Trends in Alcohol-Induced Deaths in the United States, 2000-2016

Spillane, Susan; Shiels, Meredith S.; Best, Ana F.; Haozous, Emily A.; Withrow, Diana R.; Chen, Yingxi; González, Amy Berrington de; Freedman, Neal D.

doi:10.1001/jamanetworkopen.2019.21451

Cited by 121 publications

(104 citation statements)

References 38 publications

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“…While previous studies have demonstrated a link between excessive alcohol consumption and mortality [53][54][55], we were not able to find any association in Brazil. In Argentina, however, an intriguing association remained significant after adjustment for confounders: those Argentinean provinces with higher prevalence of excessive alcohol consumption presented lower mortality from CVD.…”

Section: Discussioncontrasting

confidence: 98%

Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina

et al. 2020

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Background Despite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths. Therefore, we aimed to evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates. Methods Ecological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson’s correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates. Results Brazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15 to 9%), increase in regular fruit and vegetable consumption (from 28 to 36%), and increase in physical activity (45 to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55 to 50%) and decrease in physical activity (from 55 to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women. Conclusion Prevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population’s mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.

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Section: Discussioncontrasting

confidence: 98%

Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina

et al. 2020

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“…Alcohol use disorders (AUD) are complex, moderately heritable (50-60%) [1][2][3][4] , psychiatric disorders associated with heightened morbidity and mortality 5 . An AUD diagnosis includes aspects of physiological dependence, loss of control over drinking, as well as persistent alcohol intake despite physiological, psychological and interpersonal consequences 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Multi-omics integration analysis identifies novel genes for alcoholism with potential link to neurodegenerative diseases

Kapoor

Chao

Johnson³

et al. 2020

Preprint

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Significance: Identification of causal variants and genes underlying genome-wide association study (GWAS) loci is essential to understanding the biology of alcohol use disorder (AUD). Methods: Integration of multi-omics data is often necessary to nominate candidate causal variants and genes and prioritize them for follow up studies. Here, we used Mendelian randomization to integrate AUD and drinks per week (DPW) GWAS summary statistics with the gene expression and methylation quantitative trait loci (eQTLs and mQTLs) in the largest brain and myeloid datasets. We also used AUD-related single cell epigenetic data to nominate candidate causal variants and genes associated with DPW and AUD. Results: Our multi-omics integration analyses prioritized unique as well as shared genes and pathways among AUD and DPW. The GWAS variants associated with both AUD and DPW showed significant enrichment in the promoter regions of fetal and adult brains. The integration of GWAS SNPs with mQTLs from fetal brain prioritized variants on chromosome 11 in both AUD and DPW GWASs. The co-localized variants were found to be overlapping with promoter marks for SPI1, specifically in human microglia, the myeloid cells of the brain. The co-localized SNPs were also strongly associated with SPI1 mRNA expression in myeloid cells from peripheral blood. The prioritized variant at this locus is predicted to alter the binding site for a transcription factor, RXRA, a key player in the regulation of myeloid cell function. Our analysis also identified MAPT as a candidate causal gene specifically associated with DPW. mRNA expression of MAPT was also correlated with daily amounts of alcohol intake in post-mortem brains (frontal cortex) from alcoholics and controls (N = 92). Results may be queried and visualized in an online public resource of these integrative analysis (https://lcad.shinyapps.io/alc_multiomics/). These results highlight overlap between causal genes for neurodegenerative diseases, alcohol use disorder and alcohol consumption. In conclusion, integrating GWAS summary statistics with multi-omics datasets from multiple sources identified biological similarities and differences between typical alcohol intake and disordered drinking highlighting molecular heterogeneity that might inform future targeted functional and cross-species studies. Interestingly, overlap was also observed with causal genes for neurodegenerative diseases.

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“…A major strength of the article by Spillane et al 1 is the location of these trends within the broader national landscape, not just in comparison with white individuals as the primary reference group, which is typically the case. In this regard, Spillane et al 1 report that in 2016, the age-standardized rates of alcohol-induced deaths were highest among American Indian and Alaska Native (AIAN) men and women, substantially greater than those among their counterparts in the other major racial/ ethnic populations. Moreover, these rates increased steadily and significantly for both sexes during the 17-year period of observation.…”

mentioning

confidence: 99%

“…This challenge precedes others, including whether the options most likely adopted by AIAN communities offer the best, most well-informed, and most effective treatments 8. As Spillane et al1 note, alcohol-induced deaths are the tip of the iceberg. Alcohol-related deaths-notably suicide, motor vehicle collisions, drowning, and homicide-remain high among AIAN individuals and continue to rise.…”

mentioning

confidence: 99%

“…A related concern revolves around the manner in which we estimate trends for small populations and then extrapolate those trends to national levels for comparison with other, larger subgroups 4. With respect to rurality, Spillane et al1 operationalize residence in terms of Purchased ReferredCare, a common convention that other studies characterize as Contract Health Service Delivery Areas or Tribal Service Delivery Area counties. Careful attention to the strengths and weakness of these decisions is in order.…”

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confidence: 99%

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Alcohol-Induced Deaths Among American Indian and Alaska Native Individuals—“Drinking Was What I and Others Just Did”

Manson

2020

JAMA Netw Open

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Alcohol was a way of life for me, my family, my friends, my community. I used to think being Indian was about drinking. That I couldn't stop because I was Indian… and if I did, I would no longer be Indian. The bad things about being a drunk were all around me-liver disease, domestic violence, car accidents, suicide, PTSD [posttraumatic stress disorder]. But I never really thought about dying. Drinking was what I and others just did." The article by Spillane et al 1 awakened my memory of this reflection, shared by an Alaska Native patient in a tribal residential treatment program with which I work. His words acknowledged the widespread consumption of alcohol in many of these communities, its interface with personal identity, the acceptance of alcoholism as an inevitable part of life, and the denial of its harmful consequences, apparent as they may be. Tribes have made remarkable progress in reducing the stigma surrounding addiction in their communities and in developing prevention as well as treatment programs. There are bright

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Trends in Alcohol-Induced Deaths in the United States, 2000-2016

Cited by 121 publications

References 38 publications

Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina

Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina

Multi-omics integration analysis identifies novel genes for alcoholism with potential link to neurodegenerative diseases

Alcohol-Induced Deaths Among American Indian and Alaska Native Individuals—“Drinking Was What I and Others Just Did”

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