The toll of too much drinking is especially high
among men and among middle-aged people, according to the report,
whose authors say it's the first to tabulate deaths resulting solely
"This provides direct evidence of the impact of alcohol on the
health of countries in the region," said one of the study's authors,
Dr. Vilma Pinheiro Gawryszewski, an advisor on health information
and analysis for the Pan American Health Organization(PAHO).
In the 16 North, Central, and South American countries studied,
alcohol was the sole cause of 79,456 deaths a year, the researchers
say. That represented 1.4 percent of deaths from all causes, and
alcohol-related liver disease alone accounted for 0.6 percent of
The study was based on data collected between 2007 and 2009 for
countries in the PAHO mortality database.
The researchers excluded deaths from vehicle accidents and other
fatal situations where alcohol might have been involved but there
could also have been other causes.
Looking just at deaths due directly to alcohol, they found 63
percent were from liver disease and 32 percent were from
neurological and psychiatric conditions grouped under "degeneration
of the brain and nervous system."
Other listed causes of death included alcohol poisoning,
alcohol-linked heart and gastric problems and fetal alcohol
The death toll is the "tip of the iceberg," meaning that there are
probably many more alcohol-related deaths that the researchers were
not able to identify, said another of the study's authors, Dr.
Maristela Monteiro, regional advisor on alcohol and substance abuse
Monteiro said that raising the price of alcohol and increasing taxes
would help to prevent some of these deaths. Many countries have
found these steps effective in controlling tobacco use, but such
measures have not been used to control alcohol consumption, she
Even the U.S., which was included in the study, has not done as much
as it could, said David Jernigan, director of the Center on Alcohol
Marketing and Youth at Johns Hopkins Bloomberg School of Public
"The single most efficient thing you can do is to raise taxes,"
Jernigan told Reuters Health. "Many states haven't raised it in
decades. That means the price doesn't go up with inflation, and
alcohol gets cheaper every year."
And while the U.S. and other countries have limited tobacco
advertising, alcohol advertising "is virtually everywhere," he said.
Mortality due to alcohol was highest in El Salvador, Guatemala and
Nicaragua, with death rates of 27.4, 22.3 and 21.3 per 100,000
people, respectively. These were also the countries with the highest
consumption of hard liquor, the authors noted.
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Colombia, Argentina and Canada had the lowest death rates
attributable to alcohol at 1.8, 4.0 and 5.7 per 100,000,
respectively. The alcohol death rate in the United States was
"intermediate," at 6.7 per 100,000, Monteiro said.
Men accounted for 84 percent of the deaths overall, but that
proportion was not the same in all countries. The risk of a man
dying from alcohol in El Salvador was nearly 30 times higher than
that of a woman, but only about three times higher in Canada and the
People in the mid-to-late 50s and 60s age range were at the highest
risk. This later in life risk, Jernigan said, points to the
long-term impact of heavy drinking.
"Mostly in this country, we talk about alcohol and the risk for the
young," in whom drunk driving, violence, and accidents are important
causes of death, Jernigan said. "This really shows the impact over
the life course."
Despite the grim statistics, Jernigan says studies like this one are
a positive sign.
"On one hand, you could say, 'this is a huge problem, and not enough
is being done.' On the other," he said, "you could say, 'we're
getting better at documenting it and showing that, until we take
meaningful action, it's not going to go away.'"
In poorer countries, other factors contributing to the deaths could
include infectious diseases that hasten the course of liver disease,
as well as poor nutrition and limited access to health services.
"In the U.S., people wouldn't wait until they were too sick for help
to seek out services, because treatment is available," said Monteiro.
That is not always the case, she said, in other countries.
Addiction, online Jan. 14, 2014.
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