Distributions of alcohol use and alcohol‐caused death and disability in Canada: Defining alcohol harm density functions and new perspectives on the prevention paradox.

Aims: The aims of this study were to examine the distribution of alcohol use and to define 'harm density functions' representing distributions of alcohol‐caused health harm in Canada, by sex, towards better understanding which groups of drinkers experience the highest aggregate harms. Design: This w...

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Published in:Addiction Vol. 119; no. 4; pp. 696 - 706
Main Authors: Sherk, Adam, Churchill, Samuel, Cukier, Samantha, Grant, Sierra C., Shield, Kevin, Stockwell, Tim
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Apr2024
Online Access:View this record in EBSCOhost
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      dt: Apr2024
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Distributions of alcohol use and alcohol‐caused death and disability in Canada: Defining alcohol harm density functions and new perspectives on the prevention paradox.
      aug:
        au:
          Sherk, Adam
          Churchill, Samuel
          Cukier, Samantha
          Grant, Sierra C.
          Shield, Kevin
          Stockwell, Tim
        affil: Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
      sug:
        subj:
          Alcohol Drinking Epidemiology
          Alcohol-Related Disorders Epidemiology
          Alcohol-Related Disorders Risk Factors
          Risk Assessment
          Sex Factors
          Alcoholism Mortality
          Human
          Male
          Female
          Adolescence
          Adult
          Middle Age
          Aged
          Epidemiological Research
          Canada
          Funding Source
          Disability-Adjusted Life Years
          Binge Drinking
          Alcohol Drinking Evaluation
          Descriptive Statistics
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Aims: The aims of this study were to examine the distribution of alcohol use and to define 'harm density functions' representing distributions of alcohol‐caused health harm in Canada, by sex, towards better understanding which groups of drinkers experience the highest aggregate harms. Design: This was an epidemiological modeling study using survey and administrative data on alcohol exposure, death and disability and risk relationships from epidemiological meta‐analyses. Setting: This work took place in Canada, 2019. Participants: Canadians aged 15 years or older participated. Measurements Measures included modeled life‐time mean daily alcohol use in grams of pure alcohol (ethanol) per day, alcohol‐caused deaths and alcohol‐caused disability‐adjusted life‐years. Findings As a life‐time average, more than half of Canadians aged 15+ (62.8% females, 46.9% males) use fewer than 10 g of pure alcohol per day (g/day). By volume, the top 10% of the population consume 45.9% of the total ethanol among males and 47.1% of the total ethanol among females. The remaining 90% of the population experience a slim majority of alcohol‐caused deaths (males 55.3%, females 46.9%). Alcohol harm density functions compose the size of the using population and the risk experienced at each volume level to show that the population‐level harm experienced is highest for males at 25 g/day and females at 13 g/day. Conclusions: Almost 50% of alcohol use in Canada is concentrated among the highest 10% of drinkers, but more than half of the alcohol‐caused deaths in Canada in 2019 were experienced by the bottom 90% of the population by average volume, providing evidence for the prevention paradox. New alcohol harm density functions provide insight into the aggregate health harm experienced across the mean alcohol use spectrum and may therefore be used to help determine where alcohol policies should be targeted for highest efficacy.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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