The last
A new study adds to a growing body of evidence showing that increasing alcohol consumption among women leads to higher rates of death and disease. The report, published Friday in the journal JAMA Health Forum, looked at insurance claims data from 2017 to 2021 on more than 14 million Americans age 15 and older. Researchers found that during the first year and a half of the coronavirus pandemic, women aged 40 to 64 were much more likely than expected to experience serious complications such as alcohol-related cardiovascular and liver disease, as well as severe withdrawal .
Background
Alcohol consumption in the United States has generally increased over the past 20 years, said Dr. Timothy Naimi, director of the Canadian Institute for Substance Use Research at the University of Victoria. Dr. Naimi co-authored a recent paper showing that deaths from excessive alcohol use in the United States increased by nearly 30 percent between 2016 and 2021.
While men still die more often from drink-related causes than women, deaths among women are increasing at a faster rate. “The gap is closing,” said Dr. Bryant Shuey, assistant professor of medicine at the University of Pittsburgh and lead author of the new study.
The research
The study looked at serious health issues associated with alcohol consumption, including alcohol-related liver and heart disease, inflammation of the stomach lining leading to bleeding, pancreatitis, alcohol-related mood disorders and withdrawal . The researchers compared the insurance claims data for these complications with the rates they expected to see based on the prevalence of these conditions in the past.
Almost every month from April 2020 to September 2021, women aged 40 to 64 experienced complications from alcohol-related liver disease – a range of conditions that can develop when fat starts to build up in the liver – at higher rates than what the researchers predicted. If the damage from drinking continues, scar tissue builds up in the liver and leads to a later stage of the disease, called cirrhosis. Some people with alcohol-related liver disease also develop severe liver inflammation, known as alcohol-related hepatitis.
Rates of alcohol-related complications during the pandemic were also higher than predicted among men aged 40 to 64, but these increases were not statistically significant. But “men are not out of the woods” and still face health risks, Dr. Shuey said.
The Limitations
The study looked at data only through September 2021. Katherine Keyes, a professor of epidemiology at Columbia University who was not involved in the latest study, said she expected alcohol use could continue to rise among women — a pattern that could contribute to even more health issues.
And since the study was based on insurance claims, Dr. Shuey said it told an incomplete story. If someone is treated in the emergency room for inflammation of the pancreas but does not disclose a history of alcohol consumption, for example, this case may not be recorded as an alcohol-related complication.
“The truth is, we probably underestimate that,” he said.
The Takeaways
These findings highlight how heavy drinking patterns can translate into serious health consequences. Over the past 10 years, an increasing number of American women — and particularly middle-aged women — have reported binge drinking, Dr. Keyes said.
“It used to be that men aged 18 to 25 were the most likely to drink or overdose,” said Aaron White, a neuroscientist at the National Institute on Alcohol Abuse and Alcoholism. Now, binge drinking occurs more among people aged between 26 and 34 and is becoming more common among women. “Everything turns upside down later,” he said.
Demographic changes may also explain why women drink at higher rates, Dr. Keyes said. Women tend to marry and have children at later ages than in previous decades, so they spend more time on what Dr. Keyes calls it a “high-risk period for binge drinking.”
“People don’t realize the real health consequences these heavy drinking patterns can have,” he added.
These effects take time to develop and often appear between the ages of 40 and 60. Complications can occur after “years of heavy, persistent alcohol use,” Dr. Shuey said.
These long-term increases in alcohol consumption predated the pandemic and may have increased the risk of health problems among women before Covid-19 hit. But higher alcohol levels during lockdowns may have exacerbated these issues or contributed to new complications, especially as women shoulder the bulk of family responsibilities, Dr White said.
Even as research grows on the harms of alcohol, many people may find it difficult to change their habits, Dr. White said.
“If you’ve been drinking wine with dinner every night for the last 20 years, seeing just one headline isn’t going to be enough to make you throw away your wine,” he said. “I think it’s going to be a slow cultural change.”
