Rehm, Jurgen, Chisholm, Dan, Room, Robin and Lopez, Alan D. (2006). Alcohol. In Dean T. Jamison et al. (Ed.), Disease control priorities in developing countries2nd ed. (pp. 887-906) New York, USA: Oxford University Press.
Alcohol constitutes a serious public health problem, accounting for 4 percent of the global burden of disease and a significant social burden. The negative effects of alcohol, ranging from high blood pressure and liver damage to accidental injuries and deaths, outweigh known benefits such as reduction in coronary heart disease. Most studies on adverse effects of alcohol are focused on average high–risk drinking, defined as 20 grams per day or more of pure alcohol for females and 40 grams per day or more for males. However, the impact of high–risk drinking may be determined in part by social circumstances. A study of adult men in England and Wales showed that individuals from the lowest socioeconomic class, unskilled laborers, had a 15–fold higher risk for alcohol–related mortality than did professional men. This suggests that the impact of alcohol on disease and mortality may be more potent in countries with greater poverty and nutritional deficiencies. Cost–effective interventions can reduce the burden of alcohol–related disease by up to 25 percent, depending upon the region of the world. Policy makers should realize that cost–effectiveness is based on experience in market economies and may be more or less in the developing world. However, reducing the alcohol–related health burden in developing countries will have the added benefit of reducing the alcohol–related social burden, thereby further contributing to development.