OBJECTIVE Data regarding alcohol-caused health harms are required by policymakers for setting health priorities. However, these estimations are currently resource intensive, and estimates vary substantially by method. Thus, many countries, states, and regions do not track these harms. We address this limitation through creation of the International Model of Alcohol Harms and Policies (InterMAHP), an open-access alcohol harms estimator. InterMAHP consists of methodologies and program software designed to assist alcohol research teams in estimating alcohol-attributable mortality and morbidity, by region. It is available at www.intermahp.cisur.ca. Application is illustrated through updated estimates of alcohol-attributable mortality in Canada. METHOD Mortality counts and per capita alcohol sales were obtained from Statistics Canada. Drinking and bingeing prevalences were obtained from the Canadian Substance Use Exposure Database. InterMAHP automated the calculations of alcohol-attributable fractions (AAF) using the modern AAF formulation and a gamma distribution to specify the continuous prevalence distribution of consumption. RESULTS Alcohol is a leading driver of mortality in Canada. In 2016, more than 14,800 (95% CI [12,435, 17,127]) deaths were alcohol attributable, representing 5.5% of all deaths. This burden is borne disproportionately by men (79%). Among condition categories, cancer is the leading cause of alcohol-attributable mortality in both men and women. CONCLUSIONS InterMAHP has the potential to assist public health researchers globally in estimating alcohol harms. This open-access software was used to estimate alcohol-attributable mortality in Canada, which was shown to be substantial. Policies proven to reduce alcohol consumption and related harms should be considered to reduce this burden.

中文翻译：

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酒精危害和政策的国际模型：一种估计酒精健康危害的新方法及其在加拿大的酒精归因死亡率中的应用

目的决策者需要有关酒精引起的健康危害的数据，以设定健康优先事项。但是，这些估计当前是资源密集型的，并且估计因方法而异。因此，许多国家，州和地区没有跟踪这些危害。我们通过创建国际酒精危害和政策模型（InterMAHP）（一种开放获取的酒精危害估算器）来解决此限制。InterMAHP由旨在协助酒精研究团队按地区估算酒精归因的死亡率和发病率的方法和程序软件组成。可从www.intermahp.cisur.ca获得。通过对加拿大因酒精引起的死亡率的最新估算来说明其应用。方法死亡率计数和人均酒精销售量来自加拿大统计局。饮酒和暴饮暴食流行率来自加拿大物质使用暴露数据库。InterMAHP使用现代的AAF公式和伽马分布来自动计算酒精归因馏分（AAF），以指定消费的持续流行分布。结果酒精是加拿大死亡率的主要驱动因素。2016年，酒精引起的死亡人数超过14,800（95％CI [12,435，17,127]），占所有死亡人数的5.5％。男性（79％）过多地负担了这一负担。在疾病类别中，癌症是男性和女性酒精引起的死亡率的主要原因。结论InterMAHP有潜力协助全球公共卫生研究人员评估酒精危害。此开放获取软件用于估算加拿大的酒精归因死亡率，被证明是实质性的。为了减少这种负担，应该考虑采取减少酒精消费和相关危害的政策。