8.94%).
  • Women, young adults (25-44 years), and American Indian/Alaska Native populations showed disproportionately rapid increases in ALD mortality.

Conclusions:

  • ALD mortality has significantly increased across diverse demographic groups in the US.
  • Concerning trends were noted among women, young adults, and the American Indian/Alaska Native population.
  • Targeted public health interventions and enhanced surveillance are crucial, considering pandemic-related shifts in alcohol consumption.