Is Alcohol Mortality Rising Among Women?

We know that alcohol use has been growing over the years, but have you ever wondered how alcohol affects women differently than men? What about alcohol-related mortality in women? What are the alcohol death rates in the U.S.? Let’s explore the recent findings on alcohol mortality among women and see if there is a gender difference in mortality rates!

Facts and Trends

A recent study published in The Journal of the American Medical Association (JAMA) has found that more women, especially those over 65, are dying from alcohol-related causes than ever before, and the gap between male and female alcohol-related mortality rates is closing. Researchers looked at CDC data, analyzing over 600,000 deaths from 1999 to 2020 that were related to alcohol, like alcohol poisoning, liver diseases, heart problems, severe intoxication, and mental or behavior issues.

In the past 15 years, deaths from alcohol use have been increasing in the U.S., and although more men have died from alcohol-related use, alcohol related mortality in women is increasing at a faster rate. From 2018 to 2020, deaths rose by 12.5% each year for men but for women, deaths have gone up by 14.7% each year. The study highlighted a rise in deaths among women aged 65 and older. For this age group, deaths increased by 6.7% each year from 2012 to 2020, compared to a 5.2% increase for men aged 65 and older.

Although men are more likely to consume alcohol and engage in binge drinking, women are now drinking more frequently and in larger quantities than in the past.

A survey involving nearly 18,000 college students across the U.S. found that about one in three female students participates in binge drinking, defined as consuming four or more drinks in a short period. The study also found that the incidence of binge drinking at all-women's colleges more than doubled from 1993 to 2001. Despite a higher dependence on alcohol among college men, over half of the college students who abuse alcohol are women.

These trends are concerning because binge drinking poses health risks for both genders and also heightens the risk of engaging in unintended and potentially unwanted sexual activities.

Potential Causes

Although the JAMA study does not offer explanations for this narrowing in mortality, the study’s lead author, Ibraheem Karaye, offers a few potential theories.

• Biological differences. Biologically, women process alcohol differently than men. They generally have a higher fat-to-water ratio, which means alcohol is less diluted in their bodies. Women have less of the enzyme alcohol dehydrogenase, which is essential for metabolizing alcohol. As a result, they retain higher levels of alcohol in their body that can be harmful to organs like the liver. This also increases their risk of experiencing health problems related to alcohol. Additionally, hormonal differences can affect how women metabolize alcohol, making them more vulnerable to its adverse health effects. The hormonal fluctuations can lead to more target organ effects in women than men. 
• Sociocultural factors. The role of changing societal norms cannot be understated. In recent decades, the way society views women's alcohol consumption has shifted. Drinking has become more socially acceptable for women, and in some cases, it's even encouraged as a symbol of liberation and equality. As a result, more women across all age groups are drinking more than they had before. Moreover, marketing strategies by alcohol companies have increasingly targeted women, portraying alcohol as a glamorous and essential component of socializing and relaxation. The spread of catchy phrases such as "rosé all day" and the image of the "wine mom" has linked alcohol consumption with an upper-middle-class and middle-aged status. This, in addition to the increased role of social media in our lives, contributes to the normalization and encouragement of drinking for all women. 
• Psychological factors. Mental health plays a role in this trend. Women are more likely to suffer from certain mental health conditions, such as depression and anxiety, which can lead to increased alcohol use as a form of self-medication. The isolation and increased stress brought on by events like the Covid-19 pandemic have exacerbated these issues, leading to a rise in alcohol dependency among women.
• Work-life balance and stress. The stress of balancing work, family, and social obligations has also been identified as a significant contributor, especially with recent progress toward gender equity in the workforce. As more women enter the workforce and advance in their roles, many women turn to alcohol as a coping mechanism for stress. This is particularly evident among working mothers and women in high-pressure careers who may use alcohol to unwind from the day's stresses.
• Life transitions. Significant life transitions, such as menopause, the loss of a partner, or retirement, can also contribute to increased alcohol use among older women. These life changes can bring about feelings of loss, loneliness, and a search for coping mechanisms — and alcohol is often an accessible coping tool.

The Effect of Alcohol on Women

There are extensive implications of rising alcohol-related issues among women, not just at an individual level but also within families and society at large. Although many drink in moderation, it's important to recognize that alcohol poses specific risks to all women. Despite men being more likely to drink and develop problems from their drinking, women are significantly more susceptible to alcohol’s damaging effects.

Women often face alcohol-related health issues and other negative consequences sooner than men, and these can arise even with lower overall alcohol consumption. Exceeding light to moderate drinking levels (more than about seven drinks per week) places women at a heightened risk of car accidents, traumatic injuries, various forms of cancer, high blood pressure, strokes, and suicide. Furthermore, high levels of drinking can lead to alcohol abuse or dependency.

