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Are Americans Drinking Themselves to Death?

Alcohol destroys more lives than all other drugs combined. Why aren't policy makers wringing their hands over that?

While our current political conversations often involve concerned discussions about marijuana’s imagined dangers or potential benefits (the most recent Republican and Democratic debates both dedicated time to the question of pot legalization), our most problematic relationship actually seems to be with alcohol. America, it seems, has a drinking problem—and studies indicate it is only getting worse. There are real reasons, in addition to the pressing issue of mass incarceration and the failure of the drug war, for us to start thinking seriously about the cost of our increasing reliance on alcohol when we consider the ravages of drug use. Particularly since the toll of alcohol, though often left out of that conversation, actually outpaces those of every other legal and illicit drug combined.  

Drinking is on the rise in the U.S. Precipitously. A study released this year from the Institute for Health Metrics and Evaluation finds that heavy drinking among Americans rose 17.2 percent between 2005 and 2012. Not only are Americans drinking more, but in an increasing number of cases, they’re consuming those drinks in rapid succession. The same study found that binge drinking increased 8.9 percent nationally during the same time frame. In 2012, 8.2 percent of Americans were heavy drinkers, meaning they had one drink per day on average over the course of a month. An additional 18.3 percent of Americans that year fit the description of binge drinkers, defined by the CDC as men who have five or more drinks and women who have four or more drinks in a single drinking session.

It's women, by the way, who have largely driven these increases. In the years between 2005 and 2012, binge drinking increased just 4.9 percent among men, but jumped 17.5 percent among women. The reason for such a significant rise is likely due to changing social mores, according to Tom Greenfield, scientific director at the Alcohol Research Group, who spoke with Kaiser Health News. Men still drink more than women do, but women have narrowed the gap in recent years.

Binge drinking, always a favorite sport on college campuses, has also become more prevalent. A 2013 study from the Center for Addiction Medicine at Massachusetts General Hospital found that women in college binge-drink more often than male students. “It's not that the percentage of young people is increasing alcohol use,” George Koob, the director of the National Institute on Alcohol, told NBC News. “It's that bingeing is more intense.”

Even with so many Americans drinking more, the actual proportion of Americans drinking is the same as it’s long been. Per the HME study, “56 percent of people in the U.S. consumed…alcohol in 2005 [through] 2012.” Ali Mokdad, the lead researcher on the HME study, told USA Today, “The percentage of people who drink is not changing much, but among drinkers, we are seeing more heavy drinking and more binge drinking. We're going in the wrong direction.”

In big picture terms, the wealthiest and most educated people are most likely to drink. A Gallup poll released earlier this year confirmed that more affluent Americans drank more often than their poorer peers. “Whereas eight in 10 adults in these socio-economic status groups say they drink, only about half of lower-income Americans and those with a high school diploma or less say they drink.” (There was a racial component as well: 69 percent of non-Hispanic whites say they drink alcohol, compared with just 52 percent of nonwhites.) The reasons for the class discrepancy are likely varied; Gallup theorizes that greater means leads to more frequent involvement in activities that involve drinking, such as going on vacation, dining out and socializing with coworkers.

It also seems likely that the culture of overwork in professional environments contributes to heavier drinking. As office hours grow longer and the average workweek increases, so too does the need to blow off steam. Not to mention that drinking is ingrained in many office social cultures. As Tom Greenfield points out, “The influx of young, wealthy professionals in San Jose, Oakland and San Francisco—many in hard-working, hard-partying tech jobs—may have helped spur the Bay Area’s significant increase in binge-drinking rates.” Big jumps in drinking rates in Silicon Valley (Santa Clara county saw a 28 percent increase in drinking between 2002 and 2012, the largest increase in California) further supports this idea.

In a 2009 New York Times piece, Arthur C. Brooks suggests that goal-driven, ambitious people drink because success often feels hollow. Brooks writes that scaling the ranks “may initially relieve stress as people rise into the middle class, [but] it seems to introduce a whole new set of stressful problems for those who keep climbing.” Brooks rhetorically poses, and then answers, the question of coping mechanisms:

“Here’s one that many people try: Drink a lot. Research from 2010 found that people with high incomes reported consuming more alcohol than people of more modest means. Specifically, 81 percent of respondents making over $75,000 per year drink alcohol, versus 66 percent of those making $30,000 to $49,000 and 46 percent earning under $20,000.”

