Las Vegas Review-Journal (Sunday)
Alcohol killing U.S. women in record numbers
Researchers point to a cultural shift, ‘equal rights tragedy’
The ads started popping up about a decade ago on social media. Instead of selling alcohol with sex and romance, these ads had an edgier theme: Harried mothers chugging wine to cope with everyday stress. Women embracing quart-sized bottles of whiskey and bellying up to bars to knock back vodka shots with men.
In this new strain of advertising, women’s liberation equaled heavy drinking, and alcohol researchers say it both heralded and promoted a profound cultural shift: Women in America are drinking far more, and far more frequently, than their mothers or grandmothers did, and alcohol consumption is killing them in record numbers.
White women are particularly likely to drink dangerously, with more than a quarter drinking multiple times a week and the share of binge drinking up 40 percent since 1999, according to a Washington Post analysis of federal health data. In 2013, more than a million women of all races wound up in emergency rooms as a result of heavy drinking, with women in middle age most likely to suffer severe intoxication.
This behavior has contributed to a startling increase in early mortality. The rate of alcohol-related deaths for white women ages 35 to 54 has more than doubled since 1999, according to The Post analysis, accounting for 8 percent of deaths in this age group in 2015.
“It is a looming health crisis,” said Katherine M. Keyes, an alcohol researcher at Columbia University.
Although independent researchers are increasingly convinced that any amount of alcohol poses serious health risks, American women are still receiving mixed messages. Parts of the federal government continue to advance the idea that moderate drinking might be good for you. The National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health, is overseeing a new $100 million study, largely funded by the alcohol industry, that seeks to test the possible health benefits of moderate drinking.
Meanwhile, many ads for alcohol — particularly on social media — appear to promote excessive drinking, which is universally recognized as potentially deadly. These ads also appear to violate the industry’s code of ethics, according to a Post analysis of alcohol marketing.
“We saw it first with tobacco, marketing it to women as their right to smoke. Then we saw lung cancer deaths surpass deaths from breast cancer,” said Rear Adm. Susan Blumenthal, a former U.S. assistant surgeon general and an expert on women’s health issues. “Now it’s happening with alcohol, and it’s become an equal rights tragedy.”
Alcohol marketing is regulated primarily by industry trade groups, but dozens of studies have found lapses in their record of enforcing the rules. As a result, an international group of public health experts convened by the World Health Organization’s regional office in Washington, D.C., plans to call in January for governments worldwide to consider legislation similar to laws adopted a decade ago to curtail tobacco advertising.
“The industry’s system of self-regulation is broken,” said Thomas F. Babor, a professor at the University of Connecticut School of Medicine who is aiding the effort. “The alternatives are clear: Either you have to take their system and put it into independent hands, or you have to go with a partial or full legal ban on alcohol marketing.”
Officials with the Distilled Spirits Council of the United States, one of the largest U.S. trade groups, defend their record of oversight, saying it has received high marks from federal regulators.
“The Council’s Code of Responsible Practices sets more stringent standards than those mandated by law or regulation, or that might be imposed by government due to First Amendment constraints,” council Senior Vice President Frank Coleman said.
DISCUS tells members that ads should not “in any way suggest that intoxication is socially acceptable conduct.” The Beer Institute tells members that their “marketing materials should not depict situations where beer is being consumed rapidly, excessively.” And the Wine Institute prohibits ads that make “any suggestion that excessive drinking or loss of control is amusing or a proper subject for amusement” or that directly associate use of wine with “social, physical or personal problem solving.”
But the trade groups acknowledge that they do not investigate or act on possible violations unless they receive a formal complaint.
“The rise in hazardous drinking among women is not all due to the ads. But the ads have played a role in creating a cultural climate that says it’s funny when women drink heavily,” said Jean Kilbourne, who has produced several films and books about alcohol marketing to women. “Most importantly, they’ve played a role in normalizing it.”
‘NO GENDER EQUITY’
As it happens, drinking can be especially hazardous for women.
Women tend to have smaller bodies than men, and differences in physiology that make blood-alcohol levels climb faster and stay elevated longer. Some studies have found that women have lower levels of the stomach enzymes needed to process the toxins in alcoholic beverages.
As a result, according to the Centers for Disease Control and Prevention, women are more prone to suffer brain atrophy, heart disease and liver damage. Even if a woman stops drinking, liver disease continues to progress in ways it does not in men, said Gyongyi Szabo, a professor at the University of Massachusetts Medical School. And research definitively shows that women who drink have an increased risk of breast cancer.
“There is no gender equity when it comes to the effects of alcohol on men versus women,” Szabo said. “Females are more susceptible to the unwanted biological effects of alcohol when they consume the same amount of alcohol and at the same frequency — even when you adjust for weight.”
Many women don’t know this — nor do they understand what constitutes excessive drinking, said Robert Brewer, leader of the CDC’s alcohol program. For women in the United States, anything more than one drink a day is considered excessive. That’s 1 ounce of distilled spirits, 12 ounces of beer or 5 ounces of wine.