01.07.2014 Alcohol abuse: the greatest damage is to the economy
Alcohol-related costs. Excessive alcohol consumption weighs heavily not only those directly affected, but also on society as a whole – to the tune of over four billion francs a year. This is the conclusion of a study commissioned by the Federal Office of Public Health (FOPH). The bulk of the costs is borne by the economy: alcohol-related productivity losses amount to CHF 3.4 billion a year.
Alcohol abuse is a risk factor for 60 diseases as well as for accidents and acts of violence, and it causes productivity losses at the workplace. In the reference year 2010, alcohol consumption in Switzerland generated costs totalling 4.2 billion francs. As the study "Alcohol-related costs in Switzerland" shows, this corresponds to 0.7 percent of GDP or annual per capita costs of CHF 630 in the population aged over 15.
Economy bears 80 percent of the damage
Productivity losses to the economy generate costs of 3.4 billion francs, i.e. 80 percent of total costs. Of this amount, 1.2 billion francs are incurred directly by employers when, because of a hangover for instance, employees absent themselves from work unannounced or perform below standard. Mortality and morbidity account for costs of 0.5 billion francs to the enterprises. Mortality refers to loss of production resources, i.e. workforce, as a result of early deaths. Morbidity refers to workforce losses resulting from illness or early retirement. The remaining 1.7 billion francs are lost to the overall economy as a result of reduced prosperity.
Healthcare system: 613 million francs
In the healthcare system, a further 613 million francs of direct costs are incurred as a result of alcohol abuse. They include the cost of treating alcohol-related illnesses, accidents and injuries. At 405 million francs, the cost of residential treatment is almost twice as high as that of outpatient treatment (208 million).
Penal system: 251 million francs
Alcohol abuse promotes criminal offences such as acts of violence or drunken driving. The cost to the public finances, i.e. the police, justice and penal systems, is 251 million francs. The police accounts for almost half of these costs (113 million francs). Prison inmates detained for alcohol-related offences cost the public finances 75 million francs. The justice system accounts for a comparatively small portion of costs (64 million francs) because only unsolved cases generate such outlays. Convicted wrongdoers generally pay any administrative costs themselves.
Who actually pays?
In nominal terms, the employers pay the bulk of the direct costs, i.e. an estimated 1.7 billion francs. This sum includes the above-mentioned losses due to lower productivity and to mortality and morbidity. The remaining 1.7 billion francs of economic costs are incurred at the expense of social prosperity, i.e. they are paid by the economy as a whole and ultimately by society. The direct costs incurred in the healthcare and penal systems are borne by the social insurance funds (298 million) and the state (387 million), in other words the taxpayers. The remaining 179 million francs are costs incurred by private households in the form of medical insurance deductibles and contributions, which, for data availability reasons, were not accessible to the study. These are the only private costs taken into account.
Everyone benefits from prevention
Ultimately, therefore, it is the population as a whole that pays the cost of alcohol abuse – society bears collective responsibility. Prevention of alcohol abuse helps reduce the resulting costs and is therefore in the interests not only of employers and the social insurance funds but also of all citizens. In the "Health 2020" report on health-policy priorities, the Swiss government insists that efforts to promote health and prevent disease are to be stepped up. This would also reduce the economic costs generated by unbalanced diet, lack of physical activity and excessive consumption of alcohol and/or tobacco. In addition, the National Programme on Alcohol (NPA) specifically envisages measures that aim to reduce the negative effects of alcohol consumption on public life and the economy.
Various prevention projects
Two projects aimed at reducing costs have already been initiated. In the healthcare sector: a project to encourage self-help and a programme promoting brief interventions by family doctors. A model project on hospital referrals in cases of alcohol intoxication is also under development. The aim is to systematise cooperation between medicine, prevention, young people directly affected and their parents. At present, the procedures involved from referral to discharge vary from hospital to hospital. The model is designed to increase the effectiveness of treatments and lower their costs. Moreover, the basis for tackling the topic of alcohol & violence and measures for protecting young people at events requiring authorisation have been drawn up. Thanks to the increase in test purchases and in training courses for sales staff, enforcement of the
legal age for the sale of alcohol is expected to improve. Numerous projects are devoted to raising public awareness of the risks of problematic alcohol consumption.
Platform for employers
The FOPH and a wide-ranging alliance of partners support numerous projects in the framework of the National Programme on Alcohol. A study shows that employers in particular incur very high costs as a result of alcohol abuse. The platform www.alkoholamarbeitsplatz.ch offers, among other services, information and support measures for workplace prevention programmes.
Gabriela Scherer, joint head of Alcohol Section, firstname.lastname@example.org