By Joseph A. Califano, Jr.
Mayor Bloomberg’s efforts to improve the health of New Yorkers should be commended, but how much more it would mean if he devoted his enormous leadership talents and influence to combatting alcohol abuse instead of trying to limit the size of the soda you buy at a ballgame?
Can you believe that soon spectators at sports events at Yankee Stadium and Madison Square Garden will probably be limited to sugary sodas of 16 ounces or less while they can continue to buy beer in 24-ounce containers? New Yorkers deserve a more sensible and coherent public health policy than that.
The Mayor’s concern about obesity is understandable, but investing political capital in stopping people from drinking sodas larger than 16 ounces at restaurants, movie theaters and sports arenas seems likely to have little impact on the problem. Seriously dealing with obesity involves all sorts of food, from pizzas and bacon cheeseburgers, to loads of stuff that families buy in grocery stores every day.
It requires increasing, not cutting, physical education programs in city schools. It involves a major cultural shift away from the couch-potato society we have become, where parents sit at home watching TV and kids sit in another room playing video games. (In Brooklyn’s Crown Heights, where I grew up, we played stickball and punch ball, kick the can and ringolevio until it got dark.)
On the other hand, the Mayor could mount an effective program of public education, higher taxes and product size restrictions on alcohol — one that would do far more to protect health and safety. Here, ammunition fired at a single target — excessive and underage drinking — will result in palpable improvement in people’s lives.
The societal costs of alcohol abuse are orders of magnitude larger than any caused by drinking a few more ounces of soda. Alcohol is implicated in many of the violent crimes committed in the city — including the assaults, rapes and murders that have savaged so many families. Indeed, research at The National Center on Addiction and Substance Abuse at Columbia University (CASAColumbia), which I founded, has discovered that more than half of all inmates in America have alcohol problems of one kind or another.
Alcohol is a culprit in most of the city’s child welfare cases. Much of teen pregnancy occurs when one or both of the kids are high on a few beers or slugs of vodka. The homelessness problem in the city, domestic violence and child molestation are joined at the hip with alcohol abuse. Property damage from traffic accidents, vandalism and violence commonly involves excessive drinking. A significant number of school dropouts can be traced to underage drinking.
Research by CASAColumbia found that in 2005, substance abuse and addiction cost New York State taxpayers more than $13 billion in health care, criminal justice, social services, special education and other programs. A reasonable estimate is that at least half of that can be attributed to excessive drinking; an updated estimate would place the cost of excessive drinking to New York State taxpayers today at more than $8 billion.
In banning big sodas, the Mayor has expressed concern about the health of the city’s children. But here again, curbing underage drinking is far more important. Our research has found that more than 90% of individuals addicted to alcohol started drinking before they were 18. Drinking, particularly binge drinking, is a clear and present danger to the adolescent brain that can stunt its development and in some cases do permanent damage. So curbing teen drinking would reduce the State’s and City’s health care costs and, more importantly, help our kids to grow up healthy and become productive adults.
It would be wise for more of the space being used for obesity-related ads in subway trains to be used to warn parents of the consequences of underage drinking: potential brain damage, reduced impulse control, the risk of crippling and fatal accidents, and addiction. Bloomberg can encourage the City’s schools to work an anti-drinking message into the health curriculum, maintain gyms and physical education, and conduct health screenings and brief interventions for teen drinkers.
Yes, I know the City already funds some anti-alcohol-abuse ads, but this investment pales in comparison to what’s being done to fight sugary soda.
No one can question Bloomberg’s genuine concern about the health of individual New Yorkers. His systemwide approach to reducing smoking — high taxes, smoke-free public space and a widely publicized quit campaign — is the best in the country, if not the world. But as he aims at big sodas, he is missing a far more important target: the wine, beer and liquor so many of us drink in excess.
Califano is founder and chairman emeritus of The National Center on Addiction and Substance Abuse at Columbia University. He was President Lyndon Johnson’s top assistant for domestic affairs and secretary of health, education and welfare from 1977 to 1979.
This article originally appeared in The Daily News on July 19, 2012.