Deaths and Years of Potential Life Lost From Excessive Alcohol Use — United States, 2011–2015

Marissa B. Esser, PhD1; Adam Sherk, PhD2; Yong Liu, MD1; Timothy S. Naimi, MD3,4; Timothy Stockwell, PhD2; Mandy Stahre, PhD5; Dafna Kanny, PhD1; Michael Landen, MD6; Richard Saitz, MD3,4; Robert D. Brewer, MD1 (View author affiliations)

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Summary

What is already known about this topic?

Excessive drinking is a leading cause of preventable death in the United States and is associated with numerous health and social problems.

What is added by this report?

During 2011–2015, excessive drinking was responsible for an average of 93,296 deaths (255 per day) and 2.7 million years of potential life lost (29 years lost per death, on average) in the United States each year.

What are the implications for public health practice?

Widespread implementation of prevention strategies, including those recommended by the Community Preventive Services Task Force (e.g., increasing alcohol taxes and regulating the number and concentration of places that sell alcohol) could help reduce deaths and years of potential life lost from excessive drinking.

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Excessive alcohol use is a leading cause of preventable death in the United States (1) and costs associated with it, such as those from losses in workplace productivity, health care expenditures, and criminal justice, were $249 billion in 2010 (2). CDC used the Alcohol-Related Disease Impact (ARDI) application* to estimate national and state average annual alcohol-attributable deaths and years of potential life lost (YPLL) during 2011–2015, including deaths from one’s own excessive drinking (e.g., liver disease) and from others’ drinking (e.g., passengers killed in alcohol-related motor vehicle crashes). This study found an average of 93,296 alcohol-attributable deaths (255 deaths per day) and 2.7 million YPLL (29 years of life lost per death, on average) in the United States each year. Of all alcohol-attributable deaths, 51,078 (54.7%) were caused by chronic conditions, and 52,361 (56.0%) involved adults aged 35–64 years. Age-adjusted alcohol-attributable deaths per 100,000 population ranged from 20.3 in New Jersey and New York to 52.3 in New Mexico. YPLL per 100,000 population ranged from 613.8 in New York to 1,651.7 in New Mexico. Implementation of effective strategies for preventing excessive drinking, including those recommended by the Community Preventive Services Task Force (e.g., increasing alcohol taxes and regulating the number and concentration of alcohol outlets), could reduce alcohol-attributable deaths and YPLL.

CDC has updated the ARDI application, including the causes of alcohol-attributable death, International Classification of Diseases, Tenth Revision codes,§ and alcohol-attributable fractions. CDC used ARDI to estimate the average number of annual national and state alcohol-attributable deaths and YPLL caused by excessive drinking (i.e., deaths from conditions that are 100% alcohol-attributable, acute conditions that involved binge drinking, and chronic conditions that involved medium or high average daily alcohol consumption). ARDI estimates alcohol-attributable deaths by multiplying the total number of deaths (based on vital statistics) with an underlying cause corresponding to any of the 58 alcohol-related conditions in the ARDI application by its alcohol-attributable fraction. Some conditions (e.g., alcoholic liver cirrhosis) are wholly (100%) attributable to alcohol (alcohol-attributable fraction = 1.0), whereas others are partially attributable (alcohol-attributable fraction <1.0) to alcohol (e.g., breast cancer and hypertension). Deaths are assessed by age group and sex and averaged over a 5-year period. The alcohol-attributable fractions for chronic conditions are generally calculated using relative risks from published meta-analyses and the prevalence of low, medium, and high average daily alcohol consumption among U.S. adults, based on data from the Behavioral Risk Factor Surveillance System.** The prevalence estimates are adjusted to account for underreporting of alcohol use during binge drinking episodes (3). Alcohol-attributable fractions for acute causes (e.g., injuries) are generally based on studies that measured the proportion of decedents who had a blood alcohol concentration ≥0.10 g/dL (4). Alcohol-attributable fractions for motor vehicle crash deaths are based on the proportion of crash deaths that involved a blood alcohol concentration ≥0.08 g/dL.†† For 100% alcohol-attributable conditions, deaths are summed without adjustment.§§ YPLL, a commonly used measure of premature death, are calculated by multiplying the age-specific and sex-specific alcohol-attributable deaths by the corresponding reduction in years of life potentially remaining for decedents relative to average life expectancies.¶¶ Chronic causes of death are calculated for decedents aged ≥20 years, and acute causes are generally calculated for decedents aged ≥15 years. Deaths involving children that were caused by someone else’s drinking (e.g., deaths caused by a pregnant mother’s drinking and passengers killed in alcohol-related motor vehicle crashes) are also included.

