- Macroeconomic burden of four alcohol-attributable diseases in China rose substantially from 1990 to 2023, with VLW increasing most for AUD (US$1.84bn to US$32.40bn).
- Alcohol use disorders consistently dominated total burden; males accounted for the majority, with male-to-female VLW ratios up to 14:1 and peak ages 35-64.
- Joinpoint confirmed increasing trends; ARIMA, XGBoost and LightGBM produced divergent exploratory projections to 2030, conditional on continuation of historical trends.
Ann Med. 2026 Dec;58(1):2741441. doi: 10.1080/07853890.2026.2741441. Epub 2026 Oct 16.
ABSTRACT
BACKGROUND: Alcohol consumption contributes markedly to the global burden of disease, but macroeconomic assessments of alcohol-attributable diseases in China remain limited. Using Global Burden of Disease (GBD) data, this study quantified the macroeconomic burden of four alcohol-attributable diseases in China: alcohol use disorders (AUD), alcoholic cardiomyopathy (ACM), cirrhosis and other chronic liver diseases due to alcohol use (ALD), and liver cancer due to alcohol use (LCA).
MATERIALS AND METHODS: Disability-adjusted life year (DALY) data for the four diseases from 1990 to 2023 were extracted from GBD 2023. The macroeconomic burden was estimated using the value of lost welfare (VLW) approach, which combined DALYs with age-adjusted value of a statistical life year (VSLY) estimates derived from willingness-to-pay methodology. Results are expressed in 2021 international dollars and as a percentage of GDP. Temporal trends were evaluated using Joinpoint regression analysis, and exploratory forecasts to 2030 were generated using ARIMA, XGBoost, and LightGBM models.
RESULTS: From 1990 to 2023, VLW increased substantially for all four diseases: AUD from $1.84 billion to $32.40 billion; ACM, $0.04 to $0.53 billion; ALD, $0.22 to $3.26 billion; and LCA, $0.09 to $2.48 billion. Joinpoint regression confirmed continuously increasing trends (all AAPC > 0, all p < 0.001). Males predominated across all conditions, with male-to-female VLW ratios of 7:1 (AUD), 10:1 (ALD), 3:1 (LCA), and 14:1 (ACM) in 2023. Age at peak VLW varied: 35-39 years for AUD, 50-59 years for ALD, 65-69 years for LCA, and 50-54 years for ACM (shifted from 35-39 years in 1990). Conditional on the continuation of their respective historical trends, the three models produced divergent exploratory projections to 2030.
CONCLUSION: The macroeconomic burden of four alcohol-attributable diseases in China increased markedly from 1990 to 2023, with AUD consistently dominating and the burden overwhelmingly concentrated among males aged 35-64 years.
PMID:42886576 | DOI:10.1080/07853890.2026.2741441
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