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Estimated mortality and years of life lost attributed to alcohol use
1. Key messages
- In 2021, more than 4,000 deaths in Belgium were attributable to alcohol use. This represents 3.6% of all deaths and almost 101,368 years of life lost in Belgium for that year.
- Cirrhosis of the liver, alcohol use disorders and colorectal cancer are the main causes of death associated with alcohol use.
- Alcohol-attributable mortality rates have increased over time, with the highest increase in the Brussels Capital Region.
- Belgium's alcohol-attributable mortality rate is close to the EU-14 average.
2. Alcohol-attributable mortality
In 2021, alcohol consumption was responsible for 4,022 deaths, accounting for 3.6% of all deaths in Belgium. This represents 101,368 years of life lost related to alcohol use.
Most alcohol-attributable deaths occur in males, and mainly in old age
71% of all alcohol-attributable deaths were in men (2,842 deaths). The majority of deaths occurred in persons aged 65-84 years, who accounted for 42% of all alcohol-attributable deaths (1674 deaths), followed by persons aged 45-65 years, who accounted for 34% (1,376 deaths).
Source: Own calculations based on data from Statbel [1]
Cirrhosis of the liver, alcohol use disorders and colorectal cancer are the main causes of alcohol-attributable mortality
Alcohol use was found to be related to more than 200 diseases or health conditions. From the 34 health conditions included in this study, cirrhosis of the liver, alcohol use disorders and colorectal cancer are the main causes of alcohol-attributable mortality, responsible for 1011, 541 and 495 deaths respectively.
There are significant differences between men and women in the specific causes of alcohol-attributable deaths. Among women, breast cancer is the leading cause, accounting for 339 deaths. In contrast, for men, cirrhosis of the liver is the leading cause, with 729 deaths. Additionally, self-harm is the fourth leading cause of alcohol-attributable deaths for men, contributing to 290 deaths. However, it ranks only eight among women, with an estimated 66 deaths.
Source: Own calculations based on data from Statbel [1]
Although alcohol may appear to have a slight protective effect for certain conditions, such as ischemic heart disease and diabetes, this does not make it beneficial overall. Globally, the harmful effects of alcohol far outweigh any potential benefits. It is a major contributor to deaths from conditions like cancer, liver disease, and other cardiovascular problems. Ultimately, alcohol consumption is harmful to both individuals and society, regardless of the quantity consumed.
The alcohol-attributable mortality rate is higher in the Brussels Capital Region compared to the Walloon Region and the Flemish Region
Since 2013, there has been an overall increasing trend in alcohol-attributable mortality rates across regions.
In 2013, the Walloon Region had the highest age-adjusted alcohol-attributable mortality rate, with 42.3 deaths per 100,000 persons attributed to alcohol. The rates in the Brussels Capital Region and the Flemish Region were lower, at 39.7 and 27.6 per 100,000 persons, respectively.
Between 2013 and 2021, the Brussels Capital Region experienced the most significant increase in alcohol-attributable age-adjusted mortality rates (+14.8%). The Flemish Region also recorded a notable rise (+6.2%), while the Walloon Region saw a smaller increase (+1.5%). In 2021, the Brussels Capital Region had the highest alcohol-attributable mortality rate, at 45.6 per 100,000 deaths.
Source: Own calculations based on data from Statbel [1]
Belgium's alcohol-attributable mortality rate is close to the EU-14 average
In 2021, according to the Global Burden of Disease 2021 study [2] the estimated age-adjusted alcohol-attributable mortality rate in Belgium (19.6 per 100,000) was around the EU-14 countries mean (18.1 per 100,000).
Source: GBD 2021 study [2]
3. Read more
View the metadata for this indicator
Burden of risk factors visualization tool
Belgian National Burden of Disease Study. Patterns of alcohol use and sales in Belgium: a critical appraisal of available data sources
Background
We aimed to quantify the health impact of alcohol consumption in Belgium by using representative data from the Belgian Health Interview Survey (BHIS). This survey was selected as the best available data source. It provides detailed insights into alcohol use [3]. We then constructed a time series on the BHIS data to have annual estimates from 2013 to 2021, that offer comprehensive insights into alcohol consumption trends by age, sex, and region. This enabled us to estimate the contribution of alcohol consumption to the burden of disease through the Population Attributable Fraction (PAF) equation of each related health condition. It allows to estimate the proportion of health problems that would not have occurred if no one had consumed alcohol. Combining PAF percentages with total mortality burden estimates, we calculated the attributable-mortality burden for each disease by age group, sex, and region. Additionally, we computed rates per 100,000 individuals and age-standardised rates (BSP) using population estimates from Statbel.
We used the Comparative Risk Assessment (CRA) method to calculate alcohol-attributable mortality. It allows for the estimation of population-attributable fractions (PAFs), quantifying the disease burden caused by exposure. The attributable burden (for example deaths) represents the share of the burden that can be linked to specific risk factor exposure, such as alcohol consumption, and would not have occurred without past exposure [4].
We calculate the attributable burden of alcohol use estimates by age, sex, region, year, and cause. The complete set of estimates can be explored via https://burden.sciensano.be/shiny/risk/
Primary data about alcohol use can be consulted on this page.
Definitions
- EU-14
- The EU-14 corresponds to the following countries that belonged to the European Union between 1995 and 2004: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, and Sweden. We compare the Belgian health status to that of the EU-14 because these countries have similar socioeconomic conditions. Note: The United Kingdom is excluded as it is no longer a member of the EU.
- Age-standardised mortality rate
- The age-standardisation is a weighted average of age-specific mortality rates to remove variations arising from differences in age structure between population groups.
References
- Statistics Belgium (Statbel). https://statbel.fgov.be/en
- Institute for Health Metrics and Evaluation (IHME). (2024). Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. https://vizhub.healthdata.org/gbd-results/
- Nayani, S., Guariguata, L., & Devleesschauwer, B. (2024). Belgian National Burden of Disease Study. Patterns of alcohol use and sales in Belgium: A critical appraisal of available data sources (D/2023.14.440/81; p. 30). Sciensano. https://www.sciensano.be/en/biblio/belgian-national-burden-disease-study-patterns-alcohol-use-and-sales-belgium-a-critical-appraisal
- Plass, D., Hilderink, H., Lehtomäki, H. et al. Estimating risk factor attributable burden – challenges and potential solutions when using the comparative risk assessment methodology. Arch Public Health (2022). https://doi.org/10.1186/s13690-022-00900-8
Please cite this page as: Sciensano. Burden of disease: Risk factor attributable burden - Alcohol attributable burden, Health Status Report, 30 January 2025, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/burden-of-disease/risk-factor-attributable-burden/burden-of-alcohol-use