It seems important to recognize that while more affluent people drink on average, the consequences of drinking are often less severe than they are for poorer Americans. Researchers suggest this is partly because, despite drinking similar amounts, poorer people tend to drink to excess more often than wealthier people, who spread their consumption over more time. One study, cited by Psychology Today, found that upper-middle-class drinkers generally had 2-3.5 alcoholic beverages each day. “Conversely people close to the bottom of the income ladder mostly divide into two extremes. Either they do not drink at all, or they drink to excess.”

“Educated, affluent [people] enjoy a glass of wine every night,” Ali Mokdad told USA Today. “They can afford it, and they are cautious about their health.”

But Diane Hietpas, of the Menominee Tribal Clinic in Keshena, Wisconsin, seemed to offer the most insightful take on the issue. “[P]eople don't understand that this is a symptom of a much larger problem of poverty and trauma,” Hietpas told the paper. “Our people are hurting.” Following years of recession, war and social upheaval, it seems likely that her statement has applications across socioeconomic groups.

The price of drinking is astronomical in every way. A recent report from the Centers for Disease Control finds that binge drinking among Americans costs the country nearly $250 billion annually in lost productivity in the workplace, alcohol-related crimes and treatment for the health issues that result from excessive alcohol consumption. While the wages of Americans’ boozing have always been pretty high, the study notes that costs have notably increased in recent years. In 2006, the price of binge drinking for the nation was $223.5 billion, the equivalent of $1.90 per drink. By 2010, the figure rose to $249 billion, or $2.05 a drink. Perhaps unsurprisingly, the lion’s share of those costs, 77 percent, were related to binge drinking.

Of far greater concern should be the ways in which alcohol destroys lives. The CDC estimates that alcohol was linked to 88,000 annual deaths in America between 2006-2010, while the agency found that 38,329 people died of drug overdoses in 2010. According to the Foundation for a Drug-Free World, alcohol is the cause of death for more American teenagers than all other drugs combined, and is “a factor in the three leading causes of death among 15- to 24-year-olds: accidents, homicides and suicides.” The New York Times reports that, on average, six Americans die of alcohol poisoning each day. Three quarters of those who died were 35 to 64 years old. And 30 percent of Americans report that they’ve had enough struggles with alcohol at some point in their lives that it could be considered a problem.

Drinking is, in many ways, America’s pastime. But unlike other culturally shared activities, it often carries a hefty cost. None of this is intended to diminish the impact of a number of other social ills that desperately need to be addressed. Yet it does seem clear that misplaced fearmongering about, say, medical marijuana should be less of a legislative item than how we drink and why we drink, and how we can drink less.


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A More Equitable Economy Exists Right Next Door

In Quebec, co-ops and non-profit businesses account for 8-10 percent of GDP.

Business owners gather at an elegant Montreal event center to celebrate the 20th anniversary of a large-scale economic partnership.  The former chief of Quebec’s largest bank is the guest of honor.

Sidewalks bustle with people walking in and out of homes, offices, bank, pharmacy, workout studio and coffee shop at Montreal’s Technopole Angus, a development that already sports 56 business with 2500 employees and will eventually encompass a million-square-feet of real estate.

Morning-shift workers unload barrels of paper onto conveyor belts emptying into giant shredding machines on the shop floor of Recyclage Vanier, a Quebec City firm specializing in secure disposal of confidential documents.

A line snakes down the street for a matinee at the Cinema Beaubien, an art deco moviehouse in a quiet Montreal neighborhood. Taxis line up across the street waiting for customers who will soon be getting out of the early show.

Leonard Cohen’s gravelly voice rings through the taproom at La Barberie Brewery, located near Quebec City’s business district. Its Belgian-style saisons and blackberry blanc beers are enjoyed throughout the province. A few blocks away, an 18th-century monastery inside Quebec City’s historic walls has recently opened its doors as a hotel and spa.

Welcome to everyday life in Quebec, Canada’s second largest province with 8.2 million people. Yet these scenes of economic activity are different in a notable way from similar ones occurring throughout North America. Each enterprise involves a cooperative or non-profit organization, which together make up 8-10 percent of the province’s GDP.  More than 7,000 of these “social economy” enterprises ring up $17 billion in annual sales and hold $40 billion in assets (Canadian dollars). They account for about 215,000 jobs across Quebec.

