title: Temporal Changes in Alcohol-Related Morbidity and Mortality in Germany.
abstract: OBJECTIVE
  Trends in morbidity and mortality, fully or partially attributable to alcohol, for adults aged 18-64 were assessed for Germany.
  
  
  METHODS
  The underestimation of population exposure was corrected by triangulating survey data with per capita consumption. Alcohol-attributable fractions by sex and two age groups were estimated for major disease categories causally linked to alcohol. Absolute numbers, population rates and proportions relative to all hospitalizations and deaths were calculated.
  
  
  RESULTS
  Trends of 100% alcohol-attributable morbidity and mortality over thirteen and eighteen years, respectively, show an increase in rates of hospitalizations and a decrease in mortality rates. Comparisons of alcohol-attributable morbidity including diseases partially caused by alcohol revealed an increase in hospitalization rates between 2006 and 2012. The proportion of alcohol-attributable hospitalizations remained constant. Rates of alcohol-attributable mortality and the proportion among all deaths decreased.
  
  
  CONCLUSIONS
  The increasing trend in mortality due to alcohol until the mid-1990s has reversed. The constant proportion of all hospitalizations that were attributable to alcohol indicates that factors such as improved treatment and easier health care access may have influenced the general increase in all-cause morbidity. To further reduce alcohol-related mortality, efforts in reducing consumption and increasing treatment utilization are needed.
authors.affiliation: IFT Institut für Therapieforschung, München, Germany.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kraus
authors.forename: Alexander
authors.initials: A
authors.lastname: Pabst
authors.forename: Daniela
authors.initials: D
authors.lastname: Piontek
authors.forename: Gerrit
authors.initials: G
authors.lastname: Gmel
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Shield
authors.forename: Hannah
authors.initials: H
authors.lastname: Frick
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000401:mortality*; D002423:Cause of Death / Q000639:trends*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult