A recent study has found a sharp rise in deaths from alcohol-related liver disease (ALD) in the United States, especially among people without a college degree.
This highlights how people from lower-income or less-educated backgrounds are facing more serious health risks. Still, nearly all demographic groups—even those with higher education—are seeing increases in ALD deaths, according to research published in Alcohol: Clinical & Experimental Research.
ALD is one of the main causes of alcohol-related deaths in the U.S. What’s alarming is that the increase in these deaths is not fully explained by how much people are drinking.
The gap between rich and poor in alcohol-related deaths is growing, which shows a troubling pattern: people with fewer resources suffer more harm from alcohol even if they drink the same amount as others.
Researchers looked at data from 2001 to 2020, focusing on Americans aged 25 and older. They wanted to know if the rise in ALD deaths matched the “deaths of despair” theory.
This theory suggests that people without college degrees are dying more often from conditions like suicide, drug overdoses, and alcohol-related diseases due to worsening life circumstances, such as job loss, financial stress, and lack of social support.
Over these two decades, deaths from ALD rose by 63%, going from 9 to 17 per 100,000 people. All groups except Black Americans saw increases. The rise was especially sharp among white and Asian Americans.
Women saw a bigger jump than men, which may be due to changes in women’s drinking habits and their higher sensitivity to liver damage from alcohol.
Among women without college degrees, the increase was steepest—especially for white, non-Hispanic women over 45. This fits with the “deaths of despair” pattern. But even women with college degrees saw their ALD death rates nearly double. Among young adults aged 25–34, the risk nearly tripled. Older adults aged 55–64 were also hit hard.
The difference in risk between those with and without college degrees grew wider. White men aged 55–74 and women aged 45–74 without a college education were especially vulnerable. For example, middle-aged men in this group now have a death rate of 50 per 100,000—far higher than their more educated peers.
The researchers believe that several factors may explain these trends. Disadvantaged groups tend to have higher rates of obesity, diabetes, smoking, and binge drinking—all of which increase the risk of ALD. These findings suggest a need to focus on helping high-risk groups by providing better healthcare, support programs, and public health messaging.
This study also calls for more personalized guidelines and interventions for alcohol use. It’s not enough to offer general advice—solutions need to consider the economic, social, and medical issues that make some groups more vulnerable than others.
In summary, while ALD deaths are rising across the board, they are hitting the least advantaged the hardest. To stop this growing crisis, we must focus on both alcohol use and the deeper inequalities driving these outcomes.
If you care about wellness, please read studies about how alcohol affects liver health and disease progression, and even one drink a day could still harm blood pressure health.
For more health information, please see studies that your age may decide whether alcohol is good or bad for you, and people over 40 need to prevent dangerous alcohol/drug interactions.
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