The map shows considerable geographic variation in alcoholic cirrhosis mortality rates; rates among states in the West region were higher than among those in other US census regions.

Figure 1. State age-adjusted alcoholic cirrhosis mortality rates (men and women combined) and associated alcohol policy score tertiles. Mortality rates from 2010–2011 were compared with alcohol policy scores from 2008 to introduce a 2- to 3-year lag. States with the highest tertile of alcohol policy score (ie, strongest policy environment) are marked by 3 asterisks (***); the middle tertile, by 2 asterisks (**); and the lowest tertile, by a single asterisk (*).

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The 3 scatterplots show that, as the proportion of AI/ANs increased, so did mortality rates among males, females, and males and females combined.

Figure 2. Relationship between proportion of American Indians/Alaska Natives in states’ populations and age-adjusted alcoholic cirrhosis mortality rates of states among (2a) both sexes [r² = 0.320, P < .001], (2b) males [r² = 0.473, P < .001], and (2c) females [r² = 0.217, P = .001], United States, 2010–2011. Solid line represents curve of best fit determined by the least-squares method. Hashed lines represent upper and lower 95% confidence intervals.

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