CDC used the data available in ARDI to estimate the average annual national and state alcohol-attributable deaths and YPLL associated with excessive drinking and national estimates of alcohol-attributable deaths and YPLL by cause of death, sex, and age group. National and state alcohol-attributable deaths and YPLL per 100,000 population were calculated by dividing the average annual alcohol-attributable death and YPLL estimates, respectively, by average annual population estimates from the U.S. Census for 2011–2015, and then multiplying by 100,000. The alcohol-attributable death rates were then age-adjusted to the 2000 U.S. population.*** The number of YPLL per alcohol-attributable death was calculated by dividing total YPLL by total alcohol-attributable deaths in the United States and in states.

During 2011–2015 in the United States, an average of 93,296 alcohol-attributable deaths occurred, and 2.7 million years of potential life were lost annually (28.8 YPLL per alcohol-attributable death) (Table 1) (Table 2). Among the 93,296 deaths, 51,078 (54.7%) were caused by chronic conditions and 42,218 (45.2%) by acute conditions. Of the 2.7 million YPLL, 1.1 million (41.1%) were because of chronic conditions, and 1.6 million (58.8%) were because of acute conditions. Overall, 66,519 (71.3%) alcohol-attributable deaths and 1.9 million (70.8%) YPLL involved males. Among all alcohol-attributable deaths, 52,361 (56.1%) involved adults aged 35–64 years, 24,766 (26.5%) involved adults aged ≥65, and 13,910 (14.9%) involved young adults aged 20–34 years (Figure).

Alcoholic liver disease was the leading chronic cause of alcohol-attributable deaths overall (18,164) and among males (12,887) and females (5,277) (Table 1). Poisonings that involved another substance in addition to alcohol (e.g., drug overdoses) were the leading acute cause of alcohol-attributable deaths overall (11,839) and among females (4,315); suicide associated with excessive alcohol use was the leading acute cause of alcohol-attributable deaths among males (7,711). Conditions wholly attributable to alcohol accounted for 29,068 (31.2%) of all alcohol-attributable deaths and 762,241 (28.4%) of all YPLL.

The national average annual age-adjusted alcohol-attributable death rate was 27.4 per 100,000, and the YPLL per 100,000 was 847.7 (Table 2). The average annual number of alcohol-attributable deaths and YPLL varied across states, ranging from 203 alcohol-attributable deaths in Vermont to 10,811 in California, and from 5,074 YPLL in Vermont to 299,336 in California. Age-adjusted alcohol-attributable death rates among the 40 states with reliable estimates (excluding those with suppressed data where estimates might not account for all the alcohol-attributable deaths in the state) ranged from 20.3 per 100,000 in New Jersey and New York to 52.3 in New Mexico. YPLL per 100,000 ranged from 613.8 in New York to 1,651.7 in New Mexico.

Discussion

Excessive alcohol use was responsible for approximately 93,000 deaths and 2.7 million YPLL annually in the United States during 2011–2015. This means that an average of 255 Americans die from excessive drinking every day, shortening their lives by an average of 29 years. The majority of these alcohol-attributable deaths involved males, and approximately four in five deaths involved adults aged ≥35 years. The number of alcohol-attributable deaths among adults aged ≥65 years was nearly double that among adults aged 20–34 years. Approximately one half of alcohol-attributable deaths were caused by chronic conditions, but acute alcohol-attributable deaths, all of which were caused by binge drinking, accounted for the majority of the YPLL from excessive drinking.

Little progress has been made in preventing deaths caused by excessive drinking; the average annual estimates of alcohol-attributable deaths and YPLL in this report are slightly higher than estimates for 2006–2010, and the age-adjusted alcohol-attributable death rates are similar (5), suggesting that excessive drinking remains a leading preventable cause of death and disability (1). From 2006–2010 (5) to 2011–2015, average annual deaths caused by alcohol dependence increased 14.2%, from 3,728 to 4,258, and deaths caused by alcoholic liver disease increased 23.6%, from 14,695 to 18,164. These findings are consistent with reported increasing trends in alcohol-induced deaths (e.g., deaths from conditions wholly attributable to alcohol) among adults aged ≥25 years,††† including alcoholic liver disease,§§§ as well as with increases in per capita alcohol consumption during the past 2 decades.¶¶¶

Age-adjusted alcohol-attributable death rates varied approximately twofold across states, but deaths caused by excessive drinking were common across the country. The differences in alcohol-attributable death and YPLL rates in states might be partially explained by varying patterns of excessive alcohol use, particularly binge drinking, which is affected by state-level alcohol pricing and availability strategies (6) and differential access to medical care.

