Background Alcohol use is the seventh leading risk factor for death and disability globally, resulting in close to 2.8 million yearly deaths in 2016. The Global Burden of Disease (GBD) Study is a global enterprise, informing and developing policies through comprehensive systematic analysis of comparable data using standardised methodology. GBD estimations have become more robust for recent iterations, with new methodological improvements. The Nordic population is unique in cultural similarities, as well as having strong social and welfare programs. Alcohol is a societal issue, with a complex association with health. Therefore, any underlying notable differences across these Nordic nations will provide additional insights into population level exposure to alcohol harms, thereby informing country-specific alcohol control policies.

Methods We set out to estimate the burden of alcohol related fatal and non-fatal health outcomes in six Nordic countries (Greenland, Denmark, Finland, Sweden, Iceland, and Norway) for 2019, using the most recently available GBD Compare data. Disability-Adjusted-Life -Years (DALYs) and total deaths attributable to alcohol were estimated using the GBD comparative risk assessment framework. Improvements to GBD methodology related to alcohol estimation process, such as access to more recent data and accounting for compositional bias, and factoring in abstention, tourism-related and unrecorded information in statistical modelling. 95% Uncertainty Intervals (UI) are provided.

Results In 2019, Greenland had the highest DALYs per 100,000 (2931; 95% UI: 2074–3904) followed by Denmark (1927; 95% UI: 1678–2199); Finland (1840; 95% UI: 1578–2149); Sweden (1292; 95% UI: 1069–1549); Iceland (892; 95% UI: 722–1088); Norway (887; 95% UI: 733–1081). Total estimated deaths attributable to alcohol use were: 40 (Greenland); 3532 (Denmark); 2634 (Finland); 4340 (Sweden); 71 (Iceland); 1263 (Norway). Gender variations were also noted.

Conclusion Despite strong cultural, social and welfare ties, the Nordic countries showed notable differences in the burden of alcohol-related mortality and morbidity in recent years. This can be in part attributed to changing alcohol control policies across these nations resulting in different consumption patterns. Denmark, Greenland, Sweden and Finland showed relatively high burden compared to Norway and Iceland.