title: Surveillance of US Death Rates from Chronic Diseases Related to Excessive Alcohol Use.
abstract: OBJECTIVE
  To assess the utility of multiple-cause (MC) death records for surveillance of US mortality rates from chronic causes related to excessive alcohol use.
  
  
  METHODS
  The Alcohol-Related Disease Impact (ARDI) resource produced estimates of the population 'alcohol attributable fraction' (AAF) due to excessive drinking for each alcohol-related (AAF > 0%) cause of death, and used AAFs to estimate numbers of alcohol-related deaths from alcohol-related underlying causes (UC) in adults age 20-64 and 65+ years in 2006-2010. For surveillance, this study used MC death file to identify individual deaths (2006-2010) with an 'alcohol-induced' cause (AAF = 100%) anywhere on the certificate, and to obtain US rates of premature death (ages 15-64 and 65-74 years) for 1999-2012.
  
  
  RESULTS
  Using the selected MC records, numbers of deaths from alcohol-related chronic UC (2006-2010) were 81% of ARDI estimates for age 20-64, but only 40% for 65+ years. The MC records identified substantial numbers of deaths from causes (e.g. certain infectious diseases) not included as alcohol-related in ARDI, but included in surveillance of premature death rates for chronic UC. Also, premature death rates for chronic alcohol-induced causes using only the UC (as in routine mortality statistics) were only about half the rates based on MC; all rates increased in recent years but some reached statistical significance only by using MC.
  
  
  CONCLUSIONS
  Using MC records underestimated total US deaths from alcohol-related chronic causes as the UC, but enhanced surveillance of rates for premature deaths involving chronic causes that may be related to excessive alcohol use.
authors.affiliation: Retired, Connecticut Department of Public Health, 410 Capitol Avenue, Hartford, CT 06134, USA appoled7@yahoo.com.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Polednak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000401:mortality; D000435:Alcoholic Intoxication / Q000401:mortality*; D002310:Cardiomyopathy, Alcoholic / Q000401:mortality*; D002423:Cause of Death; D002492:Central Nervous System Depressants / Q000009:adverse effects; D002908:Chronic Disease; D000431:Ethanol / Q000009:adverse effects; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol