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Mesothelioma: A Killer
Lurks in the Lungs |
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Alcohol Abuse Tied to 75,000 Early Deaths |
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September 23, 2004 08:48:47 PM PDT , HealthDay |
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By Amanda Gardner
HealthDay Reporter |
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THURSDAY, Sept. 23 (HealthDayNews) -- Excessive drinking took more than 75,000 lives in the United States in 2001, shortening the lives of each of those who died by an average of more than 30 years, a new government report says.
In all, a total of 2.3 million "years of potential life" were lost to alcohol abuse, according to the report from the U.S. Centers for Disease Control and Prevention. That is about half of the total years of potential life lost due to smoking in 1999, the most recent year for which figures are available.
"This affirms that excessive drinking is a very serious public health problem in the United States," said Dr. Robert Brewer, alcohol team leader at the CDC and one of the co-authors of the study, which appears in the Sept. 24 issue of the CDC publication Morbidity and Mortality Weekly Report. "It's a huge public health impact."
Although there have been other estimates of deaths attributable to alcohol, this report uses a new software program to profile some 54 different conditions, Brewer said. Overall estimates are similar to estimates released earlier this year.
Excessive alcohol consumption is defined as more than two drinks per day or more than four drinks per occasion for men, and an average of more than one drink per day or more than three drinks per occasion for women. According to the report, it is the third leading preventable cause of death in the United States.
The total number of deaths (75,766) in 2001 were almost equally divided among chronic conditions (46 percent) and acute ones (54 percent). Almost three-quarters (72 percent) of deaths involved males, and 6 percent involved people under the age of 21. Three-quarters of the total deaths among males were among those over the age of 35; of those, 58 percent were due to chronic conditions. For both men and women, the leading chronic cause of death was alcoholic liver disease, while the leading acute cause was motor-vehicle crashes.
By contrast, the report pointed out, excessive alcohol use saved an estimated 11 lives in 2001, all of them due to it protective role in reducing the risk of death from gall bladder disease.
All deaths from acute conditions were linked to binge drinking (defined as five or more drinks per occasion for men and four or more drinks per occasion for women). "Binge drinking is associated with young people. In fact, we know that isn't true," Brewer said. "Most of the deaths were in men, and three-quarters of those were 35 and older. It isn't just a problem for young people. This is a problem across the full life span."
The main value of the report, Brewer added, was as a call to action. "There really are some things we can do about it. Effective intervention strategies are some that are more focused on the community, such as an increase in the price of alcohol drinks in the form of excise taxes. That is known to be effective in reducing consumption and to get health-care practitioners, specifically physicians, to screen their patients for drinking problems."
"This is a problem we'll have to work on for a while before we see serious changes," Brewer continued. "But, as a general rule, we have not taken on this problem of excessive drinking."
More information
For more on problems associated with alcohol, visit the U.S. Centers for Disease Control and Prevention. |
HIV infection disclosure to partner can vary
Last Updated: 2004-09-23 15:30:06 -0400 (Reuters Health)
By Will Boggs, MD
NEW YORK (Reuters Health) - Whether or not HIV-infected intravenous drug users (IDUs) disclose their status to their sex partners depends on different factors, according to a report in the journal AIDS Patient Care and STDs.
"Disclosure is not an all or nothing event," Dr. Jeffrey T. Parsons from Hunter College of the City University of New York told Reuters Health. "The relationship between sexual risk and disclosure among IDUs is an important one to consider."
In the Seropositive Urban Drug Injector's Study, Parsons and colleagues used data from an ethnically diverse sample of 158 HIV-positive IDUs to examine disclosure and sexual behavior based on partner type, partner infection status, and the risk of spreading HIV.
More than half the subjects disclosed that they were HIV-positive before the first sexual contact with their primary partner, the authors report, but nearly three quarters of those reporting sex with a non-primary partner disclosed their HIV-positive status before having sex for the first time.
Altogether, 79 percent of subjects disclosed their HIV positivity when the sexual partner was known to be HIV-positive, the report indicates, but only 56 percent revealed their status when the sexual partner was HIV-negative or had an unknown infection status.
Most participants consistently disclosed their status to casual sex partners, but 4 of 26 men and 5 of 15 women only did so under certain conditions or with particular individuals.
Two men and two women reported never having disclosed their HIV-positive status to their current primary partner, the researchers note, and 13 of 36 men having sex with male or female partners and 2 of 13 women with casual partners reported never disclosing their HIV status.
Those who consistently disclosed their status were more likely to feel they had a responsibility to tell sex partners they were HIV-positive if they were not sharing needles and to believe it was more important to protect sex partners from HIV.
These "consistent disclosers," the investigators report, were more likely than others to wear condoms without resentment and to endorse the attitude that it is all right if the partner doesn't want to have sex because of the disclosed HIV-positive status.
"I think that significant efforts were made early in the epidemic to focus on safer needle sharing practices among IDUs, but issues about sexuality were essentially ignored," Parsons said. "More safer-sex information needs to be provided to IDUs in the context of secondary HIV prevention."
"In addition to using this information to potentially help IDUs disclose sooner in relationships rather than later, it's also just important for providers to be alert to potential emotional problems and mental health issues that may result from disclosure," Parsons added.
"Having peers who have successfully disclosed their status to partners could have a motivating effect on IDUs," he said. "In addition, hearing stories about disclosure situations that did not go well, but hearing how the person was able to get beyond it, could help to alleviate fears about rejection and other negative reactions to disclosure."
SOURCE: AIDS Patient Care and STDs, August 2004.
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