Quebec’s social economy (also translated as “solidarity economy”) extends far beyond the province’s two major cities and includes manufacturing, agricultural cooperatives, daycare centers, homecare services, affordable housing, social service initiatives, food coops, ecotourism, arts programs, public markets, media and funeral homes. The capital that fuels all this economic activity comes from union pension funds, non-profit loan funds, credit unions, government investment and philanthropy.   

“We always say the social economy is simply the formalization of the commons. It’s social ownership, the goal of which is a sustainable, democratic economy with a market—instead of a market economy,” explains Nancy Neamtan, co-founder of Chantier de l’Economie Sociale, a network of social economy organizations whose anniversary banquet is described above. “Our mission is building a broader vision of what the economy actually is.”

“When Chantier started out, a lot of people said it wouldn’t work. We had unions, women’s organizations, green groups, and many thought it was too diverse,” Neamtan says. “But it does work.” Evidence for her assertion is visible all around—Chantier’s office is tucked into a six story building that takes up most of a city block, all of which is filled with social economy organizations.  

Not all of these social businesses are new—some of the credit unions, cooperatives and union pension funds go back a hundred years. “But they were largely invisible to many people until the name social economy became popular,” Neamtan adds.

Quebec’s social economy ranges from a video game creator’s cooperative to a social integration program for Haitian immigrants to a coop grocery in a remote town on the Gaspe peninsula to a network of 8000 home healthcare workers, half of whom were on welfare before being trained for the field.  Here are more examples showing the range of these enterprises:

Groupe Paradoxe: Chantier de l’Economie Sociale’s 20th Anniversary celebration was staged in a renovated church run by Groupe Paradoxe, which teaches at-risk young people job skills in the booming audio-visual presentation, events and meetings industries.  

Desjardins Group: The banker honored for his work at Chantier’s banquet was former president of the Desjardins credit union, founded in 1900 and today the province’s largest financial institution.   

The Nitaskinam Cooperative: Also on hand at the banquet was Nitaskinam, an Inuit-run cooperative which designs clothing inspired by art of the Atikamekw people, which has doubled from three to six members in its first year. “The social economy is our traditional economic model and fits with our values,” explains co-founder Karine Awashish, who is also an economic development official of this tribal nation. “I see good opportunities for us to create new social economy jobs in forestry, health services, tourism, arts festivals and youth projects.”

UTILE Student Housing Cooperative: One of the youngest entrepreneurs at the banquet, Laurent Levesque, helped launch a student housing development organization with other activists involved in the headline-grabbing 2012 Quebec Student Strike, collaborating with Chantier de l’économie Trust.  “Students pay 70-80 percent more in rent on average,” he explained, “which creates an inflationary spiral” that hurts not just them, but their low-income neighbors.  With start-up capital from the Concordia Student Union and further funding from social economy partners like Desjardins and the province of Quebec, UTILE is set to break ground on apartments for 160 students.

Technopole Angus: It’s no coincidence that that the Desjardins credit union has a branch in the new Technopole Angus sustainable urban village, which brings opportunities to a working class neighborhood that was rocked when the Canadian Pacific Railway shuttered its machine shops in 1992.  A number of historic brick structures were repurposed, and new eco-friendly buildings constructed, with more planned for the project’s phase II.  The community will eventually include 500 affordable housing units, 450,000 square-feet of office space, 20 local shops, four public squares, a bike-pedestrian main street and a one-acre urban farm growing organic produce.    

Recylage Vanier: A non-profit organization started 30 years ago by two out-of-work men who realized the recycling industry could benefit the disadvantaged as well as the earth, Recylage Vanier offers training for people struggling to find work because of low job skills, recent immigration, substance abuse, mental illness, disability, or other challenges.  Jobseekers arrive here for a 24-week program that emphasizes work readiness and life skills as well as on-the-job experience.  Most are long-term unemployed, who have been sent by the Quebec employment bureau and social service groups.

“They have to get along with a boss, get along with colleagues, master simple tasks and then take on new ones with more responsibility, all the way up to driving a forklift,” says Nicolas Reeves, one of Vanier’s managers.  For the final four weeks, they split their time between the recycling plant and job hunting with the help of staff counselors. About 85 percent of graduates find work, and 10 percent seek further education, according to Reeves. Recylage Vanier faces stiff competition from two private companies in the field, so clients who value the organization’s mission are important to their success—including the province of Quebec, which provides about half their business.  

