The Association Between Alcoholic Liver Disease and Alcohol Tax. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Aslam, Sadaf; Buggs, Jacentha; Melo, Samantha; Ermekbaeva, Aizara; Rogers, Ebonie; Shaw, Robert; Kumar, Ambuj; Kemmer, Nyingi
• Is Part Of: American surgeon. Volume 87:Issue 1(2021)
• Page Start: 92
• Page End: 96
• Publication Date: 2021-01
• Subjects: alcoholic liver disease -- alcohol tax -- alcohol consumption; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/0003134820945223
• Languages: English
• ISSNs: 0003-1348

Abstract

Background: The incidence of alcoholic liver disease (ALD) has increased, causing it to become a primary indication for liver transplantation in the United States. We hypothesized an association between alcohol taxation and prevalence of ALD. Methods: We conducted a retrospective study of united network for organ sharing (UNOS) waitlist additions for liver transplantation between January 2007 and December 2016. We also analyzed the average excise tax (2007-2016) for beer, wine, and spirits in listing states of liver transplant waitlist additions (LTWA). Results: There were 104 805 adult UNOS LTWA with assigned diagnoses, an annual increase from 22% to 28%. There were 24 316 LTWA with ALD diagnosis. The mean value for beer tax was significantly lower for ALD patients than for non-ALD patients across all age groups ( P < .001). The analysis demonstrated significantly more ALD in waitlisted patients 35-54 years of age (30%), compared with 18-34 years (10%) and ≥55 years (20%), P < .001. The data confirmed significantly more ALD Medicaid patients in the 35-54 year age group (28%) compared with other age groups, P < .001. Discussion: Our research demonstrated an association between lower beer tax and higher ALD prevalence across all age groups. We found a larger percentage of middle-aged (35-54 years) Medicaid patients listed with ALD. These findings raise the need for further investigation of a potential public health concern for an association between ALD and beer tax, especially for middle-aged patients of lower socioeconomic status.