Skip Navigation LinksSkip Navigation Links
Centers for Disease Control and Prevention
Safer Healthier People
Blue White
Blue White
bottom curve
CDC Home Search Health Topics A-Z spacer spacer
Blue curve MMWR spacer

Surveillance and Assessment of Alcohol-Related Mortality -- United States, 1980

Reduction of morbidity and mortality associated with misuse of alcohol is a major target of the 1990 objectives for the nation (1). Recently available Multiple Cause of Mortality tapes from the National Center for Health Statistics (NCHS) represent a tool for more comprehensive surveillance and assessment of alcohol-related mortality (2). National multiple-cause data tapes for 1980 were analyzed to (1) evaluate completeness of mortality reporting by comparing counts of alcohol-related mortality recorded as the underlying cause with those recorded as contributing causes on the death certificate* and (2) estimate premature mortality resulting from alcohol misuse.

Alcohol-related mortality attributable to specific diagnoses has been recorded on death certificates as either the underlying or contributing cause of death (Table 1). For example, 85% of the 15,174 mentions of alcoholic cirrhosis as a cause of death in 1980 were recorded as the underlying cause of death; a similar pattern was seen with alcoholic gastritis, alcoholic cardiomyopathy, and alcoholic psychosis. In contrast, although alcohol dependence was listed as a contributing cause of alcohol-related mortality in 13,911 deaths, it was only recorded as the underlying cause of death on 4,351 death certificates, 24% of the total alcohol dependence-associated deaths.** A similar pattern was seen with the third leading cause of alcohol-related mortality, alcohol abuse, which was listed as the contributory cause in 3,903 (81%) of 4,796 deaths.

Estimates of premature mortality (3) associated with alcohol misuse among persons aged 1 year through 64 years are based either on underlying cause or on contributing cause (Table 2). Alcohol dependence and alcoholic cirrhosis, the two major reported causes of alcohol-related mortality, account for substantial years of potential life lost (YPLL) due to alcohol use.** When average YPLL per death is examined, however, it is apparent that deaths resulting from the acute effects of alcohol account for relatively more mortality in younger persons. For example, an average of 29.1 years of life were lost for each death associated with excessive blood alcohol levels, in contrast with 14.4 years lost for each death from alcoholic cirrhosis. Reported by D Bertolucci, MA, C Lowman, PhD, M Dufour, MD, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland; F Stinson, PhD, Alcohol Epidemiologic Data System, CSR, Incorporated, Washington, D.C.; Epidemiologic Studies Br, Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: For two reasons, these data conservatively estimate total mortality and premature mortality associated with alcohol misuse. First, only causes of death presumed to be specific for alcohol have been included, while other deaths resulting from liver disease, but not attributed specifically to alcohol misuse (e.g., other cirrhosis, ICD-9-CM 571.4-571.9), are excluded. Second, deaths from injuries (e.g., motor vehicle incidents, homicides, suicides, fires, and falls), many of which may be alcohol-related, have been excluded (4,5). More precise monitoring of the effectiveness of efforts to reduce morbidity and mortality associated with alcohol misuse will require more complete reporting on death certificates or alternative sources of mortality data.


  1. U.S. Department of Health and Human Services. Promoting health/preventing disease: objectives for the nation. Washington, D.C.: U.S. Public Health Service, Department of Health and Human Services 1980:67-72.

  2. National Center for Health Statistics. The international classification of diseases, 9th revision, clinical modification. Vol. 1. Diseases, tabular list. Ann Arbor, Michigan: Edwards Brothers, Inc., 1980.

  3. CDC. Table V. Years of potential life lost, deaths, and death rates, by cause of death, and estimated number of physician contacts, by principal diagnosis, United States. MMWR 1985;33:27.

  4. Dufour M, Malin H, Bertolucci D, Christian C. Death certification practices in alcohol-related traffic fatalities. 112th annual meeting, American Public Health Association, Anaheim, California, November 1984.

  5. CDC. Alcohol and fatal injuries--Fulton County, Georgia, 1982. MMWR 1983;32:573-6. *An algorithm is used by NCHS to assign underlying and contributing causes from those causes listed on the death certificate. **The two patterns are not mutually exclusive. For a given death where the underlying cause is alcoholic cirrhosis, for example, alcohol dependence may be a contributing cause. While underlying causes can be added across conditions, contributing causes and total counts cannot be added.

Disclaimer   All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to

Page converted: 08/05/98


Safer, Healthier People

Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A


Department of Health
and Human Services

This page last reviewed 5/2/01