Physical Health Consequences

The physical toll of increased alcohol consumption among women is significant. Women have a greater likelihood of developing alcoholic liver diseases such as hepatitis (liver inflammation) and are more prone to dying from liver cirrhosis (a chronic disease that impairs the liver's functioning in digestion and detoxification). Alcohol-induced brain damage, including mental function decline and reduced brain size, is more common in women than in men. Heavy drinking in women also elevates the risk of many conditions:

• Osteoporosis. This condition leads to weakened bones.
• Falls and hip fractures. Increased susceptibility to falls and serious bone injuries.
• Premature menopause. Early onset of menopause.
• Infertility and miscarriages. Problems with conceiving and maintaining a pregnancy.
• High blood pressure and heart disease. Increased risk of cardiovascular issues.

Alcohol and Breast Cancer

Regular alcohol consumption can increase a woman's likelihood of developing breast cancer. Each additional 10 grams of alcohol daily (equivalent to one 4-oz glass of wine) can increase the relative lifetime risk of breast cancer by approximately 10%.

To illustrate, a woman who doesn't drink has nearly a 9% lifetime risk of developing breast cancer. This risk increases to just over 10% with two drinks per day and approximately 13% with six drinks per day.

These health challenges not only affect women’s well-being; they lead to increased healthcare costs and strain on medical resources. 

Mental Health and Well-Being

Beyond physical health, women’s mental health is profoundly impacted by alcohol. Alcohol misuse is often associated with mental health disorders like depression and anxiety. Women are also more prone to using alcohol and other substances to self-treat conditions like depression, anxiety, and stress, or to manage emotional challenges.

The cycle of drinking to cope with mental health issues, which are in turn exacerbated by alcohol, creates a detrimental loop. This not only affects women’s quality of life but also their ability to function effectively in various roles.

Alcohol During Pregnancy

Ingesting alcohol while pregnant can lead to a range of physical and mental developmental issues in the unborn child, making it the top preventable reason for intellectual disabilities in the United States. Alcohol consumed by a pregnant woman easily reaches the fetus through the placenta. Since a fetus’s digestive system processes alcohol much more slowly than an adult's, the alcohol levels in the fetus's blood can remain elevated for an extended period of time.

Drinking any type of alcohol in any amount can be detrimental to a fetus, especially during the initial two trimesters of pregnancy. Doctors and public health experts strongly advise against any alcohol consumption during pregnancy.

Societal Costs.

On a broader scale, the societal impacts are substantial. Increased healthcare costs due to alcohol-related health issues are just the tip of the iceberg. There's also a loss of productivity in the workplace, increased rates of absenteeism, and potentially higher instances of alcohol-related accidents and injuries. Moreover, there's a social cost in terms of the increased need for social services, law enforcement, and support systems for families affected by alcohol misuse. 

Although there are specific issues of alcohol use that affect women, alcohol negatively affects everyone’s health and well-being. To protect against these harms, let’s learn how we can cut back or quit drinking. 

How To Cut Back or Quit Drinking

Cutting back or quitting drinking will have many positive benefits for your health and well-being. The first step to changing your lifestyle is always recognizing the negative effects of drinking on your body, especially how alcohol can more severely affect women than men. 

• Set realistic goals. Set limits on the number of drinks per week or plan alcohol-free days. Gradual reduction is crucial for those aiming to quit, to avoid withdrawal symptoms.
• Understand triggers. Identify your triggers, which can include stress, social situations, or certain times of the day. Once these triggers are identified, you can think of ways to avoid or manage them. If after-work happy hour is problematic, suggest the group go to dinner or play games instead. If being frustrated triggers a craving, practice deep breathing, count to ten, or remove yourself from the situation.
• Build a support network. Quitting alcohol is tough, and having a strong support network is essential for navigating this journey. This support can come from various sources — family, friends, support groups, or a therapist. A reliable support system offers accountability, encouragement, motivation, and a secure environment to share both struggles and triumphs. Studies show that people who have backing from their family and friends tend to be more successful in quitting alcohol compared to those without such support.
• Develop new habits. One challenge of quitting drinking is finding new ways to cope with stress and other emotions that may have previously been dealt with through alcohol consumption. To help fill this gap, it's important to develop new healthy habits that can provide stress relief and improve your overall well-being. Some healthy habits to consider include exercise, meditation, yoga, journaling, or engaging in a hobby. These activities help reduce stress and improve your mood, while also providing a positive outlet for your energy and emotions.
• Practice self-care. Techniques like meditation, yoga, or even simple breathing exercises can help manage cravings and reduce the urge to drink. Regular exercise and healthy eating can also improve overall well-being and reduce reliance on alcohol. Getting enough sleep boosts your energy and increases emotional regulation, which help fight emotional triggers.
• Seek medical and professional help. Seeking professional help provides an opportunity to address harmful behaviors and thought patterns in a supportive setting. If you suspect that your alcohol consumption has caused health issues — whether physical, mental, or both — it's vital to consult with your doctor. They can conduct essential health checks and direct you to suitable treatment options, helping you achieve better health and addressing any health conditions.

Summing Up

Anyone who has faced the challenge of recovering from alcohol dependence or abuse understands the difficulty of this journey. Alcohol has negative impacts on everyone, but some of these effects can be more severe for women than men. However, research also indicates that women have an equal chance of recovery as men once they start treatment. It’s never too late to start the recovery process or take your first step toward an alcohol-free lifestyle!