Cinema Beaubien: This is non-profit neighborhood moviehouse explicitly proclaims its mission to “defend the primacy of persons and labor over capital in the distribution of its surpluses and incomes.”  The cinema’s importance as a community gathering spot can be witnessed in the long lines at the ticket booth, where patrons merrily chat with one another rather than staring at their phones. Taxis wait across the streets to whisk moviegoers to their next destination, about half of which are from the Taxi Coop Montreal.  (In Quebec City, all taxi drivers belong to a cooperative.)

La Barberie Cooperative Microbrewery: Operating as a worker cooperative for the past 20 years explains the success of this brewery and brewpub, says general manager Jean-Francois Genest, who joined La Barberie three years ago after running his family’s bookstore and later converting another bookstore into a cooperative. “The co-op is a good plan to keep a place going. Sharing the profits means you attract the best workers. For our part, we try to make their jobs as interesting as possible, offer more holidays and higher pay.” Emilie DuMais, who’s tended bar here for eight years, notes, “You have much more ambition working for yourself than working for someone else.”

Le Monastere des Augustines: A convent dating back to 1700s in the heart of Quebec City’s walled city has just opened as an elegantly renovated hotel, spa, museum and conference center. It is organized as a non-profit in accordance with the social mission of nuns still living there to promote holistic health and spiritual renewal. Besides tourists, spa patrons and participants in corporate meetings, guests also include activist groups holding retreats and health care workers seeking a reprieve from the stress of their jobs.

RISQ: In 1997 Chantier created RISQ (Reseau d’Investissement Social du Quebec), which has invested $25 million in technical aid and capital for social economy businesses, resulting in: 1786 new jobs, 5,119 jobs maintained and job training for 1527 marginalized workers across Quebec, according to their calculations.  RISQ financial analyst Nathalie Villemure, who worked for many years in private banking, notes that they see fewer defaults than commercial lenders. “These people have a cause bigger than themselves, so they work harder and we help them find solutions.”

Fiducie: In 2007 Chantier launched Fiducie, a $50 million “patient capital” (or slow money) fund that provides long term, non-guaranteed loans of $50,000-1.5 million to promising cooperatives and non-profits with less than 200 employees. “We don’t expect to see anything in repayment for 15 years,” says General Manager Jacques Charest. Thirty million of the investment came from union pension funds with the rest from the federal and provincial governments.   

What We Can Learn from Quebec’s Social Economy

While Quebec possesses a distinct culture and history, the emergence of a strong social economy across the province provides practical lessons for other places.  

Recognize the Social Economy When You See It

Cooperatives and non-profit initiatives already exist throughout the US and most other countries, so the first step is seeing, naming and claiming the social economy as part of the commons we all share.  

Look Widely for Inspiration & Ideas

Neamtan points out that the American tradition of community organizing was a big influence on their early work, especially community development corporations (CDCs) that arose to tackle problems of disinvestment in urban neighborhoods. The Dudley Street Initiative, which transformed a low-income community in the Roxbury district of Boston, was a particular inspiration for her. The proliferation of cooperatives in the Basque and Catalonian regions of Spain provided another model for bottom-up economic development.  

Seek Solidarity

Social economy initiatives benefit from the longstanding sense of solidarity in Quebec, where French speakers were discriminated against and their local economy dominated by English-speaking Canadians, Americans and English.  A analogous situation can be found among racial and social minorities, and in rural and deindustrialized regions where economic power is wielded from outside.

Tap the Power of Government

Government agencies have been a partners and funders in many projects through the years. Social economy initiatives often arose even when conservative politicians were slashing government programs to provide a more humane alternative to strictly market-oriented development. Legislation passed by the left-center Parti Quebecois in 1997 gave the social economy movement a big boost by offering local governments more leeway in supporting community and cooperative efforts to create jobs and promote entrepreneurship.

Partner with Unions

“The labor movement boosted the social economy by making the choice in the 1980s not to just negotiate contracts but to create jobs and support civic enterprises,” explains Neamtan, which led to the creation of the landmark Quebec Solidarity Fund, an $11-billion-dollar pension fund, of which 65 percent is invested in small- and medium-sized Quebec-owned businesses.

Partner with Faith Organizations

Historically, the Catholic church controlled many aspects of life in the province, and priests enthusiastically promoted cooperatives and non-profit institutions as models of the church’s social teaching. By the end of the 20th century when the church’s influence waned in the face of increasing secularization, social economy organizations found numerous opportunities to set up shop in closed churches and convents.  The church remains an ally, Neamtan notes, “especially now that Pope Francis talks all the time about the Solidarity Economy.”


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