Alcohol and Public Health: Failure and Opportunity

In 1986, I had dropped out of graduate school and was working as a temporary typist to pay my rent. I happened into a job with an alcohol policies project started by the Trauma Foundation, an injury prevention organization housed at San Francisco General Hospital. That was the beginning of my public health career and my focus on alcohol policies.

From the start, I was driven much more by a desire to create a more just and equitable world than by any particular personal experiences with alcohol. My work on alcohol policy has been less about why I chose alcohol than why I stayed with it: because it touches so many important aspects of human life. I often refer to alcohol as “the great cofactor.” In addition to its more obvious role in disease and addiction, alcohol causes significant social problems for both drinkers and nondrinkers. Alcohol contributes to and worsens interpersonal violence and unintentional injuries such as drownings and falls, is a leading cause of birth defects and developmental delay and a carcinogen, and exacerbates a range of disparities from health outcomes to national development.^1–8

References

1. Cherpitel CJ, Ye Y, Bond J, et al. Multi-level analysis of alcohol related injury and drinking pattern: emergency department data from 19 countries. Addiction. 2012;107(7):1263-1272. https://doi.org/10.1111/j.1360-0443.2012.03793.x
2. Parker RN, McCaffree KJ. 2013. Alcohol and Violence: The Nature of the Relationship and the Promise of Prevention. New York: Lexington Books; 2012.
3. Cherpitel CJ. Focus on: the burden of alcohol use—trauma and emergency outcomes. Alcohol Res. 2013;35(2):150-154.
4. Maier SE,West JR. 2001. Drinking patterns and alcohol-related birth defects. Alcohol Res Health. 2001;25(3):168-174.
5. Goding Sauer A, Fedewa SA, Bandi P, et al. Proportion of cancer cases and deaths attributable to alcohol consumption by US state, 2013–2016. Cancer Epidemiol. 2021;71(Pt A):101893. https://doi.org/10.1016/j.canep.2021.101893
6. Mulia N, Ye Y, Greenfield TK, Zemore SE. Disparities in alcohol-related problems among White, Black, and Hispanic Americans. Alcohol Clin Exp Res. 2009;33(4):654-662. https://doi.org/10.1111/j.1530-0277.2008.00880.x
7. Room R, Jernigan D. The ambiguous role of alcohol in economic and social development. Addiction. 2000;95 Suppl 4:S523-S535.https://doi.org/10.1080/09652140020013755
8. Room R, Jernigan D, Carlini Cotrim B, et al. Alcohol in Developing Societies: A Public Health Approach. Helsinki and Geneva: Finnish Foundation for Alcohol Studies and World Health Organization; 2002.