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1 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN TheBurdenofExcessiveAlcohol UseinWisconsin March2013,Revision1 PennyBlack,UniversityofWisconsinPopulationHealthInstitute JasonPaltzer,UniversityofWisconsinPopulationHealthInstitute ExecutiveSummary Excessive(alcohol(consumption(in(Wisconsin(is(a(public(health(problem(that(affects(every(man,( woman,(and(child(living(in(the(state.(this(study(estimates(the(economic(costs(of(excessive( alcohol(consumption(in(wisconsin(using(a(national(study(of(the(estimated(economic(cost(of( excessive(alcohol(consumption(in(the(united(states(and(wisconsin s(proportion(of(binge( drinkers.(data(from(the(national(study,(conducted(in(2006(and(published(in(2011,(was(adjusted( to(2012(dollars.(the(estimated(cost(of(excessive(alcohol(consumption(in(wisconsin(was(6.8( billion(in(2012.(this(cost(is(borne(by(everyone(in(the(state,(not(just(the(drinkers(themselves.( Revenue(generated(by(current(alcohol(taxes(covers(less(than(1%(of(the(total(economic(cost.(

2 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN Revisions 1. Thedefinitionofheavydrinkinghasbeencorrected:>1drinkperdayonaveragefora woman,and>2drinksperdayonaverageforaman. 2. ThemapontheOzaukeeCountyprofilehasbeencorrected. 3. Reference24hasbeencorrected:UnitedStatesBureauofLaborStatistics. 4. Thealcoholtaxrevenuecitedonpage5hasbeencorrectedtoaccountforcreditsgivenby thewisconsindepartmentofrevenue. 5. Reference28hasbeenmodifiedtomoreclearlyexplainwhichrateswereusedandwhy. 6. Appendix1hasbeenrevisedtoincludetheprevalenceofbingedrinkingineachcounty.

3 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN Introduction ExcessivealcoholconsumptionisoneofWisconsin sbiggestpublichealthissues.excessive alcoholconsumptionisassociatedwithmanynegativehealthandsocialconsequences, 1S15 whichcomeatagreateconomiccost.theseconsequencesandassociatedeconomiccostsare bornebyindividualusers,familymembers,neighbors,andentirecommunities.everyonewho livesandworksinwisconsinisaffectedbythehealthandeconomiccostsofexcessivealcohol consumption. In2011,themostrecentyeardataisavailable,excessivedrinkinginWisconsinresultedin approximately1529deaths, 16 48,578hospitalizations, 17 46,583treatmentadmissions, 18 60,221arrests, 19 and5,751motorvehiclecrashes(2010). 20 Wisconsinranksnumber1inthe U.S.inratesofbingedrinkingandnumber1inintensityofdrinking Wisconsinadultsreport drinkinganaverageof9drinksperoccasion. 21 Thepurposeofthisreportistopresentestimatesoftheeconomiccostofexcessivealcohol consumptioninwisconsinanditsimpactonthestate.itisourhopethattheseestimateswill beusedtomorefullyassessthepublichealthimpactofexcessivedrinkingandinform discussionsofpublicpolicy. Methods Excessive(Alcohol(Consumption( Forthepurposeofthisreport,excessivealcoholconsumptionwasdefınedasbingedrinking( 4 drinksperoccasionforawoman,and 5drinksperoccasionforaman);heavydrinking(>1 drinkperdayonaverageforawoman,and>2drinksperdayonaverageforaman);anyalcohol consumptionbyyouthaged<21years;andanyalcoholconsumptionbypregnantwomen.this defınitionisconsistentwithcentersfordiseasecontrolandprevention 21 andnationalinstitute onalcoholismandalcoholabuse 22 standardsusedtoidentifyharmfulpatternsofalcohol consumption. Economic(Costs( NationalU.S.estimatesoftheeconomiccostsofexcessivealcoholconsumptionobtainedby Bouchery,Hendrick,Sacks,Simon,andBrewer(2011) 23 wereusedtoextrapolateeconomic costsinwisconsin.bingedrinkingisresponsibleforthemajority(76%)ofalcoholsrelated costs 23 andwasthereforeusedtodeterminethepercentageofthenationalestimates attributabletowisconsin.theconsumerpriceindex 24 (CPI)wasusedtoadjustthe2006 estimatesfromboucheryetal.to2012dollars.otherstateshaveusedasimilarmethodology forestimatingalcoholsrelatedcostsincludingnewmexico 25,Oregon 26,andMinnesota. 27 State5level(estimates:( 1. NationalandWisconsinbingedrinkingratesfromtheBehavioralRiskFactorSurveillance System 28a,b weremultipliedbynationalandstateadult(18andolder)populationsizes 29 toobtaintheestimatednumberofbingedrinkersintheu.s.andwisconsin.the numberofwisconsinbingedrinkerswasdividedbythetotalnumberofbingedrinkers 1

