Korea may not be one of the world’s biggest alcohol consumers, but the proportion of Koreans binge-drinking and engaging in other forms of high-risk drinking remains persistently high. In 2013, the amount of alcohol consumed per capita per year in South Korea was 8.7 liters, on a par with the OECD average of 9.0 liters (OECD, 2014). However, the rate of alcohol use disorder (AUD) in Korea was 6.2 percent in 2010, higher than the World Health Organization (WHO) average of 4.6 percent (WHO, 2014). As of 2011, one out of every 20 Koreans (4.4 percent or 1.59 million Koreans) were alcoholics (MOHW, 2012). The medical cost of treating and managing persons with AUD has been on a steady rise. The number of such persons seeking medical care increased 1.5 times from 73,000 to 114,000 over the 10 years from 2003 to 2013, while the total medical costs more than tripled from KRW 120 billion to KRW 375 billion. The WHO and the governments of various countries have been researching the socioeconomic costs of drinking. The WHO first estimated the global burden of diseases attributable to alcohol in 2003, and concluded that alcohol accounts for 4.0 percent (Rehm et al., 2003). The WHO has been estimating the Introduction << 4 Risks and Socioeconomic Costs of Alcohol-Attributable Illnesses attributable (or etiological) fractions of burdens of diseases stemming from alcohol consumption regularly since then. The Korean government, too, applies the alcohol-attributable fraction (AAF) to estimate these socioeconomic costs, but relies largely upon data available from overseas sources. This study analyzes National Health Insurance (NHI) cohort database (for years 2002~2013) to estimate the risk of illnesses attributable to drinking. The National Health Insurance Service (NHIS)’s NHI Cohort Database specifies the details of medical care provided, of medical costs, and of the data from physical checkups performed on Korean citizens, providing a comprehensive range of information on how alcohol affects these things. Based on the risk of illnesses attributable to alcohol thus estimated, this study calculates the socioeconomic cost of problematic drinking.

I. Introduction 1

II. Illnesses Associated with Alcohol: Literature Survey 5

III. Methods for Estimating the Health Risks & Socioeconomic Costs of Drinking 25

1. Estimating the Risk of Alcohol-Attributable Illnesses 27

2. Estimating the Socioeconomic Costs of Alcohol Consumption 31

IV. Results 39

1. Risks of Alcohol-Attributable Cancers 41

2. Risks of Alcohol-Attributable Cardiovascular Diseases 44

3. Risks of Other Alcohol-Attributable Illnesses 47

4. Socioeconomic Costs of Alcohol Consumption 48

5. Costs of Alcohol-Attributable Injuries & Suicides 57

V. Conclusion 63

Bibliography 67