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Chronic liver disease mortality in the United States, 1979 through 1989
E S Hurwitz1, R C Holman, T W Strine
1Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Insights
Chronic liver disease mortality in the US declined 22% from 1979-1989. Declines were greatest in non-alcohol-related liver disease deaths, suggesting factors beyond alcohol consumption impact mortality trends.
Area of Science:
- Public Health
- Epidemiology
- Hepatology
Background:
- Chronic liver disease represents a significant public health concern in the United States.
- Understanding mortality trends is crucial for developing effective prevention and intervention strategies.
- Previous assumptions linked declining liver disease mortality primarily to reduced alcohol consumption.
Purpose of the Study:
- To examine the rates and trends of chronic liver disease mortality in the United States between 1979 and 1989.
- To analyze mortality data across different categories of chronic liver disease.
- To investigate racial disparities in chronic liver disease mortality.
Main Methods:
- Analysis of National Center for Health Statistics data on underlying causes of death for chronic liver disease (1979-1989).
- Categorization of chronic liver disease deaths into four groups: cirrhosis without alcohol, alcohol-related liver disease, liver disease without alcohol, and biliary cirrhosis.
- Assessment of mortality rates and trends stratified by race and sex.
Main Results:
- A total of 303,875 deaths from chronic liver disease occurred between 1979 and 1989.
- Mortality rates were higher for Black individuals compared to White and other racial groups.
- Overall chronic liver disease mortality decreased by 22%, with the largest declines observed in non-alcohol-related categories.
Conclusions:
- Despite declining alcohol consumption, significant reductions in chronic liver disease mortality were observed in deaths not coded as alcohol-related.
- These findings suggest that factors other than alcohol consumption play a substantial role in the decline of chronic liver disease deaths.
- Further research is needed to identify these contributing factors and inform public health initiatives.
Objectives:
Rates and trends for chronic liver disease mortality in the United States were examined.
Methods:
National Center for Health Statistics data on underlying cause of death for chronic liver disease for the United States from 1979 through 1989 were analyzed. Four groups of diseases and conditions included under the International Classification of Diseases, 9th Revision, code for chronic liver disease were assessed separately.
Results:
From 1979 through 1989, there were 303,875 deaths from chronic liver disease; 48% were in the cirrhosis without alcohol group, 42% in the alcohol-related liver disease group, 8% in the liver disease without alcohol group, and 1.5% in the biliary cirrhosis group. Chronic liver disease death rates for Blacks were more than 1.5 times greater than those for Whites and for other races. Chronic liver disease mortality declined 22% overall among both sexes. The largest decreases were for liver disease without alcohol (42%) and cirrhosis without alcohol (25%), followed by alcohol-related liver disease (14%) and biliary cirrhosis (12%).
Conclusion:
Although declines in US chronic liver disease deaths have been attributed to declining alcohol consumption, these analyses suggest that greater declines have occurred in deaths not coded as alcohol related.