4 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN intheu.s.todeterminethepercentageofu.s.bingedrinkerscomingfromwisconsin. (Seecalculationsbelow) 2. NationaleconomiccostestimateswereadjustedforinflationusingtheCPIfor Wisconsin sbingedrinkerpercentagewasmultipliedbytheadjustednationaltotaland categoricaleconomiccostestimatestodeterminetheamountattributedtowisconsin asastate. Step1 2010(WI(Population((18+)( x( Binge(Drinking(%(( =( #(of(binge(drinkers(in(wi( 4,367,605 23% 999, (US(Population((18+)( x( Binge(Drinking(%(( =( #(of(binge(drinkers(in(us(( 235,572,845 16% 37,691,655 #(of(binge(drinkers(in(wi(( ( #(of(binge(drinkers(in(us(( =( Proportion(of(Binge( Drinkers((18+)(in(WI(( 999,358 37,691, % Step2 US(National(Estimate( US(National(Estimate( (millions(2006(dollars)( x( National(CPI((2006(to(2012)( = (millions(2012(dollars)( 223, , Step3 US(National(Estimate( Proportion(of(Binge( Costs(Attributed(to(WI( (millions(2012(dollars)( x( Drinkers(in(WI( =( (millions(2012(dollars)( 257, % 6, County5level(estimates:( 1. CountySlevelbingedrinkingprevalencerates frombehavioralriskfactorsurveillance System 28 weremultipliedbycountyadult(18 andolder)populationsizes 29 toobtainthe numberofbingedrinkersineachwisconsin county. 2. Thenumberofbingedrinkersineachcounty wasdividedbythetotalnumberofbinge drinkersinwisconsintodeterminethe percentageofbingedrinkersforeachcounty. 3. Thepercentageofbingedrinkersineach countywasusedtodeterminewhat proportionofwisconsin stotaland categoricalalcoholsrelatedcostsare attributedtoeachcounty(appendix1). 2

5 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN Boucheryetal.dividedcostsintothefollowingsubScategories: Healthcare Specialtycareforabuse/dependence Hospitalizationsforthe54AlcoholSRelatedDiseaseImpact(ARDI)conditions 30 (primarydiagnosisonly) Fetalalcoholsyndrome Healthinsuranceadministration Preventionandresearch Ambulatorycareforthe54ARDIconditions(primarydiagnosisonly) Nursinghomecosts Trainingofsubstanceabuseandmentalhealthprofessionals Productivity(estimatedearningslevels) Lostproductivitywhileatwork,home,orwhileinstitutionalized Prematuremortality Incarcerationofperpetrators Absenteeism Crime(lossofworkamongvictims) Fetalalcoholsyndrome Other Criminaljustice(police,courtsystem,corrections,legalcosts) Motorvehiclecrashes Firelosses Crimevictimpropertydamage Fetalalcoholsyndrome specialeducation Boucheryetal.furtheridentifiedwhowasresponsibleforpayingthealcoholSrelatedcostsand thefollowingpercentageswerecarriedovertodeterminethebreakdownofcostsinwisconsin: Table1:PercentageofalcoholSrelatedcostsattributedtoeachpayertypebycategory* 23 Excessivedrinker Othersin Government andfamily society Healthcare Lostproductivity Criminaljustice Motorvehiclecrashes Other *Totalsmaynotequal100%duetoroundingadjustments Percapitacostsweredeterminedbydividingtheestimatedstateandcountycostsbythetotal populationinthestateandeachcounty,respectively. Othersinsociety includesprivate healthinsurers, employers,crime victims,andothers. 3

