Alcohol ranks as the number one health risk in all but two countries

Alcohol ranks as the number one health risk in all but two countries – Canada and the United States – in the Americas, according to a publication of the Pan American Health Organization (PAHO).

This is not due primarily to "alcoholism," however. The biggest problem is overconsumption by people who just drink "socially."

"The biggest misconception people have is that the problem of alcohol is alcohol dependence or alcoholism," says Maristela Monteiro, PAHO regional advisor on alcohol and substance abuse. "In terms of society, most public health problems come from acute intoxication." In other words, she explains, most of the homicides, traffic accidents, suicides, violence, domestic violence, child abuse or mistreatment and neglect are the result of "heavy drinking occasions" by people who mostly are not alcoholics or alcohol dependent.

The article, "The Problem with Drinking," appears in the latest edition of Perspectives in Health, PAHO's magazine.

The article notes that in the United States, alcohol is a factor in 25 per cent of deaths among people aged 15 to 29. Its direct costs to the U.S. health care system reach some $19 billion and to the U.S. economy as a whole, as much as $148 billion.

Public health experts note that alcohol takes a disproportionate toll on the poor because they spend a greater share of their income on alcohol and when they have drinking problems they have less access to services, may lose their jobs and bring major hardships to their families.

"For all these reasons," the article notes, "many public health experts believe that alcohol policy should be a top priority in every country of the Americas."

The most effective ways of reducing overall consumption are by increasing prices and taxes on alcohol and restricting availability: where it can be sold, to whom and by whom, at what times and on which days. These public health measures have proven to work well, but they often encounter opposition from business and industry.

"There are several examples – for a long time in Europe, the United States and Canada, and now in Latin America and elsewhere – that show that closing bars earlier reduces both accidents and violence," notes Monteiro.

Another highly effective measure is raising the minimum age for purchasing alcohol. The article notes that only a handful of countries have emulated the U.S. minimum age of 21 (formerly 18). The U.S. National Highway Traffic Safety Administration (NHTSA) estimates that raising the minimum drinking and alcohol-buying age in the United States has saved 17,359 lives since 1975.

The article also discusses measures to reduce drunk driving. According to the World Health Organization's Global Status Report: Alcohol Policy – quoted in the Perspectives article – the most effective countermeasures to drinking and driving are sobriety checkpoints, lowered blood-alcohol content limits, license suspension and graduated licensing for beginner drivers.

Experts are calling for more research and action to counter the toll of alcohol on public health. As Monteiro notes, "people not only die from drinking too much, they harm and kill those who don’t drink, too."

PAHO was established in 1902 and is the world’s oldest public health organization. PAHO works with all the countries of the Americas to improve the health and the quality of life of people of the Americas. It serves as the Regional Office for the Americas of the World Health Organization (WHO).

PAHO Member States today include all 35 countries in the Americas. France, the Kingdom of the Netherlands, and the United Kingdom of Great Britain and Northern Ireland are Participating States. Portugal and Spain are Observer States, and Puerto Rico is an Associate Member.