The findings in this report are subject to at least five limitations. First, the prevalence of alcohol consumption ascertained through the Behavioral Risk Factor Surveillance System is based on self-reported data, which substantially underestimates alcohol consumption (7). Second, these estimates are conservative, because former drinkers, some of whom might have died from alcohol-related conditions, are not included in the estimates of alcohol-attributable deaths and YPLL for partially alcohol-attributable causes of death. Third, direct alcohol-attributable fraction estimates for some chronic and acute conditions rely on data older than that of 2011–2015 (4) and might not accurately represent the proportion of excessive drinkers among persons who died of some conditions (e.g., drug overdoses) during that period. This emphasizes the importance of more timely information on alcohol involvement and various health conditions. Fourth, several conditions partially related to alcohol (e.g., tuberculosis, human immunodeficiency virus, and acquired immunodeficiency syndrome)**** are not included because published risk estimates were not available. Finally, the alcohol-attributable deaths and YPLL are based on alcohol-related conditions that were listed as the underlying (i.e., primary) cause of death, and not as a multiple cause of death, yielding conservative estimates.

The implementation of effective population-based strategies for preventing excessive drinking, such as those recommended by the Community Preventive Services Task Force (e.g., increasing alcohol taxes and regulating the number and concentration of alcohol outlets), could reduce alcohol-attributable deaths and YPLL. These strategies can complement other population-based prevention strategies that focus on health risk behaviors associated with excessive alcohol use, such as safer prescribing practices to reduce opioid misuse and overdoses (8,9) and alcohol-impaired driving interventions (10).

Corresponding author: Marissa B. Esser, messer@cdc.gov, 770-488-5463.


1Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC; 2Canadian Institute for Substance Use Research, University of Victoria, British Columbia, Canada; 3Boston Medical Center, Boston, Massachusetts; 4Boston University Schools of Medicine and Public Health, Boston, Massachusetts; 5Forecasting and Research, State of Washington Office of Financial Management; 6New Mexico Department of Health.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Timothy Stockwell reports grants and personal fees from Alko, Finland, outside the submitted work. Richard Saitz reports nonfinancial support from Alkermes; personal fees from UpToDate and Massachusetts Medical Society; support and consulting fees from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the Patient-Centered Outcomes Research Institute; travel support and consulting fees from the American Medical Association, the American Society of Addiction Medicine, Wolters Kluwer, National Council on Behavioral Healthcare, the International Network on Brief Intervention for Alcohol and other drugs, Systembolaget, Kaiser Permanente, RAND, the Institute for Research and Training in the Addictions, the National Council on Behavioral Healthcare, Charles University (Czech Republic), National Committee on Quality Assurance, and the University of Oregon; and salary support from Burroughs Wellcome Fund. No other potential conflicts of interest were disclosed.


* https://www.cdc.gov/ARDI.

https://www.thecommunityguide.org/topic/excessive-alcohol-consumptionexternal icon.

§ https://www.cdc.gov/alcohol/ardi/alcohol-related-icd-codes.html.

https://www.cdc.gov/alcohol/ardi/methods.html.

** https://www.cdc.gov/brfss/.

†† https://www-fars.nhtsa.dot.gov/Crashes/CrashesAlcohol.aspxexternal icon.

§§ Conditions that that are 100% alcohol-attributable include 13 chronic conditions (alcoholic psychosis, alcohol abuse, alcohol dependence syndrome, alcohol polyneuropathy, degeneration of the nervous system caused by alcohol use, alcoholic myopathy, alcohol cardiomyopathy, alcoholic gastritis, alcoholic liver disease, alcohol-induced acute pancreatitis, alcohol-induced chronic pancreatitis, fetal alcohol syndrome, and fetus and newborn affected by maternal use of alcohol) and two acute conditions (suicide by and exposure to alcohol and alcohol poisoning).

