State Alcohol Policies and Alcoholic Cirrhosis Deaths

In 2010, excessive drinking cost the United States $249 billion and is responsible for 88,000 deaths in America each year, including 1 in 10 deaths among working age adults.

Research shows that stronger state alcohol policies are associated with a decrease in binge drinking, the pattern of drinking that is responsible for most of these deaths and costs.

In a new study released this week in CDC’s Preventing Chronic Disease, Hadland et al examined the relationship between alcoholic cirrhosis mortality rates in the United States and the District of Columbia from 2002 through 2011 and the alcohol policy environments in these locations. The study’s authors included 29 policy indicators that can reduce excessive drinking, including alcohol taxes. Changes in mortality rates were also assessed by sex, race/ethnicity, and geographic region.

Overall, alcoholic cirrhosis mortality rates in states significantly increased during the study period from an average of 4.6 deaths per 100,000 population in 2002 to 5.3 deaths per 100,000 population in 2011. The death rates were highest in Western states and states with higher proportions of American Indians/Alaska Natives (AI/ANs). States that had stronger alcohol policy environments tended to have lower alcoholic cirrhosis mortality rates than those states with weaker alcohol policy environments, but this relationship was only significant for women and not for men. However, when AI/ANs were excluded from the analysis, alcoholic cirrhosis mortality rates were significantly lower in states with stronger alcohol environments.

The stronger protective relationship between alcohol policies and alcoholic cirrhosis mortality rates among non-AI/AN populations reflects a number of challenges related to the prevention of excessive drinking among AI/ANs. For example, many AI/ANs live in autonomous or physically remote regions in which state alcohol policies may have less influence. Differences in drinking patterns, access to health care, or other factors also may have contributed to these findings.

Overall, this article emphasizes the importance of the alcohol policy environment in states as a key determinant of excessive drinking and related harms, including deaths from alcoholic cirrhosis. It also emphasizes the importance of addressing disparities in excessive drinking and related harms, including the high death rates from alcoholic cirrhosis in the AI/AN population. For more information on the prevention of excessive drinking and related harms, visit CDC’s fact sheet on Preventing Excessive Alcohol Use.

Additional resources:   

CDC’s Alcohol and Public Health Website

The Community Guide: Preventing Excessive Alcohol Consumption

By Jessica Mesnick

Public Health Analyst, Excessive Alcohol Use Prevention Team

Division of Population Health

National Center for Chronic Disease Prevention and Health Promotion

Centers for Disease Control and Prevention