Impact of alcohol use on economy of the Association of Southeast Asian Nations member states in 2000–2023: a structural equation modelling analysis

Background Economic growth in low- and middle-income countries is usually associated with reductions in mortality; however, it also correlates with increased alcohol use. This rise contributes to mortality and other disease burden, potentially hindering further economic growth. We quantified these associations for the Association of Southeast Asian Nations (ASEAN) countries for the years 2000–2023. Methods Structural equation modelling (SEM) was used to analyse time-series data for nine ASEAN countries with full data on economic output (Gross Domestic Product [GDP] and Gross National Income per capita at purchasing power parity [PPP]), disease burden (mortality and disability-adjusted life years [DALYs]), and alcohol exposure indicators for adults aged 15 to 65. All data were obtained from publicly available international agency sources. Findings SEM results indicate a positive association between alcohol use indicators and disease burden, which was, in turn, negatively associated with economic output. In 2021, for adults aged 15–65, alcohol-attributable mortality amounted to 5% of all-cause mortality in the region with three countries exceeding 10%; proportions for DALYs were similar. In the main model, the point estimates of potential impact on GDP PPP per capita were as high as 4%. The results remained highly consistent, irrespective of the indicators used. Interpretation Alcohol consumption in ASEAN countries over the study period hindered the ability to reap the full benefits of economic growth. Funding Centre for Alcohol Studies, Prince of Songkla University, Thailand, CAS-A1-67-002; WHO Western Pacific Region (2024/1505643-0; PO 203515367); Canadian Institutes of Health Research (FRN 181677, and FRN 203773).