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Alcohol Deaths Claim Lives of Working-Age Americans

A C.D.C. study estimates that, over five years, one in eight deaths of people ages 20 to 64 occurred because of alcohol-related injuries or illness.

Rows and rows of liquor bottles on floor-to-ceiling store shelves are tended to by a kneeling store clerk at right.
Although alcohol takes a progressively heavier toll on older age groups, its effects are more noticeable in younger people, who are less likely to die of other causes. Credit...Marta Lavandier/Associated Press

An estimated one in eight deaths of Americans ages 20 to 64 in the years 2015-19 was the result of injuries or illness caused by excessive alcohol use, according to a new study from the Centers for Disease Control and Prevention.

The study, published on Tuesday in the journal JAMA Network Open, assessed the effects of alcohol on people of working age, who accounted for nearly two-thirds of the country’s annual average of 140,000 alcohol-related deaths.

The rates of excessive alcohol use and related deaths have most likely climbed since the period the C.D.C. researchers analyzed. After the onset of the pandemic, a variety of data showed Americans drank more frequently, and deaths due to a narrower set of causes attributable to alcohol rose 25 percent in 2020 over the previous year.

Although alcohol takes a progressively heavier toll on older age groups, its effects are more noticeable in younger people who are less likely to die of other causes. Among those ages 20 to 49, one in five deaths was attributable to drinking, and for those ages 20 to 34, it was one in four, the study found.

“This is really affecting adults in the prime of their life,” said Marissa Esser, who leads the C.D.C.’s alcohol program and was a co-author of the study. She said the large share of people dying in their working years meant excess drinking had an outsize effect on economic productivity.

The researchers analyzed data from the nation’s vital records and identified deaths due to excessive alcohol use over the five-year period. Some causes of death, such as alcoholic liver disease, could be wholly attributable to excess drinking. For other causes of death, like cancers related to drinking or injuries where intoxication was a known risk factor, the researchers estimated the share of fatalities due to excessive alcohol use based on surveyed drinking behavior and sales in various populations. The data are only updated every few years because the calculations rely on multiple sources of data.

If anything, the study underestimated the true number of deaths, Dr. Esser said, because the researchers did not include every cause of death in which alcohol played at least some role.

Dr. Gordon Smith, a professor of epidemiology at the West Virginia University School of Public Health who was not involved with the study, said that even after decades of studying alcohol, he was taken aback by the sheer magnitude of its toll. “I knew it was a big problem, but I think it was important to see just how much of a problem it is,” he said.

He credited the study’s authors for their methods of measuring the influence of excess drinking on various causes of death. “They’ve come up with probably the best estimates to date of the amount that alcohol contributes to these other conditions,” he said.

Alcohol is a leading cause of preventable death in the United States, but it is often overshadowed by tobacco or opiates. And its effects on Americans’ health has been growing. Nearly a decade ago, a similar study found one in 10 deaths of working-age people was due to drinking, although researchers have changed the methodology, so a perfect apples-to-apples comparison is not possible.

Katherine Keyes, a professor of epidemiology at Columbia University who was not involved in the latest study, said it painted a stark picture of the problem. “Where the science needs to go,” she said, “is what do we do about it?”

She took a hopeful view of variations in alcohol’s effects that the study found across the states. In Mississippi, alcohol accounted for 9.3 percent of working-age deaths, whereas in New Mexico, it accounted for 21.7 percent, including one in three deaths of people ages 20 to 34, which Dr. Keyes called “horrifying.”

But she said those differences were also indicative of the profound role that the surrounding environment has in any individual’s drinking habits. That suggests the most affected communities may be able to learn from others where drinking is less perilous, she said.

There is ample opportunity to improve access to treatment services, experts say. Millions of Americans struggle with alcohol use disorders, but their medical providers do not typically counsel them to reduce excessive use or offer them medications that can blunt cravings.

Dr. Esser said policymakers should take steps to make their communities safer. “Evidence-based strategies are out there and underused,” she said. The C.D.C.’s Community Preventive Services Task Force recommends a number of measures, including raising alcohol taxes and regulating the number and concentration of businesses that sell alcohol.

Last year, Congress permanently reduced federal alcohol tax rates, and state alcohol taxes have generally not kept up with inflation. But in some hard-hit states, advocates have begun pushing back. In Oregon, there was a campaign to raise alcohol taxes, and lawmakers in New Mexico recently held hearings about doing so.

A version of this article appears in print on  , Section A, Page 20 of the New York edition with the headline: Study Finds Alcohol Use Is Claiming Younger Toll. Order Reprints | Today’s Paper | Subscribe

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