¶¶ https://www.cdc.gov/mmwr/preview/mmwrhtml/00001773.htm.

*** https://www.cdc.gov/nchs/data/statnt/statnt20.pdfpdf icon.

††† https://www.cdc.gov/mmwr/volumes/68/wr/mm6833a5.htm.

§§§ https://pubs.niaaa.nih.gov/publications/surveillance111/Cirr15.htmexternal icon.

¶¶¶ https://pubs.niaaa.nih.gov/publications/surveillance110/CONS16.htmexternal icon.

**** https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf?uapdf iconexternal icon.

References

  1. Mokdad AH, Ballestros K, Echko M, et al.; US Burden of Disease Collaborators. The state of US health, 1990–2016: burden of diseases, injuries, and risk factors among US states. JAMA 2018;319:1444–72. CrossRefexternal icon PubMedexternal icon
  2. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 national and state costs of excessive alcohol consumption. Am J Prev Med 2015;49:e73–9. CrossRefexternal icon PubMedexternal icon
  3. Stahre M, Naimi T, Brewer R, Holt J. Measuring average alcohol consumption: the impact of including binge drinks in quantity-frequency calculations. Addiction 2006;101:1711–8. CrossRefexternal icon PubMedexternal icon
  4. Smith GS, Branas CC, Miller TR. Fatal nontraffic injuries involving alcohol: a metaanalysis. Ann Emerg Med 1999;33:659–68. PubMedexternal icon
  5. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis 2014;11:E109. CrossRefexternal icon PubMedexternal icon
  6. Xuan Z, Blanchette J, Nelson TF, Heeren T, Oussayef N, Naimi TS. The alcohol policy environment and policy subgroups as predictors of binge drinking measures among US adults. Am J Public Health 2015;105:816–22. CrossRefexternal icon PubMedexternal icon
  7. Nelson DE, Naimi TS, Brewer RD, Roeber J. US state alcohol sales compared to survey data, 1993–2006. Addiction 2010;105:1589–96. CrossRefexternal icon PubMedexternal icon
  8. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1). CrossRefexternal icon PubMedexternal icon
  9. Esser MB, Guy GP Jr, Zhang K, Brewer RD. Binge drinking and prescription opioid misuse in the U.S., 2012–2014. Am J Prev Med 2019;57:197–208. CrossRefexternal icon PubMedexternal icon
  10. National Academies of Sciences, Engineering, and Medicine. Getting to zero alcohol-impaired driving fatalities: a comprehensive approach to a persistent problem. Washington, DC: National Academies Press; 2018.
TABLE 1. Average annual number of deaths and years of potential life lost attributable to excessive alcohol use,* by condition and sex — United States, 2011–2015Return to your place in the text
Cause Alcohol-attributable deaths Years of potential life lost
Total Males
no. (%)
Females
no. (%)
Total Males
no. (%)
Females
no. (%)
Total 93,296 66,519 (71.3) 26,778 (28.7) 2,683,211 1,899,089 (70.8) 784,121 (29.2)
Chronic causes 51,078 35,583 (69.7) 15,495 (30.3) 1,105,190 752,936 (68.1) 352,253 (31.9)
Alcohol abuse 2,591 1,986 (76.6) 605 (23.4) 66,839 49,129 (73.5) 17,710 (26.5)
Alcohol cardiomyopathy 510 432 (84.7) 78 (15.3) 12,235 10,136 (82.8) 2,099 (17.2)
Alcohol dependence syndrome 4,258 3,269 (76.8) 989 (23.2) 109,911 81,192 (73.9) 28,719 (26.1)
Alcohol polyneuropathy 3 3 (100.0) 0 (—) 54 54 (100.0) 0 (—)
Alcoholic gastritis 33 26 (78.8) 7 (21.2) 890 696 (78.2) 194 (21.8)
Alcoholic liver disease 18,164 12,887 (70.9) 5,277 (29.1) 467,996 313,897 (67.1) 154,099 (32.9)
Alcoholic myopathy 0 0 (—) 0 (—) 0 0 (—) 0 (—)
Alcoholic psychosis 703 549 (78.1) 154 (21.9) 14,129 10,799 (76.4) 3,330 (23.6)
Alcohol-induced acute pancreatitis 278 214 (77.0) 64 (23.0) 8,284 6,247 (75.4) 2,037 (24.6)
Alcohol-induced chronic pancreatitis 52 38 (73.1) 14 (26.9) 1,507 1,046 (69.4) 461 (30.6)
Atrial fibrillation 329 228 (69.3) 100 (30.4) 2,943 2,084 (70.8) 860 (29.2)