6 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN 4 Results Economic(Costs( TheestimatedtotalannualeconomiccostofexcessivedrinkinginWisconsinis6.8billion.Ona percapitabasis,thiscostisapproximately1,198foreachman,woman,andchildinwisconsin. Ofthetotalcost,2.9billioncamefromimpairedproductivity;2billioncamefrompremature mortalitycosts;749millioncamefromincreasedhealthcarecosts;649millioncamefrom criminaljusticecosts;418millioncamefrommotorvehiclecosts;and90millioncamefrom othereffects. HealthcareCosts Ofthe749millioninhealthexpenditures attributabletoalcohol,325million(43.4%)was fromspecialtytreatmentforalcoholabuseand dependenceand156million(20.8%)from hospitalizationsforothermedicalconditions stemmingfromexcessivedrinking. LostProductivityCosts Thetwolargestproductivitylosseswerefrom lostproductivityatwork,estimatedat1.3 billion(45.9%)and1.2billion(40.3%)inlost productivityinprematuremortality. OtherCosts Thetwolargestcostswerecriminaljusticesystemcosts(55.7%)andmotorvehiclecrashes (36.4%).Ofthe649millioninWisconsincriminaljusticesystemcosts,Boucheryetal. determined76.8%,or498millioninwisconsin,camefromcrimesthatwouldnotbe thoughtofassolelyalcoholsattributable(e.g.,assault)asopposedtoobviouslyalcohols attributablecrimeslikedrivingundertheinfluenceofalcohol. Ofthetotal498millioncostofalcoholSattributablecrime,43.8%camefromcrashSrelated costsfromdrivingundertheinfluence,17.2%camefromcorrectionscosts,and15.1%came fromlostproductivityassociatedwithhomicide. WhoBearstheCost InWisconsin,2.9billionofthetotaleconomiccostofexcessivealcoholwasborneby government,includingfederal,state,andlocalgovernmentagencies(table2);2.8billion usewasbornebyexcessivedrinkersandtheirfamilymembers;and1.1billionwasborne byothersinsociety,includingprivatehealthinsurers,employers,andothers. Healthcare 749million Other 1.1billion LostProductivity 4.9billion

7 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN Table2:USNationalandWisconsinalcoholcostestimatesbycategoryandpayer(,millions) 2006(National(Estimate( (Bouchery,(2011)( 2012(National(Estimate( (adjusted(for(inflation)( 2012(Wisconsin(Estimate( Society a Government b Society Government Society Government TOTAL 223, , , , , ,867.2 Healthcare 24, , , , Lostproductivity 161, , , , , ,726.1 Criminaljustice 20, , , , Motorvehiclecrashes 13, , Other 2, , , , a Societyreferstoallpayers(government,excessivedrinkerandfamily,andothersinsociety) b Governmentreferstoallgovernmententities;Federal,State,andlocal. Discussion TheburdenofexcessivealcoholconsumptioninWisconsinismanifestedinsocial,health,and economicdamages.althoughthisburdenisnotsharedequallybyeveryoneinthestate,its impactisfeltbyeveryonebecausemanyofthecostsfilterthroughouttheeconomyviahigher insurancerates,divertedgovernmentspendingtoaddresssubstanceabuserelatedcrimesand consequences,losteconomicoutput,andhigherhealthcarecosts. Itshouldbenotedthat,althoughthe6.8billionfıgureisthebestcurrentlyavailableestimate ofthecostofexcessivedrinkinginwisconsin,boucheryetal.cautionthatitisasubstantial underestimateduetodatalimitations,conservativeestimates,andthenonsinclusionof intangiblecostslikepain,suffering,andbereavement. Despitetheselimitations,thisstudyshowsthattheeconomicimpactofexcessivealcohol consumptioniscarriedbypeopleotherthantheexcessivedrinkersthemselves.the56million in2012staterevenuesfromalcoholtaxes 31 donotbegintocovertheeconomiccosts. Effectiveinterventionstoreduceexcessivealcoholconsumption includingincreasingalcohol excisetaxes,limitingalcoholoutletdensity,maintainingandenforcingtheminimumlegal drinkingageof21years,andspecifıccountermeasuresforalcoholsimpaireddrivingsuchas sobrietycheckpoints areavailablebutareunderutilizedinreducingthehealth,social,and economicimpactsofexcessivedrinking.formoreinformationregardingevidencesbased preventionstrategies,visitwhatworksforhealth( WisconsinStateCouncilonAlcoholandOtherDrugAbuse sreportonalcohol,cultureand Environment( Guide( Estimatesoftheeconomiccostofexcessivealcoholconsumptionineachcountyareprovided tofacilitatelocaldiscussion,planning,andaction. 5

