Females from 1999 to 2008 showed a negative trend (APC − 0.9298%/year, 95% CI: -1.2649 to -0.5937, P = 0.000038), changing into an upward trend shift from 2008 to 2018 (APC 0.9979%/year, 95% CI: 0.6830 to 1.3138, P = 0.000008), continuing through 2018 up until 2021 (APC 8.0298%/year, 95% CI: 4.7989 to 11.3602, P = 0.000085) (Fig. 3 C).
Trends of other causes according to ethnic/racial background have also shown a similar trajectory to alcohol-induced trends, as from 1999 to 2008, the Black/African American population have shown a marked descend (APC − 2.9179%/year, 95% CI: -3.3539 to -2.4800, P < 0.000001), and from 2008 to 2014, kept decreasing (APC − 0.3465%/year, 95% CI: -1.4012 to +0.7194, P = 0.487667), with even a further descend from 2014 until 2018 (APC − 2.1343%/year, 95% CI: -4.3455 to +0.1281, P = 0.061945); however in 2018, a major shift occurred with a positive trend up until 2021 (APC +6.3883%/year, 95% CI: +1.8690 to +11.1081, P = 0.009410), followed by a major descend from 2021 to 2023 (APC − 4.2571%/year, 95% CI: -8.2248 to -0.1179, P = 0.044907) (Fig. 4 C).