Cancer, breast (females only) 584 NA 584 (NA) 11,203 NA 11,203 (NA)
Cancer, colorectal 996 898 (90.2) 98 (9.8) 15,540 14,016 (90.2) 1,524 (9.8)
Cancer, esophageal§ 494 430 (87.0) 64 (13.0) 8,038 7,007 (87.2) 1,031 (12.8)
Cancer, laryngeal 248 233 (94.0) 15 (6.0) 4,002 3,737 (93.4) 265 (6.6)
Cancer, liver 1,609 1,545 (96.0) 64 (4.0) 28,191 27,129 (96.2) 1,061 (3.8)
Cancer, oral cavity and pharyngeal 909 830 (91.3) 79 (8.7) 16,034 14,715 (91.8) 1,319 (8.2)
Cancer, pancreatic 186 151 (81.2) 35 (18.8) 2,827 2,301 (81.4) 526 (18.6)
Cancer, prostate (males only) 188 188 (NA) NA 1,952 1,952 (NA) NA
Cancer, stomach 58 56 (96.6) 3 (5.2) 943 897 (95.1) 46 (4.9)
Chronic hepatitis 2 2 (100.0) 0 (0.0) 42 36 (85.7) 6 (14.3)
Coronary heart disease 3,537 2,971 (84.0) 567 (16.0) 46,698 40,183 (86.0) 6,515 (14.0)
Degeneration of nervous system attributable to alcohol 145 118 (81.4) 27 (18.6) 2,617 2,030 (77.6) 587 (22.4)
Esophageal varices 112 77 (68.8) 34 (30.4) 2,414 1,711 (70.9) 703 (29.1)
Fetal alcohol syndrome 4 2 (50.0) 2 (50.0) 212 122 (57.5) 90 (42.5)
Fetus and newborn affected by maternal use of alcohol 1 1 (100.0) 0 (0.0) 76 76 (100.0) 0 (—)
Gallbladder disease 0 0 (—) 0 (—) 0 0 (—) 0 (—)
Gastroesophageal hemorrhage 31 20 (64.5) 10 (32.3) 517 359 (69.4) 157 (30.4)
Hypertension 3,584 1,638 (45.7) 1,946 (54.3) 50,016 26,021 (52.0) 23,994 (48.0)
Infant death, low birthweight** 2 1 (50.0) 1 (50.0) 133 69 (51.9) 65 (48.9)
Infant death, preterm birth** 44 24 (54.5) 19 (43.2) 3,410 1,845 (54.1) 1,565 (45.9)
Infant death, small for gestational age** 0 0 (—) 0 (—) 13 5 (38.5) 7 (53.8)
Liver cirrhosis, unspecified 9,801 5,696 (58.1) 4,105 (41.9) 197,875 114,580 (57.9) 83,295 (42.1)
Pancreatitis, acute 0 0 (—) 0 (—) 0 0 (—) 0 (—)
Pancreatitis, chronic 15 12 (80.0) 3 (20.0) 317 252 (79.5) 65 (20.5)
Pneumonia†† 133 105 (78.9) 29 (21.8) 3,714 2,839 (76.4) 875 (23.6)
Portal hypertension 61 34 (55.7) 26 (42.6) 1,267 729 (57.5) 538 (42.5)
Stroke, hemorrhagic 938 565 (60.2) 374 (39.9) 14,497 8,856 (61.1) 5,641 (38.9)
Stroke, ischemic 342 243 (71.1) 100 (29.2) 3,867 2,837 (73.4) 1,030 (26.6)
Unprovoked seizures, epilepsy, or seizure disorder 134 112 (83.6) 22 (16.4) 3,987 3,352 (84.1 635 (15.9)
Acute causes 42,218 30,935 (73.3) 11,283 (26.7) 1,578,021 1,146,153 (72.6) 431,868 (27.4)
Air-space transport 75 64 (85.3) 11 (14.7) 2,268 1,867 (82.3) 401 (17.7)
Alcohol poisoning 2,288 1,735 (75.8) 553 (24.2) 76,224 56,511 (74.1) 19,713 (25.9)
Aspiration 255 141 (55.3) 114 (44.7) 4,765 2,695 (56.6) 2,070 (43.4)
Child maltreatment§§ 148 87 (58.8) 61 (41.2) 11,000 6,294 (57.2) 4,706 (42.8)
Drowning 981 772 (78.7) 210 (21.4) 33,853 27,108 (80.1) 6,745 (19.9)
Fall injuries¶¶ 2,645 1,873 (70.8) 772 (29.2) 70,815 49,887 (70.4) 20,927 (29.6)
Fire injuries 457 274 (60.0) 183 (40.0) 10,950 6,491 (59.3) 4,459 (40.7)
Firearm injuries 337 284 (84.3) 53 (15.7) 12,917 10,768 (83.4) 2,149 (16.6)
Homicide 5,306 4,267 (80.4) 1,039 (19.6) 230,047 187,052 (81.3) 42,995 (18.7)
Hypothermia 296 194 (65.5) 102 (34.5) 6,199 4,354 (70.2) 1,845 (29.8)
Motor-vehicle nontraffic crashes 190 144 (75.8) 47 (24.7) 5,588 4,249 (76.0) 1,339 (24.0)
Motor-vehicle traffic crashes*** 7,092 5,522 (77.9) 1,570 (22.1) 323,610 245,447 (75.8) 78,163 (24.2)
Occupational and machine injuries 126 117 (92.9) 9 (7.1) 3,294 3,060 (92.9) 234 (7.1)
Other road vehicle crashes 170 137 (80.6) 33 (19.4) 5,632 4,473 (79.4) 1,159 (20.6)
Poisoning (not alcohol) 11,839 7,524 (63.6) 4,315 (36.4) 444,235 280,270 (63.1) 163,965 (36.9)
Suicide 9,899 7,711 (77.9) 2,189 (22.1) 332,791 252,674 (75.9) 80,117 (24.1)
Suicide by and exposure to alcohol 38 24 (63.2) 14 (36.8) 1,267 764 (60.3) 503 (39.7)
Water transport 75 65 (86.7) 9 (12.0) 2,566 2,189 (85.3) 377 (14.7)

