Files and links (1)
Published, Version of Record (VoR)CC BY V4.0, Open
Journal article
Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes
Journal of hepatology, v 80(3), pp 409-418
01 Mar 2024
PMID: 37992972
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The long-term impact of alcohol-related public health policies (PHPs) on disease burden is unclear. We aimed to assess the association between alcohol-related PHPs and alcohol-related health consequences.
We conducted an ecological multi-national study including 169 countries. We collected data on alcohol-related PHPs from the WHO Global Information System of Alcohol and Health 2010. Data on alcohol-related health consequences between 2010–2019 were obtained from the Global Burden of Disease database. We classified PHPs into five items, including criteria for low, moderate, and strong PHP establishment. We estimated an alcohol preparedness index (API) using multiple correspondence analysis (0 lowest and 100 highest establishment). We estimated an incidence rate ratio (IRR) for outcomes according to API using adjusted multilevel generalized linear models with a Poisson family distribution.
The median API in the 169 countries was 54 [IQR 34.9–76.8]. The API was inversely associated with alcohol use disorder (AUD) prevalence (IRR 0.13; 95% CI 0.03–0.60; p = 0.010), alcohol-associated liver disease (ALD) mortality (IRR 0.14; 95% CI 0.03–0.79; p = 0.025), mortality due to neoplasms (IRR 0.09; 95% CI 0.02–0.40; p = 0.002), alcohol-attributable hepatocellular carcinoma (HCC) (IRR 0.13; 95% CI 0.02–0.65; p = 0.014), and cardiovascular diseases (IRR 0.09; 95% CI 0.02–0.41; p = 0.002). The highest associations were observed in the Americas, Africa, and Europe. These associations became stronger over time, and AUD prevalence was significantly lower after 2 years, while ALD mortality and alcohol-attributable HCC incidence decreased after 4 and 8 years from baseline API assessment, respectively (p <0.05).
The API is a valuable instrument to quantify the robustness of alcohol-related PHP establishment. Lower AUD prevalence and lower mortality related to ALD, neoplasms, alcohol-attributable HCC, and cardiovascular diseases were observed in countries with a higher API. Our results encourage the development and strengthening of alcohol-related policies worldwide.
We first developed an alcohol preparedness index, an instrument to assess the existence of alcohol-related public policies for each country. We then evaluated the long-term association of the country's alcohol preparedness index in 2010 with the burden of chronic liver disease, hepatocellular carcinoma, other neoplasms, and cardiovascular disease. The strengthening of alcohol-related public health policies could impact long-term mortality rates from cardiovascular disease, neoplasms, and liver disease. These conditions are the main contributors to the global burden of disease related to alcohol use. Over time, this association has not only persisted but also grown stronger. Our results expand the preliminary evidence regarding the importance of public health policies in controlling alcohol-related health consequences.
[Display omitted]
• The alcohol preparedness index (API) is a new instrument to assess the existence of alcohol-related public policies for each country.
• A more stringent policy environment correlates with declines in AUD prevalence and ALD mortality over time.
• Strengthening alcohol-related public health policies could also impact long-term mortality due to CVD, HCC and other neoplasms.
• The association between API and alcohol-related outcomes became more robust over time.
Metrics
Details
- Title
- Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes
- Creators
- Luis Antonio Díaz - Pontificia Universidad Católica de ChileEduardo Fuentes-López - Pontificia Universidad Católica de ChileFrancisco Idalsoaga - Pontifical Catholic University of ChileGustavo Ayares - Pontificia Universidad Católica de ChileOscar Corsi - Pontificia Universidad Católica de ChileJorge Arnold - Pontificia Universidad Católica de ChileMacarena Cannistra - Pontificia Universidad Católica de ChileDanae Vio - Pontificia Universidad Católica de ChileAndrea Márquez-Lomas - Anahuac Mayab UniversityCarolina Ramirez-Cadiz - London Health Sciences CentreMaría Paz Medel - Pontifical Catholic University of ChileMaría Hernandez-Tejero - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USACatterina Ferreccio - Pontifical Catholic University of ChileMariana Lazo - Drexel University, Community Health and PreventionJuan Pablo Roblero - University of ChileThomas G. Cotter - Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USAAnand V. Kulkarni - Asian Institute of GastroenterologyWon Kim - Seoul National UniversityMayur Brahmania - University of CalgaryAlexandre Louvet - InsermElliot B. Tapper - University of Michigan–Ann ArborWinston Dunn - University of Kansas Medical CenterDouglas Simonetto - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAVijay H. Shah - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAPatrick S. Kamath - Mayo Clinic in ArizonaJeffrey V. Lazarus - Barcelona Institute for Global HealthAshwani K. Singal - University of LouisvilleRamon Bataller - Hospital Clínic de BarcelonaMarco Arrese - Pontificia Universidad Católica de ChileJuan Pablo Arab - Hospital Clínico de la Universidad de Chile
- Publication Details
- Journal of hepatology, v 80(3), pp 409-418
- Publisher
- Elsevier
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Community Health and Prevention
- Web of Science ID
- WOS:001188598400001
- Scopus ID
- 2-s2.0-85180594670
- Other Identifier
- 991021883215704721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
Highly Cited Paper
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Gastroenterology & Hepatology