In an analysis by race, sex, age, and geography, alcohol-induced death rates in 2024 are nearly double those in 1999, with a sharp increase at the onset of the COVID-19 pandemic. Although rates are higher for men, the largest increase in alcohol-induced deaths over the full 25-year period occurred in females aged 25-34, according to a study published on September 17 by Dr. Tony Wong and colleagues at UCLA in the open-access journal PLOS Global Public Health.
Alcohol-induced deaths have been increasing over the past two decades. Particularly concering are increases between 2019 and 2021, when the population was under significant stress from isolation due to the COVID-19 pandemic, and people with alcohol-use disorders were less able to access treatment. Quantifying mortality trends and determining whether alcohol-induced deaths have returned to pre-pandemic levels is essential for understanding long-term temporal patterns and dynamics. To examine these trends, the authors of this study analyzed data from the Centers for Disease Control and Prevention's National Vital Statistics System, focusing on 14 specific alcohol-induced causes of death.
Wong et al. found that rates of alcohol-induced deaths in the United States nearly doubled between 1999 and 2024, reaching their highest level in 2021. Most deaths are due to alcoholic liver disease and, to a lesser degree, alcohol-related mental and behavioral disorders. The largest overall increase in alcohol-induced mortality across all race, sex, age groups occurred in 2021 when fatalities peaked at 54,258 deaths overall. By 2024, fatalities had declined, but the average alcohol-induced mortality rate across U.S. counties remained approximately 25% higher than in 2019.
American Indian/Alaska Native populations (AIAN) remain the most affected, with male AIAN rates of alcohol-induced mortality three times higher than that of white males, and female AIAN mortality rates four times higher than that of white females, over the entire period of investigation.
The largest increase by demographic was among females aged 25-34, which rose from 0.9 deaths per 100,000 in 1999 to 3.2 per 100,000 in 2024 — a 255 percent increase. The second largest increase was in males aged 25-34, from 2.3 fatalities per 100,000 in 1999 to 6.5 in 2024 — a 188 percent increase. As deaths from chronic diseases related to alcohol use, such as certain cancers or cardiovascular events, were not included in this study, the overall fatality counts may be underestimated. These findings underscore the critical need for targeted policies to reduce excessive alcohol consumption and improve access to treatment for those who need it most.
Senior author Maria R D'Orsogna adds: "The rapid rise of alcohol-induced deaths among women is particularly concerning. Although men still die at higher rates, the gender gap appears to be closing. Notably, for the population aged 25-34, the male-to-female mortality ratio has decreased from three-to-one in 1999 to two-to-one in 2024."
The authors conclude: "The rise in alcohol-induced mortality is widespread and affects the entire country, with particularly large surges arising during the COVID-19 pandemic. In the early months of the pandemic, alcohol-induced deaths among AIAN males increased by as much as 40% in a single month and remained unusually high for nearly four years. Similar trends were observed among AIAN and Black females, whose alcohol-induced death rates rose by over 30% in one month."
In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://plos.io/4nra5UI
Citation: Wong T, Böttcher L, Chou T, D'Orsogna MR (2025) Alcohol-induced deaths in the United States across age, race, gender, geography, and the COVID-19 pandemic. PLOS Glob Public Health 5(9): e0004623. https://doi.org/10.1371/journal.pgph.0004623
Author Countries: United States
Funding: This work was supported by the ARO through a grant [W911NF-23-1-0129 to LB and MRD], and by the U.S. National Science Foundation through a grant [OAC-2320846 to MRD]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
