Public Health Has a Drinking Problem
Public health has an alcohol problem. Not a moral problem or dependency problem, but a scientific one. It’s a statement that may seem provocative at first glance, but it opens up a crucial conversation about the role of alcohol in our society and, more specifically, within the realm of public health itself. As someone deeply embedded in the public health community, this discussion is not just academic for me; it’s personal. This St. Patrick’s Day marks my sixth year without alcohol. It wasn’t a decision born out of a personal moral or dependency issue with drinking. My choice was influenced by something far more compelling: data.
In the summer of 2018, I first encountered a systematic analysis published in The Lancet, which compiled data from over 650 sources across 195 countries and territories, examining the global burden of disease attributable to alcohol consumption. The findings of this comprehensive study were startling and unequivocal. Contrary to long-held beliefs in the protective health benefits of moderate alcohol consumption, the analysis demonstrated that alcohol offers no redeeming health advantages. The stark conclusion was that alcohol consumption is unsafe at any level and does not belong in a healthy diet.
Yet, despite this compelling evidence, the public health community seems to be in a state of denial when it comes to our own practices and endorsements. Alcohol is not just a social lubricant used by society at large; it is entrenched in the very fabric of our professional gatherings. From conferences to seminars, every major event in the public health calendar seems to be punctuated with cocktail mixers and wine bars. This is not just a paradox; it's a problem.
The American Public Health Association (APHA), a leading figure in the realm of public health, took a commendable stand in 2014 by refusing to host conferences in New Orleans until the city enacted a smoking ban in bars and restaurants. This move was a public declaration of the APHA’s commitment to health-promoting environments. However, this stance starkly contrasts with the continued endorsement of alcohol consumption at these very same conferences. While we pat ourselves on the back for shunning tobacco, we simultaneously clink glasses filled with a substance that, according to robust scientific evidence, poses significant health risks.
The contradiction is glaring. How can we, as public health professionals, advocate for healthy lifestyles and policies while simultaneously normalizing and participating in behavior that directly contradicts our own research and recommendations? The message this sends is confusing at best and hypocritical at worst. It undermines our credibility and the critical public health messages we aim to communicate.
The issue at hand is not one of individual morality or choice. It is a matter of aligning our public health practices with the evidence at our disposal. If we are to lead by example, it is time for the public health community to reevaluate its relationship with alcohol. This doesn’t necessarily mean banning alcohol from every event but rather rethinking how we incorporate it into our professional gatherings and what message that sends to both our peers and the public.
Public health has an alcohol problem. But acknowledgement is the first step to recovery. By confronting this issue head-on, we have an opportunity to lead by example and champion a truly health-first approach in every aspect of our lives, both personal and professional. This St. Patrick’s Day, as I celebrate another year of my decision informed by data, I invite my colleagues in public health to reflect on our collective drinking problem. Together, we can redefine what it means to promote health, starting with our own practices.