Rehab 4 Addiction

UK government research shows that alcohol misuse is now the biggest killer of working-age adults in England, overtaking 10 of the most dangerous forms of cancer.

Older and more financially deprived men are more likely to have a problem with alcohol that could kill them.

At the opposite end of the scale, women who live in less deprived areas and who are younger are significantly less likely to die from alcohol-related harm. 

This data has been released by two UK government organisations:

The Office of National Statistics (ONS), which published a paper in 2021 called “Alcohol-specific deaths in the UK: registered in 2019”, looking at alcohol-specific deaths. 

The now-disbanded Public Health England (PHE), which published a paper called “Working years of life lost due to alcohol mortality” in 2020, looking at the number of working-age years lost to alcohol-related causes in England in 2018. 

Both show similar results, and we will focus on the headline data in this article. 

What Was Measured

What was measured

The ONS looked at the number of deaths that were related to:

While the research was narrowly focused on these three direct causes, it did look at the whole of the UK, giving breakdowns for each nation.

Meanwhile, the PHE report looked at a much wider set of data including:

It worked out how many working years were lost due to alcohol by looking at deaths between the age of 16 and 64, and subtracting the age of death from the age of 65. 

If someone died at age 62 this would count as three working years, whilst if someone died at the age of 20 this would be 45 working years lost. It shows the impact of alcohol on the economy as a whole. 

The PHE however looked at only the data for England.

Using both reports we can look at alcohol-related harm across the UK and what is likely related to causes of such mortality. 

ONS – UK-wide Data  

Male mortality rate

In 2019 there were 7565 alcohol-specific deaths in the UK. Men had a far higher mortality rate at 16.1 per 100,000 population, while women had a mortality rate of 7.8 per hundred thousand. 

Nationwide, 72.2% died of alcoholic liver disease with suicide accounting for 12.7% and accidental poisoning, 6.4%. 

There was significant variation among the three nations. Northern Ireland saw a mortality rate of 18.8 per hundred thousand, while Wales was 11.8 and England was 10.9. 

Though overall UK trends were up significantly – 11.3% since 2001 – Scotland saw its alcohol-specific mortality rate plummet from 28.5 per hundred thousand in 2006 to 18.6 per hundred thousand in 2019. 

There has been a concerted effort by governments and local authorities in Scotland to tackle the mortality rate.

While Scotland still ranked second among the nations, it has seen death rates fall even as the other three nations saw a rise. 

The age factor

Age was a major factor behind alcohol-related mortality too.

The ONS showed that those between the age of 55-59 had a mortality rate of 40 per hundred thousand men and 20.5 per hundred thousand women.

Among the 60-64 age group this was 40.7 and 19.1.

Alcoholic liver disease is a cumulative illness – unless people get to grips with their drinking, they face liver failure.

This shows that older people drinking too much and not getting enough exercise shortens their lives considerably.

PHE – a Look at England


The PHE data looked at the situation in England, which as we have seen above had the lowest alcohol-related mortality rate among the four nations.

Using wider attributable mortality data, it examined what led to alcohol-related deaths and the impact on the economy as a whole.

In 2018, 178,933 working years were lost to alcohol-related fatalities.

 In England that year, 135,559 working years were lost to the ten most dangerous cancers, and many of those were linked to alcohol misuse.

This shows that at an economic level, alcohol is the biggest killer of working-age adults.  

The four biggest causes of death were:

  • Liver disease – 49,612 years
  • Accidental poisoning – 33,851 years
  • Intentional self-harm – 26,145 years
  • Transport – 9,305 years

Age difference

As discussed in the ONS statistics, the older you are the higher the alcohol-related mortality rate.

Among those aged 45-54, 57,558 years were lost, or roughly a third of all working years lost in England related to alcohol in that age group.

Considering in that age group far more people would have to physically die to have an impact on the data (between 19 and 11 years per death) you can also see far more people actually died to achieve this economic-related figure than in younger age groups.

Across all age groups, men accounted for more than 70% of those working years lost at 131,403 years and women, 47,530.

Deprivation a Major Factor


Both the PHE and ONS show a stark difference between alcohol mortality rates between those who live in better-off areas or who are better off financially and those who are classed as the most deprived.

In England, the PHE showed that over 20% (34,697 years) of the working years lost were in the most deprived 10% of people in the UK.

This contrasts with a little over 5% (8,748 years) of the deaths being from the top 10% least deprived.

Looking across the UK, the ONS showed similar data, only instead of deciles (10% groups) it looked at quintiles (20% groups).

It showed that 29.1 per hundred thousand in the most deprived quintile of the UK had alcohol-related mortality, while just 7.6 per hundred thousand of the least deprived quintile would suffer alcohol-related death. 

In short, the ONS and PHE both show that those who are the most deprived in the UK and England are four times more likely to suffer alcohol-related mortality. 

This shows that there are strong social factors at play that dictate the likelihood of severe alcohol misuse leading to mortality.

Alcohol and crisis

A lot of things lead to alcohol misuse, with evidence showing that almost anyone can end up with an acute alcohol problem. 

This evidence hints at other factors at play, with a suggestion that those who experience poverty and deprivation are more likely to misuse alcohol and drugs to change their reality.

Scotland is a country that has issues with poverty and deprivation. However, we have observed that:

  • Between 2006 and 2019 it significantly reversed the trend of increased alcohol-related mortality.
  • It has separate public health, NHS and social care systems to England. Together these services have achieved this significant fall in alcohol-related deaths.
  • This suggests that the situation where alcohol has overtaken cancer as the biggest cause of death in England can be reversed with proactive policy at a national and local level.

This situation in England can be reversed using the tools already in the hands of policymakers. Ultimately, it just takes a decision from the top and these alarming trends can be reversed.


Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.