Publications [#266393] of Philip J. Cook

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1. Cook, PJ, The Social Costs of Drinking (1991), Norewegian Ministry of Health and Social Affairs
   (last updated on 2024/04/25)

   Abstract:
   Societies in which drinking is widespread experience a wide variety of negative social and economic consequences. Several accounting frameworks are commonly used to assess the relative importance of these effects, and to calculate some sort of “total cost” figure. The public health framework measures costs in terms of excess mortality and morbidity. The economic cost framework is also concerned with health effects, but measures them in terms of resulting lost productivity in employment and in the household. The economic framework also takes account of other resources expended or lost as a result of alcohol use, and measures all of these effects in monetary units. A variant of this approach distinguishes between costs borne by the drinker, and costs imposed by the drinker on other people; only the latter are deemed appropriate as a basis for government action. A review of social cost studies in the United States and other advanced western nations suggests that of the various consequences of alcohol use, two dominate the cost statistics; lost productivity due to alcohol-related morbidity, and trauma deaths due to alcohol-related accidents and intentional violence. Alcohol use is associated with absenteeism, job accidents, and poor work performance, as well as impaired productivity in household tasks. But recent research, based on population survey data in the United States, has generally found no relationship between how much a man drinks and how productive he is (as measured by his earnings, or days lost from work). While these results may prove to reflect biases in the survey data or an inadequate conceptual framework, for now there is little basis for asserting that alcohol use imposes large costs on the U.S. economy in terms of lost job productivity. On the other hand, there is firm evidence that alcohol use causes a substantial increase in total accidents and victimization from violent crime, and that these consequences are of considerable importance. Estimates of the total cost of alcohol use, whether based on the public health or economic accounting frameworks, are commonly used to quality the importance of this problem. A more appropriate use of this perspective is in the evaluation of specific policy interventions intended to reduce problems related to alcohol consumption.