When the party is over


An ability to ‘skull’ 16 pints doesn’t make a man masculine – it makes him unhealthy, writes MICHAEL KELLY

EXCESSIVE ALCOHOL consumption is one of the most significant threats to the health of Irish men, according to public health campaigner Prof Joe Barry of Trinity College Dublin.

“In terms of the global burden of disease, the World Health Organisation puts alcohol in the top three,” he says.

“Given that Irish men have nearly the highest alcohol consumption rates in the world, it’s fair to say that it is causing very significant harm to their health.”

According to figures in the Department of Health and Children’s recently published National Men’s Health policy document, Irish men drink on average 14.3 litres of pure alcohol per annum – twice that of men surveyed in other European countries.

Young men aged between 18 and 29 years drink even more comparatively – up to 17.9 litres a year. The 2007 Slán survey of lifestyle, attitudes and nutrition found that Irish men drink far more than their female compatriots – 45 per cent of men reported drinking at least two to three times a week, compared with 29 per cent of women. Just 15 per cent of the men surveyed were non-drinkers.

But it is not just the amount of alcohol that we drink which is dangerous, but also the type of drinking. Nearly 60 per cent of all drinking occasions for Irish men involve binge drinking (five or more units) which is widely recognised as the most dangerous pattern of alcohol consumption.

There is a major misconception that the health problems caused by alcohol are confined to alcoholics, Barry says.

“The problem we have in this country is that our overall consumption is too high across the board. Our consumption rate is 15 per cent higher than the EU average and we have a long way to go just to get ourselves in line with that average.

“The drinks industry is dead set against that happening because of course they are business people making a profit and they make the same profit on the tenth pint that a man drinks as they do on the first.”

Excessive alcohol consumption can have a serious impact on the physical health of men (see panel), increasing the risk of obesity, high blood pressure, certain cancers, heart failure and liver disease.

There is a proven causal relationship between alcohol consumption and more than 60 different types of disease and injury. “It has a multi-dimensional health impact,” says Barry. “First and foremost it affects the brain and when young men drink they are more likely to be dependent when they get older. It affects all the organs and the peripheral nervous system. It increases blood pressure, and the incidence of cancers, stroke and epilepsy.”

Excessive alcohol consumption also has a significant impact on the mental health of men. Studies in Britain show that the alcohol-dependent population is more than seven times more likely to be depressed than the non-dependent population.

It is also believed that alcohol is a very significant factor in suicides. At a conference in Cork late last year, public health consultant Dr Declan Bedford referred to that link when he said: “The Irish suicide rate increased consistently from 1980 to 2006 with a slight drop in recent years. The alcohol consumption rate mirrors the suicide rate. The more a nation drinks, the more alcohol-related harm there will be.”

In addition to these substantial physical and mental health issues, excessive drinking has serious social consequences. Irish men experience more adverse consequences of drinking than their European counterparts, such as getting into a fight, partaking in criminal or anti-social behaviour, being in an accident or engaging in unsafe sex.

In the Slán survey 17 per cent of men owned up to consuming two or more alcoholic drinks and then getting behind the wheel of a car in the previous year. In 2003, 90 per cent of drivers involved in fatal road traffic accidents, where alcohol was a contributory factor, were male.

Part of the problem which public health professionals face in dealing with these issues is that drinking is seen as a masculine thing to do and is often the only environment in which men bond. A quote from one of the men participating in the National Men’s Health Policy consultation phase is telling about the attitude of men to drinking: “If I can’t skull 16 pints,” he said, “I’m not a real man.”

The association between excessive drinking and “masculinity” is compounded according to the policy document by the drinks’ industry sponsorship of sport. The most popular sports in Ireland are quite literally saturated in drinks industry sponsorship (Gaelic games with Guinness, soccer with Carlsberg, and rugby with Guinness, Heineken, Magners and Bud Light) and promotional campaigns contain not-so-subliminal masculine overtones that suggest a link between alcohol consumption and masculinity, strength and performance. “There is a link between marketing and consumption and also a link between consumption and harm,” says Barry. “So, by extension, there is a link between marketing and harm. Government is talking about phasing out drinks industry sponsorship in sport and I certainly hope that happens soon.”