Abbreviation: NA = not applicable.
* In the Alcohol-Related Disease Impact application (https://www.cdc.gov/ARDI), deaths attributable to excessive alcohol use include deaths from 1) conditions that are 100% alcohol-attributable, 2) deaths caused by acute conditions that involved binge drinking, and 3) deaths caused by chronic conditions that involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks [men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels of average daily alcohol consumption.
Numbers might not sum to totals, and row percentages might not sum to 100% because of rounding.
§ Deaths calculated for the proportion of esophageal cancer deaths caused by squamous cell carcinoma only, based on the Surveillance, Epidemiology, and End Results data in 18 states (SEER18). https://seer.cancer.gov/external icon.
Deaths among those consuming high average daily levels of alcohol only.
** Alcohol consumption prevalence estimates calculated among women aged 18–44 years only.
†† Deaths among persons aged 20–64 years only because of the high number of deaths from pneumonia among persons aged ≥65 years that are not alcohol-related and the lack of relative risks that differ by age.
§§ Deaths among persons aged 0–14 years.
¶¶ Deaths among persons aged 15–69 years only because of the high number of deaths from falls among persons aged ≥70 years that are not alcohol-attributable and the lack of alcohol-attributable fractions that differ by age.
*** Deaths among persons of all ages. A blood alcohol concentration level of ≥0.08 g/dL is used for defining alcohol attribution for this condition.

