The burden of death, disease and disability due to alcohol in New Zealand

Abstract

Aim: To estimate the burden of death, disease, and disability attributable to alcohol consumption in New Zealand. Methods: We applied the World Health Organization's comparative risk assessment methodology at country level; separately for Maori and non-Maori where possible. We combined the best estimates of alcohol consumption in the populations, with best estimates of alcohol-disease relationships from the international and, where available, national epidemiological literature, to calculate the proportions of alcohol-related conditions attributable to alcohol. Results: We estimated that 3.9% of deaths in New Zealand in 2000 were attributable to alcohol consumption (approximately 1037 deaths), and approximately 981 deaths were prevented by alcohol, resulting in a net loss of about 56 lives. As a consequence, 17,200 years of life were lost, but only 5,300 years of life gained; a net loss of almost 12,000 years of life. The burden was substantially higher for younger age groups, for men compared with women, and for Maori compared with non-Maori. Injury was the biggest contributing cause of death and years of life lost, while positive effects were largely due to reduced coronary disease mortality in elderly people. The impact of alcohol on these conditions depended on the pattern as well as volume of drinking. In a separate analysis that included estimates of morbidity, we calculated a net loss of 26,000 disability-adjusted life years (DALYs) due to alcohol in 2002, with 76% lost by men. Alcohol use disorders accounted for about half of all DALYs lost. Conclusions: Five main messages emerged from the analysis that can inform policy to reduce the health burden of alcohol: there are no health benefits of drinking alcohol before middle age; pattern of drinking is an important determinant of health effects; injuries are a major component of the alcohol burden; alcohol use disorders underlie many adverse effects; and the health impact of alcohol falls inequitably on Maori.