The impact of the cost-of-living crisis on health is linked to, and exacerbated by harmful alcohol use. In our recent article in The Lancet Regional Health Europe, we explored the cost-of-living crisis in the UK and its potential impact on public health. This crisis, caused by factors such as high inflation, trade disruption, Brexit, and the COVID-19 pandemic, has significant implications for the population’s health. We argued that it is crucial to consider the health implications of the crisis and the policy responses to it, as well as to build back better, fairer, and differently.
The cost-of-living crisis has pushed many households into poverty, forcing individuals to choose between “eating or heating”. Housing insecurity is also a significant risk, with income reductions making housing less affordable, leading to stress and homelessness. The pathways linking poverty and income insecurity to mental health have a direct and immediate impact, including dealing with stress through self-medicating behaviours, an increased likelihood of developing alcohol use disorders or harmful drinking behaviours.
Increased alcohol consumption, caused by or combined with economic stress, can impact mental wellbeing, increasing depression and anxiety, as well as physical effects of increased cardiovascular, liver and cancer health issues1,2. Alcohol consumption is also closely linked to health inequalities, with those already experiencing poverty and economic stress more likely to suffer the negative health outcomes associated with excessive alcohol consumption3,4. The burden of alcohol-related harm is often borne disproportionately by the most vulnerable populations, exacerbating existing health inequalities.
In our article we presented a case study illustrating how increasing home energy costs pose a threat to mental health. Increases in the energy cap without appropriate policy responses could take an additional 4.8 million people into poverty, with over 440,000 additional children at risk of developing common mental disorders (CMDs). Although the UK government’s targeted policy responses could mitigate some of the effects, 2.8 million people still risk falling into poverty, resulting in 362,000 more people at risk of CMDs. Hence, there is a need for a whole-of-government response and investment in public and third-sector organisations to address the crisis. We also highlighted the importance of considering the long-term effects of the crisis, including the climate emergency, and the need for urgent and drastic action to avoid catastrophic climate change.
How does this link to alcohol?
Alcohol related harm creates additional financial burden on individuals, families, and society as a whole. Alcohol-related harm in the UK is estimated to cost at least £21 billion per year5, with healthcare costs accounting for approximately £3.5 billion in England alone6. In addition to healthcare costs, alcohol-related harm also impacts the economy through lost productivity, absenteeism, and premature mortality. Alcohol-related absenteeism alone costs UK businesses over £1.7 billion per year7. Furthermore, alcohol-related mortality leads to lost income and productivity, with an estimated cost of over £6 billion per year8. The burden of these costs is borne disproportionately by those on low incomes, exacerbating existing health inequalities.9
The role of the alcohol industry
It’s important to note that the alcohol industry has a significant role to play in harmful alcohol consumption, particularly in times of economic stress. The industry has historically opposed policies aimed at reducing alcohol consumption and related harms10, such as minimum unit pricing, and has been known to use its influence to shape policy to promote its own interests rather than those of public health11. During the COVID-19 pandemic the industry heavily marketed alcohol as a coping mechanism, encouraging people to drink to alleviate stress and anxiety caused by the crisis12, 13, 14. Such marketing can be particularly harmful to vulnerable populations, exacerbating existing health inequalities.
Conclusion: How should we approach the cost-of-living crisis?
Addressing the root causes of economic stress and poverty, such as low wages and high living costs, can have a positive impact by reducing harmful alcohol consumption and negative health outcomes15,16. It can also help to alleviate the economic burden of alcohol-related harm on individuals, families, and society. Policy interventions aimed at reducing alcohol-related harm, such as minimum unit pricing, have been shown to be effective in reducing alcohol consumption and related harms while generating revenue for the government9.
Targeted interventions and accessible and affordable mental health services can also reduce the risk of alcohol-related harm for those struggling with economic stress17.
Failing to address the complex interplay between economic stress, harmful alcohol consumption, and public health can have significant individual and social consequences. It is therefore essential that policymakers, public health professionals, and other stakeholders work together to develop and implement interventions that address the root causes of the cost-of-living crisis, remain vigilant of the industry’s activities, and hold industry accountable for its role in harmful alcohol consumption. By taking a holistic approach that recognises the impact of economic stress on alcohol related harms, we can help to alleviate their burden on individuals and society, while also promoting economic stability and reducing health inequalities. The time to act is now.
Written by Dr Philip Broadbent, Specialty Registrar in Public Health, NHS Dumfries and Galloway.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.