TABLE 2. Annual average number of deaths and years of potential life lost from excessive alcohol use,* by state — United States, 2011–2015Return to your place in the text
Location Alcohol-attributable deaths Age-adjusted alcohol-attributable deaths per 100,000-population Years of potential life lost Years of potential life lost per 100,000-population Years of potential life lost per alcohol-attributable death
U.S. total 93,296 27.4 2,683,211 847.7 28.8
Alabama 1,446 28.0 44,074 912.4 30.5
Alaska 292 29.4 9,631 1,313.2 33.0
Arizona 2,594 37.0 74,450 1,120.9 28.7
Arkansas 892 28.3 26,512 896.2 29.7
California 10,811 26.9 299,336 779.1 27.7
Colorado 1,810 32.5 54,054 1,024.0 29.9
Connecticut 900 22.8 25,738 716.3 28.6
Delaware 271 19.3 8,136 878.2 30.0
District of Columbia 207 26.4 5,861 905.2 28.3
Florida 6,778 29.8 183,199 932.5 27.0
Georgia 2,556 24.7 75,681 756.3 29.6
Hawaii 348 17.1 9,470 673.4 27.2
Idaho 491 29.5 14,037 868.3 28.6
Illinois 3,295 24.0 95,560 742.3 29.0
Indiana 1,900 27.4 56,502 860.2 29.7
Iowa 834 24.5 22,014 711.6 26.4
Kansas 750 24.7 22,152 765.7 29.5
Kentucky 1,524 32.3 45,422 1,032.9 29.8
Louisiana 1,523 31.5 47,217 1,020.9 31.0
Maine 424 18.8 11,261 847.3 26.6
Maryland 1,453 22.9 43,804 738.6 30.1
Massachusetts 1,729 23.3 48,305 720.4 27.9
Michigan 3,123 28.9 89,332 902.3 28.6
Minnesota 1,333 22.7 36,537 674.2 27.4
Mississippi 913 29.3 27,950 935.4 30.6
Missouri 1,860 28.8 55,813 923.2 30.0
Montana 414 37.4 12,232 1,205.5 29.5
Nebraska 453 23.0 12,610 674.6 27.8
Nevada 1,037 34.6 29,604 1,057.8 28.5
New Hampshire 420 20.1 11,364 858.2 27.1
New Jersey 1,967 20.3 57,455 645.2 29.2
New Mexico 1,129 52.3 34,424 1,651.7 30.5
New York 4,390 20.3 120,761 613.8 27.5
North Carolina 2,811 26.5 82,568 838.7 29.4
North Dakota 215 21.2 6,352 880.2 29.5
Ohio 3,608 28.6 103,809 896.8 28.8
Oklahoma 1,465 36.4 43,597 1,132.5 29.8
Oregon 1,498 33.5 39,310 997.9 26.2
Pennsylvania 3,768 26.5 108,168 846.4 28.7
Rhode Island 337 20.5 9,240 876.9 27.4
South Carolina 1,629 31.4 48,121 1,007.2 29.5
South Dakota 282 22.0 8,608 1,020.9 30.5
Tennessee 2,102 30.0 62,325 958.9 29.7
Texas 7,097 26.9 213,553 804.7 30.1
Utah 68 26.1 21,803 751.0 31.9
Vermont 203 21.0 5,074 809.8 25.0
Virginia 1,972 22.2 56,965 689.9 28.9
Washington 2,195 28.8 59,665 854.1 27.2
West Virginia 725 35.3 21,621 1,167.8 29.8
Wisconsin 1,722 27.2 47,374 825.0 27.5
Wyoming 236 27.1 7,317 1,262.3 31.0

* In the Alcohol-Related Disease Impact application (https://www.cdc.gov/ARDI), deaths attributable to excessive alcohol use include deaths from 1) conditions that are 100% alcohol-attributable, 2) deaths caused by acute conditions that involved binge drinking, and 3) deaths caused by chronic conditions that involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks [men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels of average daily alcohol consumption.
The estimate might be unreliable because of suppressed estimates of the number of alcohol-attributable deaths in two or more age groups, and estimates might not account for the total number of alcohol-attributable deaths in the state.

Return to your place in the textFIGURE. Average annual number of deaths attributable to excessive alcohol use,* by sex and age group — United States, 2011–2015
The figure is a group of glass bottles arranged in the shape of the United States with text about the number of people who die each year from excessive alcohol use.

* In the Alcohol-Related Disease Impact application (https://www.cdc.gov/ARDI), deaths attributable to excessive alcohol use include deaths from 1) conditions that are 100% alcohol-attributable, 2) deaths caused by acute conditions that involved binge drinking, and 3) deaths caused by chronic conditions that involved medium (>1 to ≤2 drinks of alcohol [women] or >2 to ≤4 drinks [men]) or high (>2 drinks of alcohol [women] or >4 drinks [men]) levels of average daily alcohol consumption.


Suggested citation for this article: Esser MB, Sherk A, Liu Y, et al. Deaths and Years of Potential Life Lost From Excessive Alcohol Use — United States, 2011–2015. MMWR Morb Mortal Wkly Rep 2020;69:981–987. DOI: http://dx.doi.org/10.15585/mmwr.mm6930a1external icon.

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