Full report: Alcohol Attributable Fractions report – finalF.pdf (hpa.org.nz)

Executive summary

INTRODUCTION

Alcohol is a component cause for numerous disease and injury conditions. This report provides an
updated estimate for alcohol-attributable morbidity and mortality for Māori, non-Māori, and the
overall Aotearoa New Zealand population in 2018. One approach to quantifying the wide-ranging
health harms of alcohol is the use of attributable fractions, which estimate the proportion of a
disease or condition in a population that is associated with a particular risk factor (e.g. alcohol). The
estimates reflect currently available risk quantifications on the health impacts of alcohol
consumption and Aotearoa New Zealand alcohol consumption patterns. The estimates also lay the
groundwork for the future monitoring of alcohol harms in the Māori and non-Māori population.
Specifically, this report addresses the following research questions:

1. What is the alcohol-attributable morbidity and mortality as measured by deaths,
cancer registrations, hospitalisations, Accident Compensation Corporation (ACC)
injury claims and disability-adjusted life years (DALYs)?
2. What are the differences in alcohol-attributable morbidity and mortality in Māori and
non-Māori?

CONCLUSIONS

Alcohol causes a substantial preventable health burden via a range of disease and injury conditions.
The health burden from alcohol is disproportionately borne by Māori and males. Cancers, injuries and
conditions that are wholly attributable to alcohol use (e.g. alcoholic gastritis and alcohol use disorders
– contained in the ‘other’ category) contribute the majority of alcohol-attributable mortality and
morbidity. Our estimates are conservative for a number of reasons, including: 1) they assume there
are potential protective effects of low-level consumption, for which the evidence is heavily contested;
2) our inability to include the full range of alcohol-attributable conditions (e.g. fetal alcohol spectrum
disorder); 3) our inability to include other measures of health loss such as utilisation of secondary and
community mental health and addiction treatments; 4) the GBD’s relative risk functions used in this
analysis produce estimates ~25% lower than studies using the World Health Organisation’s relative
risks.

In addition to the health burden, these alcohol-attributable heath impacts also place a substantial
economic burden on individuals and the Government. Given the current policy landscape in Aotearoa
New Zealand and international best practice, the most effective policy avenues for reducing the
alcohol-attributable health burden are restrictions on alcohol marketing and availability, increases
to excise tax, and implementation of a national screening and brief intervention programme.