Alcohol-attributable risks pertaining to the Pierce County population are unknown. Estimation of alcohol-related mortality was based in this study on the estimates of alcohol-attributable fractions (AAF) calculated for the U.S. population in 1987^*. The application of the U.S. AAFs to the Pierce County population was based on two assumptions:

Relative risks pertaining to alcohol use and abuse are the same for the U.S. and Pierce County populations, and
Exposure of the U.S. population (1987) to the health risks relating to alcohol is considered as the lower estimate for the Pierce County population exposure to those health risks.

Alcohol-related deaths ARM_k and years of potential life lost A_YPLL_k were calculated from

ARM_k = DEATHS_k*AAF_k and A_YPLL_k = YPLL_k*AAF_k ,

where DEATHS_k and YPLL_k are the numbers of deaths and YPLL due to cause k.

The estimation of the number of the hospital bed-days A_k and visits to the outpatient hospital B_k, both pertaining to disease k and related to alcohol misuse, was performed in a similar way as it was for tobacco.

*CDC Morbidity and Mortality Weekly Report. March 23, 1990.