COST EFFECTIVENESS CHANGES IN NATIONAL ALCOHOL USE

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Moderate alcohol use is associated with a lower incidence of coronary heart disease than is abstention. However, consumption, even in moderation, is not without risk, including a progressive rise in consumption to excessive levels. It is of great importance to determine how changes in the patterns of national alcohol use could affect public health. This project will examine the probable effects of changes in national alcohol consumption through the Coronary Heart Disease (CHD) Policy Model, a computer-simulation state-transition (MARKOV) model of CHD in adults in the United States. The model uses data from the national surveys and published cohort-studies to predict CHD incidence and mortality, revascularization procedures, and non-cardiac mortality. Longitudinal changes in the incidence of coronary heart disease (and associated changes in morbidity, mortality, and costs_) that occur following in the prevalence of moderate alcohol consumption will be estimated. Changes in non-cardiac mortality that may occur with different magnitudes of alcohol intake will be predicted across a range of assumptions about the likelihood of moderate consumption escalating to excessive use, and the cost-effectiveness of different patterns of alcohol consumption will be assessed. These changes will also be modeled separately in people of different gender and history of CHD. These results may prove of interest to public health professionals trying to balance the population wide risks of alcohol abuse and CHD, physicians who care for patients with these illnesses, and members of the public hoping to avoid these diseases.