The contribution of alcohol to the East-West life expectancy gap in Europe from 1990 onward

BACKGROUND: Central and Eastern European (CEE) countries have lower life expectancies and higher alcohol-attributable mortality than Western European countries. We examine the contribution of alcohol consumption to mortality across Europe, and specifically to the East-West life expectancy gap from 1990 onward. METHODS: We retrieved alcohol-attributable mortality rates (GBD Study 2013) and all-cause mortality rates (Human Mortality Database) by age and sex for nine CEE countries and for the EU-15 countries. We assessed country-specific potential gains in life expectancy (PGLE) by eliminating alcohol-attributable mortality using associated single decrement life tables. We decomposed the life expectancy differences between each CEE country and the EU-15 population-weighted average for 1990-2012/13 into alcohol-attributable and non-alcohol-attributable mortality. RESULTS: In 2012/13, the PGLE for men and women were, respectively, 2. 15 and 1. 00 years in the CEE region and 0. 90 and 0. 44 years in the EU-15 region. The contribution of alcohol to the East-West gap in life expectancy was largest among men in Russia 2. 88 years uncertainty interval (UI): 1. 57-4. 06, Belarus 3. 70 years (UI: 1. 75-5. 45) and Ukraine 2. 47 years (UI: 0. 90-3. 88). The relative contributions increased in most of the countries between 1990 and 2005 (on average, from 17. 0% to 25. 4% for men, and from 14. 7% to 22. 5% for women), and declined thereafter (20. 2% for men and 20. 5% for women in 2012/13). CONCLUSIONS: Alcohol contributed substantially to the East-West life expectancy gap in Europe, and to its increase (1990-2005) and decline (2005 onward). Diminishing alcohol consumption in CEE countries to Western European levels can contribute to mortality convergence across Europe.