Public health successes and missed opportunities
Public-health-successes-and-missed-opportunities-alcohol-mortality-19902014
Public-health-successes-and-missed-opportunities-alcohol-mortality-19902014
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Burden of alcohol-attributable mortality in the WHO European Region, 1990–2014<br />
Fig. 80. Trends in age-st<strong>and</strong>ardized rates of adult mortality due to alcohol-attributable liver cirrhosis in the<br />
WHO European Region <strong>and</strong> selected subregions, 1990–2014<br />
Rate per million<br />
180<br />
160<br />
140<br />
120<br />
100<br />
80<br />
60<br />
EU<br />
Central-western EU<br />
Mediterranean<br />
South-eastern WHO<br />
European Region<br />
Central-eastern EU<br />
Eastern WHO<br />
European Region<br />
WHO<br />
European Region<br />
40<br />
20<br />
0<br />
1990<br />
1992<br />
1994<br />
1996<br />
1998<br />
2000<br />
2002<br />
2004<br />
2006<br />
2008<br />
2010<br />
2012<br />
2014<br />
Alcohol-attributable cancer mortality rates have shown relatively small variations over the observation period within<br />
regions, <strong>and</strong> predictably, the rates between regions reflect the consumption level, with the south-eastern WHO European<br />
Region having markedly lower consumption <strong>and</strong> lower alcohol-attributable cancer mortality (Fig. 81).<br />
Fig. 81. Trends in age-st<strong>and</strong>ardized rates of adult mortality due to alcohol-attributable cancer in the WHO<br />
European Region <strong>and</strong> selected subregions, 1990–2014<br />
Rate per million<br />
120<br />
100<br />
80<br />
60<br />
40<br />
EU<br />
Central-western EU<br />
Mediterranean<br />
South-eastern WHO<br />
European Region<br />
Central-eastern EU<br />
Eastern WHO<br />
European Region<br />
WHO<br />
European Region<br />
20<br />
0<br />
1990<br />
1992<br />
1994<br />
1996<br />
1998<br />
2000<br />
2002<br />
2004<br />
2006<br />
2008<br />
2010<br />
2012<br />
2014<br />
Alcohol-attributable cardiovascular mortality varies widely between <strong>and</strong> within regions over time (Fig. 82). Cardiovascular<br />
causes of death, especially ischaemic categories, are impacted by fluctuations in heavy drinking occasions, <strong>and</strong> thus<br />
even relatively small changes in the level of consumption, which increase irregular or chronic heavy drinking, will have<br />
a considerable impact also on cardiovascular mortality. During the already-mentioned Gorbachev-era anti-alcohol<br />
campaign, alcohol consumption in the Soviet Union went down, even after correcting for increases in unrecorded alcohol<br />
(170) <strong>and</strong>, in association, deaths due to “circulatory disease” decreased, which was the code used for cardiovascular<br />
causes of death in the Soviet Union in 1987 (–9% in men from 1984, –6% in middle-aged women) (169). Cardiovascular<br />
57