Some Factors Affecting the Geographic Comparison of Alcoholism Prevalence Rates. Implications for the Use of the Jellinek Estimation Formula

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Abstract
This is a statistical dissection of the parameter that serves as the heart of the Jellinek estimation formula, namely, the reporting of deaths with cirrhosis of the liver. Statistical analysis was made of the differences between ratios of directly recorded cirrhosis-of-the-liver deaths (1083 deaths) to associated or contributory cirrhosis deaths (518 deaths), as affected by population size, by whether or not an autopsy was performed, and by age of the decedent. The analyses showed that cirrhosis was more likely to be certified as the underlying cause of death in areas of larger population size, in areas where autopsies are performed more frequently, and in younger decedents. These differences suggest that, as recorded on current death certificates, all cirrhosis appearing thereon, and not just that recorded as underlying cause, should be taken into account if cirrhosis mortality data are to be used in the estimation of the number of alcoholics.