In her Feb. 8 commentary “A crisis in need of urgent attention,” Susan Shepard Carlson describes prenatal alcohol exposure as “a major public health crisis.” While commenting on a national study, she raises concerns about Minnesota by noting that 22.6 percent of Minnesota women binge-drink — the fourth-highest rate in the country. Recent data from the Minnesota Department of Health support her concern: 18.1 percent of pregnant women in Minnesota reported using alcohol while pregnant and 5.4 percent of pregnant women reported binge drinking in the preceding month, with an average of three binges per month. Too many babies are put at risk, which truly is a public health crisis.
Unfortunately, what most Minnesotans don’t understand, or choose to ignore, is that prenatal alcohol exposure is just the tip of the iceberg of the problems caused by alcohol. Alcohol causes countless diseases, car crashes, intentional and unintentional injuries, and crimes. Each year approximately 1,700 Minnesotans die due to alcohol. And for each death, there are numerous hospitalizations, emergency-room visits and EMS responses.
Sadly, Minnesota’s alcohol-related problems are increasing. From 2000 to 2016, the alcohol-related death rate increased by more than 50 percent. Since 2005, the increase in the number of alcohol-related deaths has matched that of opioids. Notably, the number of alcohol-related hospitalizations is more than 40 percent higher than for opioids.
Abuse of alcohol is a public health crisis of staggering proportions that is largely unrecognized and certainly not seriously addressed. In fact, recent policy changes to allow Sunday sales of alcohol and to loosen restraints on brewers and distillers of alcohol have actually increased the availability of alcohol.
Education about the problems of excessive alcohol use is often offered as a way to decrease harm, but studies show it’s one of the least effective approaches. One of the most effective ways to reduce the harm of overconsumption is to increase the price. Studies have shown that a 10 percent increase in the price of alcohol will lead to a reduction of alcohol consumption of at least 5 percent to 8 percent. The reduction is seen in all drinkers, from the light to the abusers. Canada saw a 10 percent price increase lead to a 32 percent reduction in alcohol-related deaths. The improvement was in both acute conditions such as alcohol poisoning and chronic conditions such as cirrhosis of the liver.
One approach used by many countries is to set a price floor for alcohol, that is, setting the lowest possible price that can be charged by a retailer. Besides raising the price of alcohol, this helps eliminate drink specials that often lead to excessive alcohol consumption.
Another approach is to increase the alcohol tax. The federal tax on alcohol has been the same since 1991, and Minnesota’s tax is at the 1987 level. Neither levy is indexed to inflation, so each year alcohol becomes cheaper. The impact on public health of increasing the alcohol tax would be significant. Studies show that adding 50 cents to the price of the average six-pack of beer or a bottle of wine would reduce alcohol-related deaths by 35 percent, fatal car crashes by 11 percent, sexually transmitted disease rates by 6 percent, violence by 2 percent and crime by 1.4 percent.
Beyond the human suffering, alcohol also takes a huge economic toll on Minnesota. A 2007 Health Department study estimated the economic costs associated with alcohol use in Minnesota as $5.06 billion, or $975 for every Minnesotan. In 2007, these costs were 17 times greater than the $296 million in tax revenue collected from alcohol sales, and they have only increased since then.
Unfortunately, alcohol abuse is so pervasive that most Minnesotans fail to recognize it as a major public health problem, even though it is the third leading cause of preventable death. That needs to change. Our policymakers must show courage and leadership by increasing the price of alcohol. Raising the alcohol tax would be the most effective way to help reduce the economic, health and societal burdens caused by alcohol. Just adding a dime a drink would protect babies before birth along with every Minnesotan from the damaging effects of excessive alcohol use. It’s a small but appropriate price to pay to keep Minnesota healthy and safe.
Dr. Edward Ehlinger is a former commissioner of the Minnesota Department of Health.