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Patterns of Drinking and Estimates of Alcohol-Related Mortality in New Zealand

The two main population groups in New Zealand have different average drinking patterns but similar average alcohol consumption. This article compares three approaches to incorporating pattern of drinking into estimates of alcohol-attributable mortality and years of life lost for New Zealand. We adapted the comparative risk assessment (CRA) methods developed by World Health Organization (WHO), and applied them at a country and subpopulation (Māori/non-Māori) level, using different alcohol-attributable fractions for injuries and coronary heart disease for Maori and non-Maori populations based on drinking patterns. When the impact of differences in drinking pattern between Maori and non-Maori was included, overall alcohol-attributable mortality and Years of Life Lost (YLL) rates increased, and ethnic disparities in alcohol-related health burden increased markedly. Thus using a single measure of pattern of drinking for the whole country resulted in an underestimation of the national health burden of alcohol, and masked important differences in health impacts of alcohol between Maori and non-Maori populations.