The latest health and lifestyle surveys show we have gone on the roller-coaster ride of consumer capitalism without a safety bar in place, writes Fintan O'Toole.
If you listen to the business news, you will sometimes be informed in sombre tones that consumption is down. Consumer confidence is falling. We are not buying enough. Like falling profits or rising unemployment or soaring inflation, its undesirability can be taken entirely for granted.
Every now and then, however, the concept that there might be too much consumption gets a brief airing. Too much alcohol, too many cigarettes, too many drugs, too many layers of fat on the body put there by too many fast-food meals and too much sugar. The publication of the Department of Health's National Health and Lifestyle Surveys this week is such a moment.
We've known for a long time, of course, that there are two kinds of malnutrition. There's the starvation that haunted this country 150 years ago and shaped modern Ireland. There's also the over-indulgence that haunts the rich West, and that makes 64.5 per cent of US adults overweight and 30.5 per cent obese (double the proportion in 1980).
And, at some level, we probably realise that we're on a journey between The Great Hunger and Fast Food Nation. With Irish obesity rates rising from 11 per cent of men in 1998 to 14 per cent in 2002 and from 9 per cent of women in 1998 to 12 per cent in 2002, we are closer now to the problems of feast than those of famine.
The symptoms of over-consumption are obvious enough, after all. We don't need surveys to tell us that we have a problem with the abuse of drink and drugs, that too many people still smoke, that we eat too much of what's bad for us.
It is not any great surprise to learn that nearly a third of men and over a fifth of Irish women drink more than the recommended safe limit for alcohol.
It is only when we think about what is supposed to cheer us up that the full extent of the problem hits home.
It's a sign of hope, apparently, that the number of 10- to 11-year-olds who say they've had a drink in the last month has dropped by two thirds, or that the number of boys who were really drunk at least 10 times has fallen from 15 per cent in 1998 to 7 per cent in 2002. The very fact that it now makes complete sense to include pre-adolescent children in national surveys of drinking habits ought to shake us to the core.
All of these figures are based on what people choose to remember, or to put it another way, on how honest we are about our drinking. The possibility that we are not very honest at all, that even the worrying statistics are in fact a form of denial, is suggested by one easily-missed detail. Almost 6,000 adults were surveyed. But just under half - 2,966 people - actually responded to the question about alcohol consumption.
The same may well apply to drugs. On the face of it, the survey suggests, for example, that six times as many Irish men have used magic mushrooms in the last month than have used heroin. It is quite possible that this is true and that for every heroin addict straining the available services like the Merchants Quay Project in Dublin to breaking point, there are six blissed-out children of nature with mushroom juice on their lips lying in fields marvelling at Technicolor sheep.
But it seems rather more likely that while using magic mushrooms is an exotic adventure that nobody minds owning up to, heroin use is still covered up.
It's not as if Irish people don't worry about the price of oral gratification. We're trying to give up butter. We're trying to give up smoking. We're trying to stop our children drinking. Women at least have become very conscientious about having their blood pressure checked. But there's a kind of indulgence at work here too. Instead of being able to observe level-headed limits, we seem to swing from too much to too little.
The astonishing 13 per cent of the population that's on a diet at any one time shows that guilt about consumption has itself become another form of consumerism. You deal with the downside of prosperity by buying another range of products that carries the same false promise of happiness.
That 15 per cent of our children report that they never have breakfast during the week suggests that the idea of stable, sensible consumption of food is falling prey to the erosion of family life and of the family meal that is a feature both of poverty at one end of the scale and of overworked two-income households on the other. It surely tells us something about the nature of the Irish family now that both boys and girls rate their best friends as easier to talk to than either their mothers or their fathers.
It is also striking that as well as creating the problems of over-indulgence, money is also seen as the cure. The greatest single factor identified by those surveyed (36.3 per cent of men and 45.4 per cent of women) as preventing people from improving their health is financial problems. Logically, this cannot be true. Giving up smoking or cutting down on the drink or having a bowl of Bran Flakes rather than a fry costs less, not more. Going for a walk costs nothing. But in a society dominated by the ethic of consumption, health itself is seen as something you can buy.
This is not to say that health is simply a matter of lifestyle. The surveys show time and again that social class and education - which in Ireland tend to amount to the same thing - have a huge impact on healthy and unhealthy behaviour.
You can see this starkly among children. It's not accidental that, for example, over twice as many 10- to 11-year-olds in the lowest socio-economic categories than in the highest classes admit to having been really drunk. Or that while 37 per cent of 15- to 17- year-old boys in the lower categories smoke, only 23 per cent of those in the privileged echelons of society do so.
But this in turn is about much more than money. All those nebulous but inescapable factors like happiness, a sense of being in control and a sense of fulfilment must have a major bearing on the use of mind-altering substances. Bombarded with the values of consumption but unable to live the lifestyle projected in the advertisements, young people in underprivileged circumstances often seek the most immediate and accessible forms of gratification.
It's not just the losers in the new economy who feel powerless, however. Underlying all of the figures in surveys may be the fallacy that a consumer society is one in which people feel empowered. The messages that tell us to seek happiness through retail therapy are predicated on the notion that purchasing is power. Yet coming out of the greatest boom in the history of the island, many Irish people still seem to feel that they themselves are out of control.
We still have great difficulty with the simple notion of looking after yourself. Large numbers of us binge-drink on a regular basis, rendering ourselves purposely incapable of being responsible for our actions. Nearly a quarter of Irish men own up to driving while over the limit. About the same proportion still refuse to wear a seat-belt even in the front seat of a car.
And most astonishingly of all, 43 per cent of sexually active women and 26 per cent of sexually active men admit that they don't always use contraception or protection when they have sex. Aside from those in stable relationships actively trying to conceive, that still leaves Ireland as a carnal Las Vegas where games of roulette are played, with pregnancy and venereal disease as the stakes.
This kind of recklessness suggests a society that has gone on the roller-coaster ride of consumer capitalism without the safety bar of a set of social values and without the sense of balance that stops you from becoming dizzy.
Consumption, the surveys tacitly remind us, is a word that has two meanings and one of them is a life-threatening disease.
The latest National Health and Lifestyle Surveys were carried out in 2002 for the Department of Health. The report focuses on two cross-sectional studies - adults aged 18+ years and school-going children aged 10-17 years. The adult study is based on a random electoral register sample of 5,992 adults, conducted by post. The chidren's study is based on a random sample from Department of Education school lists of 93 schools/5,712 pupils, conducted by post