Allegheny County Health Department Chronic Liver Disease: On the Rise in Allegheny County
Chronic liver disease was the 11th leading cause of death in the United States in 2017. Cirrhosis, which is Allegheny County the most common chronic liver disease, is characterized by healthy liver tissue becoming replaced Fast Facts with scarred liver. Chronic liver disease may not cause • Liver disease, which kills symptoms in its early stages, leading to delayed ~300 residents annually, diagnosis and less effective treatment. is one of few chronic Chronic liver disease mortality has been increasing in diseases that is increasing Allegheny County, Pennsylvania, and the entire U.S. over the past two decades. in incidence among county residents Chronic Liver Disease Mortality Rates† • This increasing rate is 24 2000-2017 likely due to the high 19.8 burden of obesity and 20 15.8 hepatitis in the region 16 14.7 14.2 • In Allegheny County,
12 11.2 death from chronic liver disease is more common adjusted rate/ 100,000 10.9 - 8 among than among
Age men women and more common among blacks Allegheny County Pennsylvania USA than among whites. Data source: CDC Wonder
Risk Factors for Chronic Prevalence of Chronic Liver Disease Risk Factors Liver Disease & Cirrhosis: 80 2016-2018 64 66 • Heavy alcohol use 60 • Excess body weight (BMI >25) 40 23 18 • Hepatitis B & C infection 20 9 11 • Diabetes Percent of Population (%) • Hereditary liver 0 Diabetes Binge Drinking§ Overweight (BMI>25) diseases Allegheny County Pennsylvania ACHD 2020 Data source: BRFSS via EDDIE, PADOH Disparities in Mortality from Chronic Liver Disease Chronic Liver Disease affects various demographic groups differently based on a variety of factors, including socioeconomic status, access to care, environmental exposures, health-related behaviors (such as diet and alcohol use), and genetic factors.
Chronic Liver Disease Related Mortality‡ Chronic Liver Disease Related Mortality‡ in Allegheny County by Gender in Allegheny County by Race 45 2000-2017 40 2000-2017 33.6 33.0 35 35 28.9 30.5 30 25 23.8 17.2 25 14.2 A 19.8 15 20 adjusted adjusted 100,000 rate/ adjusted adjusted 100,000 rate/ 5 15 Age - Age -
Male Female White Black Data source: CDC Wonder Average Annual Liver Disease-Related Allegheny County Health Dept. Mortality by Etiology* 2008-2017 Recommendations 6 5.4 For Adults 5 4.0 • Maintain a BMI less 4 3.7 3.6 3.3 than 25 3 2.7 • Avoid alcohol or limit
2 1.6 to ≤1 drink daily for adjustedrate/ 100,000 - 0.9 women and ≤2 drinks Age 1 0.3 0.3 daily for men 0 Alcoholic Fatty Liver Hepatitis B Hepatitis C Liver Cancer • Get tested for Liver Disease Disease Hepatitis C at least Allegheny County Pennsylvania once as an adult (18+) Data source: CDC Wonder †Include deaths with underlying cause ICD-10 codes K70, K73, K74, K76, B18. ‡Include deaths with any cause ICD-10 codes K70, K73, K74, K76, B18. *Includes deaths with any cause ICD-10 codes Alcoholic Liver Disease (K70), Fatty Liver Disease (K76.0), HBV (B16, B18.0, B18.1), HCV (B17.1, B18.2), Liver Cancer (C22.0). §Binge drinking is defined as ≥5 drinks/ day for men or ≥4 drinks/ day for women in past month. Kochanek et al. Deaths: Final Data for 2017. National Vital Statistics Reports; vol 68 no 9.National Center for Health Statistics. 2019. | Heidelbaugh JJ, Bruderly M. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation. American Academy of Family ACHD 2020 Physicans; 74:756 –762. 2006. | Yoon & Chen. Liver Cirrhosis Mortality in the United States: National, State and Regional Trends, 2000- 2015. National Institute of Alcohol Abuse and Alcoholism. U.S. Department of Health and Human Services. 2018.