After studying public health in Ireland, I noticed that my professors and authors, whose texts I read, differed from my American public health professors in one major way: the topics of focus differed largely between the two nations. In America, my studies have often tended to focus on obesity, HIV/AIDS, and global development. In contrast, my studies in Ireland focused largely on alcohol and substance abuse, mental health, and salt intake. Although I recognize these subject matters are largely a reflection of my interests and not necessarily a reflection of the United States’ global health agenda, I couldn’t help but notice the discrepancy. As a result, I took great interest in alcohol as one of Ireland’s popular health-related topics; in particular, alcohol as a component of the post-2015 global health agenda.
“Alcohol: a Key Determinant for Ill Health and an Obstacle to Development,” a paper from the Global Alcohol Policy Alliance for the WHO’s call for papers in the Health in the Post-2015 Development Agenda, highlights how alcohol use and abuse contributes to non-communicable diseases (NCDs), has many detrimental social and economic implications, instigates violence, affects family life, and threatens the development of the next generation.
Though the 2011 United Nations High Level Meeting discussed the need to concentrate on health-related incidents and diseases pertaining to alcohol use, the MDGs have not yet addressed this topic directly. This is concerning, seeing as alcohol is the world’s third risk factor for death and disability and in 2010, there were 4.9 million deaths related to alcohol. Furthermore, alcohol use is becoming more and more popular among youth. Consequently, the coming generation is experiencing lack of motivation, violence, and/or NCDs that in the past tended to affect an older generation. And the consumers of alcohol are not the only ones that feel its effects—alcohol can cause violence, drain economic resources, or complicate or cause other diseases, all of which have a detrimental effect on family, friends, and caregivers.
The article seeks to halt and reverse these troubles by combatting the source of the problem: alcohol. The authors suggest regulating alcohol sales to deter those who cannot afford to buy alcohol from buying it and to reduce alcohol consumption overall. They recommend bolstering alcohol-related health services as a strategy to be used in tandem with regulating alcohol sales—there should be primary health care services dedicated to rehabilitating alcohol-related health problems as well as providing support and guidance for alcohol users. Finally, the authors emphasize the need for international backing of the WHO’s alcohol-related interventions.
Ireland has taken particular notice of alcohol as a concern for the post-2015 health agenda because alcohol has a measurably poor impact on its people. In Ireland, there are twice as many alcohol-related deaths than deaths attributed to all other drugs combined, with alcohol factoring into one third of unnatural deaths and accounting for 4.4% of deaths nationwide. One in four emergency accidents and traumatic brain injuries involve alcohol, and alcohol liver diseases have more than tripled since 1995.
Ireland can prevent many alcohol-related disasters by equipping people with appropriate alcohol education and awareness in schools, clinics, community centers, and support groups. Efforts have already been made in this regard. Ireland’s Drink Aware foundation supports a variety of student alcohol education campaigns like University of Limerick’s “Be Honest With Yourself” campaign, an informational video campaign addressing the consequences of over-drinking.
University of Limerick also championed an Alcohol & Identity educational campaign that points out the positive effects of drinking responsibly. Additionally, Ireland’s Alcohol Action charity sponsors an annual Alcohol Awareness Week, which focuses on raising awareness of the dangers associated with alcohol. This campaign is particularly effective in that it reaches a variety of demographics: youth, adults, academics, policy makers, and more.
Moreover, Ireland can combat alcohol-related issues by instituting alcohol treatment and support programs in primary health care settings, increasing the likelihood of people encountering alcohol-related health services and obtaining the information, support, or treatment that they might need. An example of this would be the UK’s Four-Tier model of care, a treatment system applied to substance abusers. This method involves four levels of patient care: the first level includes sharing basic drug and alcohol-related information to the patient. The second level includes advice and treatment referrals. The third tier involves more tangible interventions in specialized community or clinical settings, including detoxifications or therapy. The fourth tier encompasses the most severe interventions, where hospitalization or inpatient rehabilitation programs may be necessary. Though this program has yet to be fully instituted in Ireland, it is at the very least on health executives’ radars—the next step is its actual implementation.
Overall, Ireland has identified the need to focus on alcohol as a key concern in the post-2015 health agenda. Given the significance of the issue, it will be interesting to see how the problem is tackled and perhaps even addressed on a global scale.