More Wisconsin residents dying from alcohol-related liver failure, according to new research – WPR

Report on the Escalation of Alcohol-Related Liver Disease Mortality and Implications for Sustainable Development Goals

Introduction: A Public Health Crisis Impeding SDG 3

Recent research indicates a significant nationwide increase in mortality from alcohol-related liver disease, posing a direct challenge to the achievement of Sustainable Development Goal 3 (Good Health and Well-being). The data reveals a particularly acute crisis in Wisconsin, where deaths from alcohol-related liver cirrhosis have surged, undermining progress towards Target 3.5, which calls for strengthening the prevention and treatment of substance abuse, including the harmful use of alcohol.

Analysis of Mortality Trends

National and State-Level Data

An investigation published in the JAMA Open Network highlights a concerning trend that jeopardizes public health objectives. Key findings include:

• A nationwide increase of nearly 9 percent in deaths from alcohol-related liver disease.
• A 35 percent increase in deaths from alcohol-related liver cirrhosis in Wisconsin between 2019 and 2023.
• A tripling of overall alcohol-related deaths in Wisconsin from 1999 to 2020.

This escalation represents a significant setback for SDG 3, particularly Target 3.4, which aims to reduce premature mortality from non-communicable diseases.

Demographic Disparities and Links to SDGs 5 and 10

The mortality increase is not evenly distributed across the population, revealing inequalities that conflict with the principles of the Sustainable Development Agenda.

1. Age-Related Vulnerability: The sharpest rise in deaths nationally was observed among young adults aged 25 to 44, highlighting a failure to protect the health and well-being of a generation in its prime productive years, a concern central to SDG 10 (Reduced Inequalities).
2. Gender-Specific Impacts: Within this younger demographic, women experienced a more pronounced increase in mortality. This trend directly challenges SDG 5 (Gender Equality) by exposing gender-specific vulnerabilities in health outcomes that require targeted intervention.
3. Emerging Youth Crisis: Healthcare providers report treating patients for severe alcohol-related liver conditions, such as hepatitis and cirrhosis, in their twenties and thirties—a previously rare occurrence.

Causal Factors and Systemic Challenges

Socioeconomic Stressors and Mental Health

The period during and after the COVID-19 pandemic has been identified as a critical catalyst for the surge in harmful alcohol consumption. Factors contributing to this trend are directly related to core tenets of SDG 3:

• Pandemic-Related Stress: Isolation, unemployment, and general stress associated with the pandemic are cited as major drivers.
• Mental Health Crisis: The use of alcohol as a form of self-medication for underlying mental health conditions like depression and anxiety underscores the need to integrate mental and physical health services, as promoted by SDG 3.4.

Cultural Norms as a Barrier to Public Health

In regions like Wisconsin, deeply embedded cultural norms surrounding alcohol consumption present a significant obstacle to achieving public health goals. The state consistently ranks high in problematic drinking behaviors, such as heavy consumption and driving under the influence. This cultural context complicates efforts to address the harmful use of alcohol as mandated by SDG 3.5.

Strategic Interventions for SDG Attainment

Policy and Community-Level Actions

Addressing this crisis requires a multi-faceted approach that aligns with several SDGs. Proposed interventions include:

• Policy Reform: Implementing local policies to reduce the density of alcohol outlets and limit high-volume sales aligns with SDG 11 (Sustainable Cities and Communities) by fostering safer and healthier environments.
• Strengthening Institutions: Improving the enforcement of existing laws, such as those prohibiting alcohol sales to minors, contributes to SDG 16 (Peace, Justice and Strong Institutions) by upholding the rule of law for public protection.

Public Awareness and Education

A critical component of the response is public health education aimed at shifting perceptions and behaviors. It is imperative to raise awareness that regular, moderate consumption (e.g., two to three drinks daily) can lead to severe liver damage. This challenges the common misconception that alcohol use disorder is only characterized by extreme, socially disruptive behavior and promotes a more informed approach to personal health, in line with the preventative focus of SDG 3.

SDGs Addressed in the Article

Based on the article’s content, the primary Sustainable Development Goal (SDG) that is addressed is:

• SDG 3: Good Health and Well-being

  The entire article focuses on a significant public health issue: the sharp increase in deaths from alcohol-related liver disease. It discusses mortality rates, the causes behind the increase (such as the COVID-19 pandemic and mental health crises), and the specific populations affected. The article’s core subject is the detrimental impact of harmful alcohol consumption on human health and well-being, which is a central concern of SDG 3.

Specific SDG Targets Identified

The article’s discussion allows for the identification of specific targets under SDG 3:

1. Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

   This target is directly relevant as the article is centered on the consequences of the “harmful use of alcohol.” It highlights the failure of prevention, evidenced by the rising death rates. The work of Maureen Busalacchi, who “works with communities all over the state to reduce problematic drinking” through policy and education, is a direct example of efforts aimed at achieving this target.

2. Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

   This target is applicable for two main reasons discussed in the article:

   • Premature mortality from non-communicable diseases: Alcohol-related liver cirrhosis is a non-communicable disease. The article emphasizes a rise in “premature mortality” by stating that “deaths from alcohol-related liver disease rose more sharply for young adults from 25 to 44 years old.”
   • Promote mental health and well-being: The article explicitly links the rise in alcohol abuse to mental health challenges. Dr. Patrick Remington states, “we also know that there’s a mental health crisis in our nation … alcohol can be used to self-medicate. It’s an attempt to really blunt the pain that comes from depression and or anxiety.” This connects the issue directly to the mental health component of this target.

Indicators for Measuring Progress

The article mentions or implies several indicators that can be used to measure progress towards the identified targets:

• Mortality rate from alcohol-related liver disease

  This is the most direct indicator mentioned. The article provides specific data points, such as the “35 percent” jump in deaths from alcohol-related liver cirrhosis in Wisconsin from 2019 to 2023 and the nationwide increase of “nearly 9 percent.” Tracking this rate is a clear way to measure the success or failure of interventions related to Target 3.5.

• Age- and gender-specific mortality rates

  The article provides a more granular indicator by noting that deaths “rose more sharply for young adults from 25 to 44 years old — and particularly for women.” This allows for a more detailed measurement of premature mortality (Target 3.4) and helps identify the most vulnerable groups.

• Prevalence of problematic drinking behaviors

  Dr. Remington mentions that Wisconsin has topped the charts for “problematic behaviors tied to alcohol — like drinking and driving as well as rates of heavier drinking.” These behaviors are key indicators of the “harmful use of alcohol” (Target 3.5) and can be tracked through surveys like the Behavioral Risk Factor Surveillance System mentioned in the text.

• Incidence of alcohol-related diseases in younger populations

  An implied indicator is the rate at which younger people are being treated for severe alcohol-related conditions. The article notes that providers are now treating patients for “alcohol, hepatitis or cirrhosis in their twenties or thirties,” which was previously rare. Tracking the age of onset for these diseases serves as an indicator of worsening premature health outcomes.

Summary of Findings

Source: wpr.org