Public health successes and missed opportunities

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Burden of alcohol-attributable mortality in the WHO European Region, 1990–2014 Fig. 69. Trends in age-standardized adult mortality due to alcohol-attributable intentional injury for the Russian Federation, 1990–2014 600 500 Russian Federation WHO European Region 400 Rate per million 300 200 100 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 Fig. 70. Trends in age-standardized adult mortality due to alcohol-attributable intentional injury for Albania, WHO Euro Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Serbia and the former Yugoslav Republic of WHO Euro Macedonia, 1990–2014 Russian Federation Rate per million 160 140 120 100 80 60 40 20 Albania Bosnia and Herzegovina Bulgaria Croatia Montenegro Serbia The former Yugoslav Republic of Macedonia WHO European Region 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 WHO Euro Macedonia Serbia 49
Public health successes and missed opportunities Fig. 71. Trends in age-standardized adult mortality due to alcohol-attributable intentional injury for Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkey, Turkmenistan and Uzbekistan, 1990–2014 200 Armenia Azerbaijan Georgia Rate per million 150 100 50 Kazakhstan Kyrgyzstan Tajikistan Turkey Turkmenistan Uzbekistan WHO European Region 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 WHO Euro Regional differences in alcohol-attributable mortality Uzbekistan OVERALL TREND IN ALCOHOL-ATTRIBUTABLE MORTALITY BETWEEN 1990 AND 2014 BY MAJOR CAUSE-OF-DEATH CATEGORIES Turkey Fig. 72 gives an overview of the age-standardized alcohol-attributable mortality rates per million by major categories of cause of death at the beginning and the end of the observation period, i.e. 1990 and 2014. For the WHO European Region as a whole, there was higher alcohol-attributable mortality in 2014 than in 1990 (+4%), even though the overall consumption decreased slightly over this time period (see Fig. 10). The increase in attributable mortality burden was mainly driven by the mortality trends in the eastern WHO European Region (+22%) and in the south-eastern part of the WHO European Region (+65%, albeit from a relatively low level in 1990). On the other hand, alcohol consumption decreased in more affluent countries such as most parts of the EU, more in the Mediterranean (–27%) and the centralwestern (–25%) than in the central-eastern regions (–15%). The increase in the burden of alcohol-attributable mortality in the WHO European Region, despite a small decrease in overall per capita consumption, is due to a number of reasons: first and foremost, the exponential increase in mortality risk for many cause-of-death categories with increasing levels of average consumption (159–161), which led to a substantial increase in alcohol-attributable mortality, especially in regions where already high consumption levels per drinker further increased (see the eastern WHO European Region in Fig. 13 and 14). Second and related to this, heavy drinking occasions have a specific detrimental effect on cardiovascular and injury mortality, over and above the level of drinking (see also next paragraph). Finally, the Russian Federation and surrounding countries can be characterized by an overall raised adult mortality rate and low life expectancy (141,162), which had even led to a separate mortality stratum in the WHO classification (163,164). The decrease in alcohol-attributable mortality in the central-eastern EU countries was due to an overall decline in mortality rates in this region (141,162). Even with stable alcohol-attributable fractions or slightly increasing alcohol-attributable fractions, such a decline results in lower standardized rates. 50
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abbreviations CI CVD EU FAS GDP GIS
Page 9 and 10: Executive summary This report aims
Page 11 and 12: for voluntary behaviours. 1 Second,
Page 13 and 14: MONITORING ALCOHOL EXPOSURE The key
Page 15 and 16: Public health successes and missed
Page 27 and 28: BURDEN OF ALCOHOL-ATTRIBUTABLE MORT
Page 31 and 32: Table 1. Standardized mortality fro
Page 33 and 34: Table 1 contd Country Liver Liver C
Page 59: Public health successes and missed
Page 71 and 72: CONCLUSION: THE NEED FOR AN ALCOHOL
Page 88: The WHO Regional Office for Europe
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