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Deaths attributable to alcohol: what are the differences between Brazil and the United States?

22 Janeiro 2023

Are there differences between deaths related to harmful alcohol consumption between the richest country in the world, the United States, and Brazil?

A recent study, published in the renowned journal JAMA Open Network, analyzed deaths attributable to alcohol in the United States (1). Alcohol consumption data came from a survey of more than 2 million Americans that monitored behavioral risk factors between 2015 and 2019. From these results, the authors estimated the number of deaths that occurred in the population aged 20 to 64 years in the country, also extrapolating for all age groups, in addition to separating the number of deaths for each of the 50 states and Washington, DC.

The study's main estimate is that harmful alcohol consumption is responsible for one in eight deaths among adults aged 20 to 64 in the United States. The main death causes attributable to alcohol estimated for the entire population were alcoholic liver diseases (classified with ICD K70), which include alcoholic hepatitis and alcoholic liver cirrhosis. Next, alcohol poisoning (ie, overdose) and traffic accidents were listed as the main causes of death. In total, it is estimated that alcohol was responsible for 5% of all deaths in the country, considering the entire population. This percentage is similar to that found in Brazil and in the world (2). However, when considering the age group from 20 to 64 years old, which covers the majority of drinkers, alcohol was responsible for 12.9% of all deaths. As for the age group of young adults (20 to 34 years old), this estimate rises to a worrying 25.4%. The main causes of alcohol-related deaths among young people were poisoning, traffic accidents and homicides.

Regarding the states, the figure below presents the estimates of deaths attributable to alcohol in the age group 20 to 49 years for the federal units of the United States. The selection for this age group is made because it represents a population with a high economic impact in the country. In general, it is observed that the states of the north and west have higher rates of deaths attributable to alcohol. In the country as a whole, it was estimated that alcohol was responsible for one in five deaths in people aged 20 to 49 between 2015 and 2019, with some states reaching more than one in four deaths.

How is Brazil compared to the United States?

 With regard to deaths attributable to alcohol, Brazil and the United States have some similarities. Comparing this North American study with the survey carried out by CISA, “Alcohol and Health of Brazilians: 2022 Panorama”, it is observed that alcohol was responsible for 5.8% of deaths in 2010 and 4.3% of deaths in 2020 , values ​​similar to the estimate of 5% observed in the United States for the historical series from 2015 to 2019.

Furthermore, in Brazil, both in 2019 and in 2020, liver cirrhosis was the leading cause of death attributable to alcohol, similar to estimates for alcoholic liver disease in the United States. Overall, alcohol is responsible for 43.2 deaths per 100 inhabitants in the United States, and in Brazil this figure ranged from 34 to 31.4 between 2010 and 2020, a figure considerably lower than in the United States.

Unlike the United States, Brazil presented interpersonal violence as one of the main factors of death attributable to alcohol, taking third place between 2010 and 2019 (second only to traffic accidents and liver cirrhosis), being the second leading cause of death attributable to alcohol for people up to 34 years old.

Another similar, and worrying, factor across countries is the high rate of Heavy Episodic Drinking (HED) among younger adult populations, responsible for the increased chances of premature deaths. The authors point out that, in the United States, the fact that young people consume more alcohol in a harmful way is what makes this substance one of the main risk factors for deaths related to traffic accidents and overdose. Similarly, in Brazil, as CISA has been highlighting in its social networks, young people are more prone to traffic accidents and fights, a factor strongly associated with the high prevalence of HED in the 18-34 age group.

Finally, data from both countries highlight the importance of public policies that combat harmful consumption and reduce the negative impact that alcohol can have on society, an impact that can be very serious even in a developed country like the United States.


Additional Info

  • Referências:

     1. Esser MB, Leung G, Sherk A, Bohm MK, Liu Y, Lu H, et al. Estimated Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 64 Years, 2015 to 2019. JAMA Netw Open [Internet]. 2022 Nov 1 [cited 2022 Nov 30];5(11):e2239485–e2239485. Available from:
    2. OMS. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. [Internet]. Poznyak V, Rekve D, editors. 2018 [cited 2020 Apr 15]. 478 p. Available from:

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