The burden of disease and injury attributable to alcohol in New Zealanders under 80 years of age: marked disparities by ethnicity and sex.

AIM To update and improve estimates of morbidity and mortality due to alcohol consumption in New Zealand. METHOD We applied the comparative risk assessment methods of the Global Burden of Disease Study at country level, and separately for Maori and non-Maori where possible. Analysis was restricted to 0-79 year olds. RESULTS We estimated 5.4% of all deaths under 80 years old were attributable to alcohol in 2007 (802 deaths) and these represented 13,769 years of life lost (YLLs). Injuries accounted for 43%, cancer for 30% and other diseases for 27% of deaths. We also calculated 351 deaths were averted by alcohol use, but only 3095 YLLs, resulting in a net annual loss of more than 10,000 years of life. Sex and ethnic disparities were marked, with twice as many deaths in men as women for both Maori and non- Maori, and the age-standardised death rate for Maori two and a half times the rate for non-Maori. Injury was the biggest cause of alcohol-related deaths and YLLs in the young and overall, but the leading cause of alcohol-related death in both Maori and non-Maori women was breast cancer. We estimated 6.5% of all healthy life lost among 0-79 year olds in 2004 was attributable to alcohol (28,403 DALYs lost), and 6538 DALYs were prevented. The sex disparity in DALYs lost mirrored the mortality analysis, but no disaggregation by ethnicity was possible. CONCLUSION Alcohol consumption results in substantial loss of good health across the life course in New Zealand. It makes an important contribution to Maori/non-Maori and male/female health disparities. High average consumption and heavy drinking occasions confer the greatest risk of harm to the drinker and others. At a population level there are no documented health benefits of drinking before middle-age and benefits in later life are increasingly uncertain.