The macroeconomic burden of four alcohol-attributable diseases in China, 1990–2023, and projections to 2030: results from GBD 2023

BACKGROUND: Alcohol consumption contributes markedly to the global burden of disease, but macroeconomic assessments of alcohol-attributable diseases in China remain limited. Using Global Burden of Disease (GBD) data, this study quantified the macroeconomic burden of four alcohol-attributable diseases in China: alcohol use disorders (AUD), alcoholic cardiomyopathy (ACM), cirrhosis and other chronic liver diseases due to alcohol use (ALD), and liver cancer due to alcohol use (LCA). MATERIALS AND METHODS: Disability-adjusted life year (DALY) data for the four diseases from 1990 to 2023 were extracted from GBD 2023. The macroeconomic burden was estimated using the value of lost welfare (VLW) approach, which combined DALYs with age-adjusted value of a statistical life year (VSLY) estimates derived from willingness-to-pay methodology. Results are expressed in 2021 international dollars and as a percentage of GDP. Temporal trends were evaluated using Joinpoint regression analysis, and exploratory forecasts to 2030 were generated using ARIMA, XGBoost, and LightGBM models. RESULTS: < 0.001). Males predominated across all conditions, with male-to-female VLW ratios of 7:1 (AUD), 10:1 (ALD), 3:1 (LCA), and 14:1 (ACM) in 2023. Age at peak VLW varied: 35-39 years for AUD, 50-59 years for ALD, 65-69 years for LCA, and 50-54 years for ACM (shifted from 35-39 years in 1990). Conditional on the continuation of their respective historical trends, the three models produced divergent exploratory projections to 2030. CONCLUSION: The macroeconomic burden of four alcohol-attributable diseases in China increased markedly from 1990 to 2023, with AUD consistently dominating and the burden overwhelmingly concentrated among males aged 35-64 years.