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by Sally Casswell in The Lancet, 02/05/11
It was heartening to read of the forthcoming UN high-level meeting on chronic non-communicable diseases and the excellent strategic analysis by Robert Geneau and colleagues (Nov 13, p 1689),1 which addressed the links between chronic disease and poverty and the reasons for inaction.
As Geneau and colleagues‘ Series paper states, alcohol (a fast-growing risk factor in the populous, disproportionately young countries with growing economies) is a contributor to important chronic diseases including cardiovascular disease, cancer, and tuberculosis. It therefore qualifies for attention in this forum because of its contribution to premature mortality, the basis on which Geneau and colleagues suggest that resource allocation should be made. However, alcohol differs somewhat from other risk factors mentioned in the Series in that its contribution to the global burden of disease and injury is, in large part, via its effect on morbidity (injury from violence and motor vehicle crashes, alcohol dependence, and depression). Much of the effect is in young people, and disability-adjusted life-years are equivalent to those of tobacco globally.

Use of population-attributable fractions from the Global Burden of Disease Study.
Conclusions: Alcohol consumption is a major contributor to premature mortality in San Francisco, especially among males. Interventions to avert alcohol-related harm in San Francisco should be taken at the population level and deserve the same attention that is given to other major risk factors, such as smoking or obesity. (Source: BMC Public Health 2010), 10:682doi:10.1186/1471-2458-10-682, Published: 9 November 2010