In an analysis by race, sex, age, and geography, alcohol-induced death rates in the United States last year were nearly double those in 1999, with a sharp increase at the onset of the Covid-19 pandemic, according to a recent study.
Although rates are higher for men, the largest increase over the full 25-year period was in women aged 25-34, showed the findings by Dr Tony Wong and colleagues at the University of California-Los Angeles and published in PLOS Global Public Health.
News-Medical.net reports that deaths linked to alcohol have been increasing over the past two decades. Particularly concerning are increases between 2019 and 2021, when the population was under significant stress from isolation due to the pandemic, and people with alcohol-use disorders were less able to access treatment.
Quantifying mortality trends and determining whether these deaths have returned to pre-pandemic levels is essential for understanding long-term temporal patterns and dynamics, said the researchers.
To examine these trends, they analysed data from the Centres for Disease Control and Prevention’s National Vital Statistics System, focusing on 14 specific alcohol-induced causes of death.
Wong et al. found that rates of these deaths in the United States nearly doubled between 1999 and 2024, reaching their highest level in 2021. Most were due to alcoholic liver disease and, to a lesser degree, alcohol-related mental and behavioural disorders.
The largest overall increase in alcohol-induced mortality across all race, sex, age groups occurred in 2021 when fatalities peaked at 54 258 deaths overall. By 2024, fatalities had declined, but the average alcohol-induced mortality rate across US counties still remained 25% higher than in 2019.
American Indian/Alaska Native populations (AIAN) remain the most affected, with male AIAN rates of alcohol-induced mortality three times higher than that of white males, and female AIAN mortality rates four times higher than that of white females, over the entire period of investigation.
The largest increase by demographic was among females aged 25-34, which rose from 0.9 deaths per 100 000 in 1999 to 3.2 per 100 000 in 2024, a 255% increase. The second largest increase was in males aged 25-34, from 2.3 fatalities per 100 000 in 1999 to 6.5 in 2024, a 188% increase.
As deaths from chronic diseases related to alcohol use, such as certain cancers or cardiovascular events, were not included in this study, the overall fatality counts may be under-estimated.
The authors said these findings underscore the critical need for targeted policies to reduce excessive alcohol consumption and improve access for treatment for those who need it most.
“The rapid rise of these deaths among women is particularly concerning,” said Maria D’Orsogna, Department of Mathematics, California State University at Northridge.
“Although men still die at higher rates, the gender gap appears to be closing. Notably, for the population aged 25-34, the male-to-female mortality ratio has decreased from three-to-one in 1999 to two-to-one in 2024.”
Study details
Alcohol-induced deaths in the United States across age, race, gender, geography, and the Covid-19 pandemic
Tony Wong, Lucas Böttcher, Tom Chou, Maria D’Orsogna.
Published in PLOS Global Public Health on 17 September 2025
Abstract
We analyse alcohol-induced deaths by race, gender, age and geography on a yearly (1999–2024) and monthly (2018–2024) basis, using data from the National Vital Statistics System. Crude rates for alcohol-induced deaths increased by 89% from 1999 to 2024. The largest relative increase occurred among females aged 25–34, with a 255% increase, and males aged 25–34, with a 188% increase. American Indian and Alaska Native populations remain the most affected. While alcohol-induced deaths are higher among males, crude rates are rising faster among females across all demographics, a concerning trend. Sharp increases occurred at the onset of COVID-19, peaking in 2021. For most demographics across the nation, crude rates remained abnormally high throughout 2023; significant decreases emerged only in 2024, four years after the start of COVID-19. Females were more impacted by alcohol-related liver disease than males; alcohol-related mental and behavioral disorders affected both genders. The largest monthly increases in alcohol-induced deaths occurred in American Indian and Alaska Native males (41% increase between May and June 2020) and females (32% increase between June and July 2020), black females (32% increase between April and May 2020), males aged 15–34 (28% increase between April and May 2020) and females aged 35–44 (28% increase between April and May 2020). Since 2010, the highest crude rates have been in New Mexico. Record increases occurred in all states between 2019 and 2021; the largest was in Mississippi (122% increase between 2019 and 2021). By 2024, rates had returned within 10% of their 2019 levels in about half the states. In Oglala Lakota County (SD), McKinley County (NM), and Apache County (AZ), crude rates have exceeded an astonishing 80 fatalities per 100,000 annually since 2020. These findings emphasise the urgent need for targeted policies to reduce excessive alcohol consumption and improve access to treatment.
News-Medical.net – New study reveals a 25-year rise in alcohol-induced mortality (Open access)
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