De impact van alcohol op de gezondheid en samenleving

5. What social and economic problems are linked to alcohol use?

• 5.1 How can work performance be affected by alcohol consumption?
• 5.2 How can the familly be affected by alcohol consumption?
• 5.3 What is the link between alcohol and poverty?
• 5.4 What is the link between alcohol and violence between partners?
• 5.5 What are the estimated economic and social costs?

Alcohol consumption can have adverse social and economic effects on the individual drinker, the drinker’s immediate environment and society as a whole. Indeed, individuals other than the drinker can be affected, for example, by traffic accidents or violence. It has an impact on society as a whole in terms of resources required for criminal justice, health care and other social institutions.

This text is a summary of: WHO Global Status Report on Alcohol 2004
 Social problems associated with alcohol use. P.59

5.1 How can work performance be affected by alcohol consumption?

Alcohol consumption can affect work performance in several ways:

• Absences - There is ample evidence that people with alcohol dependence and drinking problems are on sick leave more frequently than other employees, with a significant cost to employees, employers, and social security systems. In Costa Rica, an estimated 30% of absenteeism may be due to alcohol. In Australia, a survey showed that workers with drinking problems are nearly 3 times more likely than others to have injury-related absences from work.
• Work accidents - In Great Britain, up to 25% of workplace accidents and around 60% of fatal accidents at work may be linked to alcohol. In India about 40% of work accidents have been attributed to alcohol use.
• Productivity - Heavy drinking at work may reduce productivity. In Latvia, 10% of productivity losses are attributed to alcohol. Performance at work may be affected both by the volume and pattern of drinking. Co-workers perceive that heavy drinkers have lower performance, problems in personal relationships and lack of self-direction, though drinkers themselves do not necessarily perceive effects on their work performance
• Unemployment- Heavy drinking or alcohol abuse may lead to unemployment and unemployment may lead to increased drinking.

This text is a summary of: WHO Global Status Report on Alcohol 2004
 Social Problems associated with alcohol use, Alcohol consumption and the workplace, p.59-60

5.2 How can the familly be affected by alcohol consumption?

Drinking can impair how a person performs as a parent, a partner as well as how (s)he contributes to the functioning of the household. It can have lasting effects on their partner and children, for instance through home accidents and violence.

Children can suffer Fetal Alcohol Spectrum Disorders (FASD), when mothers drink during pregnancy. After birth, parental drinking can lead to child abuse and numerous other impacts on the child’s social, psychological and economic environment.

The impact of drinking on family life can include substantial mental health problems for other family members, such as anxiety, fear and depression.

Drinking outside the home can mean less time spent at home. The financial costs of alcohol purchase and medical treatment, as well as lost wages can leave other family members destitute. When men drink it often primarily affects their mothers or partners who may need to contribute more to the income of the household and who run an increased risk of violence or HIV infection.

Case example 1: Botswana – debt and child neglect

Case example 2: Nepal – impacts perceived by family members

This text is a summary of: WHO Global Status Report on Alcohol 2004
 Social Problems associated with alcohol use, Alcohol consumption and the family, p.60-62

5.3 What is the link between alcohol and poverty?

The economic consequences of alcohol consumption can be severe, particularly for the poor.

Apart from money spent on drinks, heavy drinkers may suffer other economic problems such as lower wages and lost employment opportunities, increased medical and legal expenses, and decreased eligibility for loans. A survey in Sri Lanka indicated that for 7% of men, the amount spent on alcohol exceeded their income.

Case example 3: Cameroon – cost of one beer represents a large share of daily wage

Case example 4: India – families affected by debt, illnesses, or injuries

Case example 5: Malaysia – exacerbation of poverty and burden on women

This text is a summary of: WHO Global Status Report on Alcohol 2004
 Social Problems associated with alcohol use, Alcohol and poverty, p.62-63

5.4 What is the link between alcohol and violence between partners?

Alcohol plays a role in a substantial number of domestic violence incidents, especially in the case of abusing husbands. Often both the offender and the victim have been drinking.

The relationship between alcohol and domestic violence is complex and the precise role of alcohol remains unclear. Heavy drinking has been strongly linked to violence between partners and to a lesser extent to violence towards others, possibly because proximity increases the opportunities for violence.

Studies conducted for instance in Nigeria, South Africa, Uganda, India, and Colombia show that a large fraction of reported domestic violence incidents is related to alcohol use by the male partner. For instance, in Uganda, 52% of the women who recently experienced domestic violence reported that their partner had consumed alcohol, and in India, 33% of abusing husbands were using alcohol. There is a need to better understand the possible role of alcohol intoxication or dependence in the processes through which incidents escalate into violence.

There is little doubt that alcohol consumption has many social consequences, but more quantifiable data is needed to enable meaningful comparisons between countries.

This text is a summary of: WHO Global Status Report on Alcohol 2004
 Social Problems associated with alcohol use, Alcohol and domestic violence, p.63-64

5.5 What are the estimated economic and social costs?

Strong efforts are made in many countries to estimate the overall economic and social costs of alcohol use.

Social and economic costs cover the negative economic impacts of alcohol consumption on the material welfare of the society as a whole.They comprise both direct costs - the value of goods and services delivered to address the harmful effects of alcohol, and indirect costs - the value of personal productive services that are not delivered as a consequence of drinking.

In industrialized countries, estimates of social and economic costs of alcohol use can reach several percent of the Gross Domestic Product (GDP), ranging for instance from 1.1% in Canada to 5-6% in the case of Italy.

Estimates of social and economic costs can help:

• make the case for public policies on alcohol,
• target policies and public expenditure on the most important problems (e.g. the costs of alcohol versus other psychoactive drugs such as tobacco),
• identify information gaps,
• assess the effectiveness of policies and programmes against alcohol abuse.

Estimating the costs of the impact of alcohol on the material welfare of society is often difficult and requires estimates of the social costs of treatment, prevention, research, law enforcement, lost productivity and some measure of years and quality of life lost.

Table 21 [bis]: Social and economic costs of alcohol abuse for selected countries

This text is a summary of: WHO Global Status Report on Alcohol 2004
 Economic and social costs of alcohol use, p.65-66