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Background-Hispanics have much higher cirrhosis mortality rates than non-Hispanic Blacks and Whites. Although heavy alcohol use and hepatitis C virus (HCV) infection are two major risk factors for cirrhosis, no studies have systematically assessed the contribution of alcohol-and HCV-related cirrhosis deaths to the total cirrhosis mortality for Hispanics as a whole and its variations across Hispanic subgroups. To fill this gap, the current study presents the latest data on total cirrhosis mortality as well as its component alcohol-and HCV-related cirrhosis mortality for all Hispanics and for Hispanic subgroups.

Objective-To quantify the effect of comorbid alcohol and drug use disorders on premature death, as reflected by the manner of death (suicide and other unnatural death versus natural death) and the age at death, among decedents with unipolar and bipolar disorders.Methods-This study is based on the U.S. Multiple Cause of Death (MCD) public-use data files for [1999][2000][2001][2002][2003][2004][2005][2006].Secondary data analysis was conducted comparing decedents with unipolar/bipolar disorders and decedents with all other causes of death, based on the death records of 19,052,468 decedents in the MCD data files who died at age 15 and older. Poisson regression models were used to derive prevalence ratios (PRs) to assess the effect of comorbid substance use disorders on the risks for being an unnatural death among mood disorder deaths. Multiple-cause life table analysis and mean age at death were used to quantify the effect of comorbid substance use disorders on premature mortality among mood disorder deaths.Results-Prevalence of comorbid substance use disorders was higher among unipolar and bipolar disorder deaths than that among all other deaths. Among unipolar and bipolar disorder deaths, comorbid substance use disorders were associated with elevated risks for suicide and other unnatural death in both males and females (prevalence ratios ranging 1. 49-9.46, p<.05). They also were associated with reductions in mean ages at death (ranging 11.7-33.8 years, p<.05). In general, these effects were much stronger for drug use disorders than for alcohol use disorders. Both substance use disorders had stronger effects on suicide among females, whereas their effects on other unnatural deaths were stronger among males.Conclusions-This study is among the first to provide population mortality-based evidence to further establish comorbid substance use disorder as one of the key risk factors for premature death among individuals with unipolar or bipolar disorders in the United States. Clinicians need to be aware of the potentially lethal risk associated with these comorbid conditions.

Background: Acute alcohol consumption is known to be a risk factor for fall injuries. Objective: The study sought to determine whether usual alcohol consumption increases the risk for nonfatal fall injuries. Method: Data from 289,187 sample adults in the 2004–2013 U.S. National Health Interview Surveys were analyzed. Of these, 3,368 (~1 percent) reported a total of 3,579 fall-injury episodes requiring medical consultation in the past 3 months. Latent class analysis based on four contextual indicators identified four ecological subtypes of fall injury within two age groups (18–49 and 50+). Five drinking patterns (i.e., lifetime abstainer, former drinker, low-risk drinker, increased-risk drinker, and highest-risk drinker) were categorized according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) low-risk drinking guidelines. Controlling for potential confounders, negative binomial regression estimated the adjusted rates of any type and subtypes of fall injury, by gender, for each drinking pattern relative to lifetime abstainer. Results: Compared with lifetime abstainers, the adjusted rate of any fall injury for adults ages 18–49 was significantly higher among highest-risk drinkers (men: incidence rate ratio [IRR]=2.59, 95% confidence interval [CI] [1.60, 4.20]; women: IRR=1.90, 95% CI [1.24, 2.91]) and increased-risk drinkers (men: IRR=1.94, 95% CI [1.25, 3.00]; women: IRR=1.51, 95% CI [1.11, 2.07]). Furthermore, highest-risk drinkers had higher adjusted rates of either leisure- or sports-related fall injuries than lifetime abstainers. Conclusions: Alcohol consumption exceeding NIAAA’s low-risk drinking guidelines is associated with elevated rates of nonfatal fall injuries. Findings underscore the importance of adhering to these recommendations.

Introduction: So-called "deaths of despair"-those involving drug overdoses, alcohol-related liver disease, and suicide-have been rising in the U.S. among middle-aged non-Hispanic white adults without a college degree. Premature deaths (ages 25-69) from alcoholic liver disease were examined specifically in this study from 1999 to 2018, by sex, race/Hispanic origin, and age group.Methods: Data were drawn from the 1999-2018 Multiple Cause of Death database and bridgedrace estimates of the U.S. resident population, including 281,243 alcoholic liver disease deaths or an average of eight deaths per 100,000 population. Analyses examined alcoholic liver disease death rates for sex differences among three age groups (25-49, 50-59, and 60-69 years), by race/ Hispanic origin, from 1999 to 2018, as well as age-adjusted and age-specific annual percentage changes (accounted for cohorts), years of potential life lost, and age of death for sociodemographic backgrounds, alcoholic liver disease clinical courses, and comortalities.Results: Non-Hispanic whites increasingly experienced greater alcoholic liver disease mortality than non-Hispanic blacks and Hispanics, confirming the racial/ethnic crossover observed in previous studies. Although men consistently had higher rates of mortality, male-to-female ratios decreased in the past 2 decades and were the lowest among ages 25-49 years and especially among ages 25-34 years. Although women generally had longer life expectancies, women died of alcoholic liver disease on average about 2-3 years earlier than men.Conclusions: Prevention and intervention efforts are imperative to address the narrowing sex gap and widening racial disparities in alcoholic liver disease premature deaths.

Objective: Evidence from previous studies suggests that heavy alcohol use (HAU) exacerbates the rate of fibrosis progression in the liver and results in increased probability for premature death among patients with hepatitis C virus (HCV) infection. The current study uses population-based mortality data to investigate whether heavy drinking affects the age of death among individuals with HCV and, if so, whether this effect differs between men and women.Methods: A total of 7,263,163 death records in the United States between 2000 and 2002 were drawn from the Multiple Cause of Death (MCD) public-use data files compiled by the National Center for Health Statistics (NCHS). International Classification of Diseases, Tenth Revision (ICD-10) codes were used to identify the presence of HCV (B17.1 and B18.2) and HAU (as indicated by alcohol-induced medical conditions, F10 and K70) either as the underlying cause or as one of the contributing causes of death. The deaths were divided into 4 distinctive cause-of-death categories: HCV without HAU, HAU without HCV, HCV plus HAU, and all others. The mean ages of death and the cumulative probabilities of death derived from multiple-cause life table were compared across these categories.Results: Hepatitis C virus deaths showed an excessive prevalence of HAU when compared with non-HCV deaths. Compared with deaths of HCV without HAU, the mean age of death was shortened for deaths of HCV plus HAU (from 55.1 to 50.0 years among males, and from 61.0 to 49.1 years among females). The cumulative probability of death before age 65 was much higher for the latter than the former group (0.91 vs 0.68 among males, and 0.88 vs 0.47 among females). While HCV alone showed a disproportionate effect on premature death in males, HAU presented a stronger effect in females, resulting in a ''catching-up'' effect that diminished the gender difference in age of HCV death.Conclusions: This study provides mortality-based evidence to further establish heavy alcohol consumption as one of the key risk factors contributing to premature deaths from HCV in the United States. More importantly, this study, for the first time, presents empirical evidence that alcohol consumption affects men and women differently in HCV mortality.

The incidence of PDR in Korean NIDDM patients is comparable to that reported in other populations. Poor glycemic control is the most important risk factor for both the development and progression of diabetic retinopathy in NIDDM patients.