Measuring the health consequences of alcohol consumption: current needs and methodological challenges.
OBJECTIVE
Extensive research has shown that alcohol consumption leads to poor health and premature death through its causal or contributing roles in numerous chronic health conditions and acute health outcomes, including various cancers, liver disease, and injuries. Paradoxically, advances in understanding of the causal associations between alcohol consumption and various conditions have complicated our ability to discern trends in the health consequences of alcohol consumption over time.


METHODS
Four distinct needs for information on alcohol's role in causing adverse health outcomes are identified. Estimates of alcohol-attributable mortality from two US studies are compared and differences identified.


RESULTS
Differences in the conditions included and alcohol-attributable fractions employed accounted for large differences in the estimated alcohol-attributable mortality for several health outcomes.


CONCLUSIONS
Despite the broad consensus on many health consequences of alcohol consumption, further research is needed to clarify the conditions that are caused by alcohol consumption, magnitudes of causal relationships, and effects of different patterns of consumption and individual characteristics. Comparisons over time are needed to identify areas where improvements in public health may be occurring or are most needed, to support evaluation of specific interventions, and to encourage the public awareness of alcohol problems that is necessary to change attitudes and behaviors involving alcohol consumption.
Bloss
Gregory
G
National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD 20892-9304, USA. gbloss@mail.nih.gov
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D002423:Cause of Death; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology