Health Opinion

Drinking down, deaths up: Inside Australia's alcohol paradox

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Cheers, Australia! Statistics show that alcohol consumption has continued to decline (Image via Pexels)

Despite the decreasing levels of alcohol consumption in Australia, alcohol-related deaths have risen every year for the past four years. Finn Connolly examines why.

SINCE 1977, Australia has experienced a continuing, downward trend in alcohol consumption. While there are occasional fluctuations, Australians have maintained a rate of consumption of around ten litres per capita for the past decade. However, the Australian Bureau of Statistics reports that alcohol-related deaths have risen each year for the past four years.

The greater risk of alcohol-related harm, faced by disadvantaged communities and the availability of cheap, high-alcohol products may be affecting the rate of alcohol deaths.

(Source: ABS)

(Source: ABS)

The alcohol harm paradox

Studies indicate that people from advantaged communities generally drink more than or equal to those from disadvantaged communities. However, the latter experiences higher rates of alcohol-related harm. This phenomenon is known as the alcohol harm paradox.

Spokesperson for the Alcohol and Drug Foundation, Robert Taylor, explains this phenomenon and how it may relate to rising alcohol deaths in Australia:

“In these communities, there are overlapping risk factors. Someone might live in a community that has less access to resources and there may be fewer opportunities. There might already be a prevalence of drugs and alcohol.”

According to the Australian Institute of Health and Welfare (AIHW), individuals living in the five lowest socioeconomic areas of the country experience twice the rate of hospitalisation than people from the highest.

In addition to a lack of resources, Robert explains that people from disadvantaged communities are likely to face greater difficulties in seeking and receiving treatment:

There are multiple barriers to accessing treatment — these could include a lack of service availability in your area, long wait times, stigma within services, poor cultural safety.

 

Investment in publicly funded bed-based treatments for withdrawal and rehabilitation services is needed in almost all jurisdictions, as is expanded access to non-bed-based treatments like counselling.

Alcohol tax and cheap alcohol

While the average Australian is drinking less, the heaviest percentage of drinkers continue to consume high levels of alcohol. In 2019, the top 10% of Australian drinkers consumed 54% of all alcohol. Along with regular strength beer, cask wine (or “goon”) was the most popular drink for the top 10% of drinkers.

While most alcohol products in Australia are taxed by alcohol content (excise tax), wine is taxed by value (wine equalisation tax). As such, cask wine can be sold for a cheap price despite its high alcohol content.

The effect this has on Australian alcohol consumption is displayed in a 2023 study, ‘Cask wine: Describing drinking patterns associated with Australia's cheapest alcohol’, where it was found that individuals who choose cheap cask wine are twice as likely to be among the top 10% of drinkers in Australia than individuals who consume more expensive, bottled wine.

Due to the alcohol harm paradox, top drinkers who live in disadvantaged communities are at a high risk of harm.

A 2022 report from the Centre for Alcohol Policy Research shows that the top 10% of drinkers came from both advantaged and disadvantaged communities, at near equal amounts.

In disadvantaged communities, the availability of cask wine not only contributes to the high levels at which heavy drinkers consume but also the higher risk of alcohol harm.

Solution

In response to the rising death toll, Robert Taylor explains how the issue of cheap alcohol and the alcohol harm paradox can be approached:

“The availability of cheap alcohol is always an issue. Until we have better tax reform and minimum unit pricing in more places it will be an issue. The people who drink that sort of alcohol are the ones who drink the most.”

Minimum unit pricing is a strategy that has been used in the Northern Territory since 2018 which has had a positive effect on alcohol consumption.

Instead of serving as a tax, the purpose of minimum unit pricing is to set a minimum cost for a standard drink. The more standard drinks a product contains, the more expensive it will be in turn. Under the Northern Territory’s minimum unit price ($1.30), cask wine can now cost over $30.

Even after appropriate tax reform, Australians from disadvantaged communities would still experience a greater risk of alcohol harm.

Robert explains that the stigma surrounding alcoholism and seeking help is still strong and that a focus on education and accessible treatment is vital:

There is research to suggest that the median time to reach out for help is 18 years. You wouldn’t wait that long for a broken arm. But people are waiting for something this serious.

 

We need to see an effort to invest in education and help build resilience in communities, so individuals are less likely to experience harm. We need to see greater accessibility for treatment and to encourage conversations.

Finn Connolly is a lifelong storyteller with a keen interest in writing. He currently holds a Bachelor of Communications and a major in Journalism from Western University.

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Drinking down, deaths up: Inside Australia's alcohol paradox

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