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Alcohol-attributed disease burden in four Nordic countries: a comparison using the Global Burden of Disease, Injuries and Risk Factors 2013 study

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Emilie E Agardh, Anna-Karin Danielsson, Mats Ramstedt, Astrid Ledgaard Holm, Finn Diderichsen, Knud Juel, Stein Emil Vollset, Ann Kristin Knudsen, Jonas Minet Kinge, Richard White, Vegard Skirbekk, Pia Mäkelä, Mohammad Hossein Forouzanfar, Matthew M Coates, Daniel C Casey, Mohesen Naghavi, Peter Allebeck

AIMS: To compare alcohol-attributed disease burden in four Nordic countries 1990-2013, by overall disability adjusted life years (DALYs), and separated by premature mortality (YLL), and health loss to non-fatal conditions (YLD), 2) to examine whether changes in alcohol consumption informs alcohol-attributed disease burden and 3) to compare the distribution of disease burden separated by causes.

DESIGN: A comparative risk assessment approach.

SETTING: Sweden, Norway, Denmark and Finland.

PARTICIPANTS: Male and female populations of each country MEASUREMENTS: Age-standardized DALYs, YLLs and YLDs per 100 000 with 95% uncertainty intervals (UIs).

FINDINGS: In Finland, with highest burden over the study period, overall alcohol-attributed DALYs were 1616 per 100 000 in 2013, while in Norway with lowest burden, corresponding estimates were 634. DALYs in Denmark were 1246 and in Sweden 788. In Denmark and Finland, changes in consumption generally corresponded to changes in disease burden, but not to the same extent in Sweden and Norway. All countries had a similar disease pattern and the majority of DALYs were due to YLLs (62-76%), mainly from alcohol use disorder, cirrhosis, transport injuries, self-harm and violence. YLDs from alcohol use disorder accounted for 41% and 49% of DALYs in Denmark and Finland compared to 63% and 64% in Norway and Sweden 2013.

CONCLUSIONS: Finland and Denmark has a higher alcohol-attributed disease burden than Sweden and Norway in the period 1990 to 2013. Changes in consumption levels in general corresponded to changes in harm in Finland and Denmark, but not in Sweden and Norway for some years. All countries followed a similar pattern. The majority of disability-adjusted life years were due to premature mortality. Alcohol use disorder by non-fatal conditions accounted for a higher proportion of disability-adjusted life years in Norway and Sweden, compared with Finland and Denmark.

Original languageEnglish
Issue number10
Pages (from-to)1806–1813
Number of pages8
Publication statusPublished - Oct 2016

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