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Key Takeaways

• Studies on substance use and mental health issues related to structural stigma, racism, and sexism recently have increased sharply in number.
• The structural determinant measures used in the studies were diverse and often innovative.
• Most of the studies used passive-observational (correlational) designs, which limited the ability to assess whether the structural determinants...

Key Takeaways

• The literature on social determinants of alcohol-related mortality includes many studies focused on area-level determinants of alcohol-involved motor vehicle crashes and cirrhosis or liver disease mortality.
• Extant research highlights the benefits of stronger alcohol policies and the importance of socioeconomic conditions as determinants of alcohol-related mortality.
• Substantial gaps in...

Introduction

Sexual minority (e.g., lesbian, gay, bisexual, queer, asexual) and gender minority (e.g., transgender, nonbinary, other gender-diverse) people are at heightened risk for alcohol use, hazardous drinking,^[*] and alcohol use disorder (AUD) compared to their heterosexual and cisgender counterparts.^2-6 (For definitions of various sexual and gender minority [SGM] populations, see, for...

Introduction

In 2020, an estimated 17% of the U.S. population was older than age 65; this proportion is projected to rise to about 23% by 2060.^1,2 This prompts an urgent need for identifying potential and modifiable risk factors contributing to health decline.^3,4 After tobacco, alcohol is the most misused substance in the United States and abroad.⁵ Even prior to the coronavirus disease 2019 (COVID...

Introduction

Abundant cross-sectional data indicate that alcohol use and related problems are accompanied by disruptions to sleep and circadian rhythms.¹ Alcohol's negative impacts on sleep are well established, especially in adults, and a smaller body of literature also reports alcohol's disruption of circadian rhythms.^2-4 Growing evidence supports sleep and circadian factors as influencing...

Introduction

Alcohol-associated liver disease (ALD) is a leading cause of morbidity and mortality in people with alcohol use disorder (AUD).¹ Alcohol exerts its effect on the liver through both direct and indirect pathways and can eventually lead to steatosis, steatohepatitis, fibrosis, hepatocellular carcinoma, and cirrhosis.² However, only approximately 10% to 20% of patients with ALD develop...

Introduction

Although historically cisgender women (i.e., women whose sex assigned at birth is consonant with their gender) in the United States have had lower levels of alcohol consumption than cisgender men, recent analyses of historical and cohort data suggest that overall gender differences are narrowing.¹ This narrowing is largely due to substantial increases in cisgender women's alcohol use...

Introduction

Alcohol misuse is the most common form of substance misuse and is associated with liver, cardiovascular, and metabolic diseases as well as with infections and cancers.¹ Although an estimated 20% to 25% of people who drink heavily develop alcohol-related liver disease,² 40% to 60% of people with alcohol misuse have alcohol-related myopathy.³ Evidence that alcohol use leads to skeletal...

Introduction

Although the awareness of the negative impact of prenatal alcohol exposure (PAE) was already alluded to in ancient writings¹ and the impact of ethanol embryopathy in animal models was studied as early as 1910,² the conceptualization of a syndrome associated with PAE was not recognized within modern medicine until the mid-20th century.^3,4 The syndrome or disorder was not uniformly...

Introduction

Prenatal alcohol exposure (PAE) is linked to miscarriage, stillbirth, preterm birth, sudden infant death syndrome, and fetal alcohol spectrum disorders (FASD).¹ Although PAE is the sole necessary cause of FASD, the etiology of this leading preventable cause of disability is multifaceted and complex, including lifestyle, maternal, sociodemographic, social, gestational, and genetic risk...