8 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN 6 Acknowledgements TheUniversityofWisconsinPopulationHealthInstitutewouldliketothankthefollowing peopleforprovidingdata,expertise,andsupportindevelopingthisreport: JeremyArney,PhD,AssistantProfessor,PublicAdministrationandPoliticalScience UniversityofWisconsin,LaCrosse RichardL.Brown,MD,MPH,Professor UniversityofWisconsinSchoolofMedicineandPublicHealth BarryBusby,CountyCoroner WinnebagoCounty MaureenBussalachi,ExecutiveDirector HealthFirstWisconsin DorothyChaney,ProprietorandDirector WisconsinCommunityHealthAlliance MelissaDotter,DrugFreeCommunitiesProgramCoordinator MarathonCountyHealthDepartment/MarathonCountyAODPartnershipCouncil ChrisFitzgerald,Sheriff BarronCounty HonorableJudgeDanielKoval CityofMadisonMunicipalCourt PaulKrupski,AlcoholPolicyandGrassrootsSpecialist HealthFirstWisconsin SarahAppleMattes,CommunicationCoordinator WisconsinClearinghouseforPreventionResources FrancieMcGuire`Winkler,ExecutiveDirector FocusonCommunity JacobMelson,Epidemiologist GreatLakesInterSTribalCouncil/GreatLakesInterSTribalEpidemiologyCenter ChristineNiemuth,PreventionCoordinator,SubstanceAbuseServicesSection BureauofPreventionTreatmentandRecovery,WisconsinDepartmentofHealthServices LouOppor,SectionChief,SubstanceAbuseServicesSection BureauofPreventionTreatmentandRecovery,WisconsinDepartmentofHealthServices RickPeterson,Director,CrawfordAbuseResistanceEffort(CARE)Council PrairieduChienMemorialHospital

9 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN JeffreyJ.Sacks,MD,MPH,PublicHealthConsultant SueBinderConsulting,Inc. JuliaSherman,Coordinator,WisconsinAlcoholPolicyProject UniversityofWisconsinLawSchool TomSieger,DirectorofPreventionServicesandCampusHealthInitiatives UniversityofWisconsinUniversityHealthServices AnneZiege,PhD,BehavioralRiskFactorSurveyDirector WisconsinDivisionofPublicHealth,WisconsinDepartmentofHealthServices FundingforthisprojectwasprovidedbytheUniversityofWisconsinSchoolofMedicineand PublicHealthfromtheWisconsinPartnershipProgram. SuggestedCitation:BlackPD,PaltzerJT.TheBurdenofExcessiveAlcoholUseinWisconsin. UniversityofWisconsinPopulationHealthInstitute,February

10 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN ReferencesandEndnotes 1. AmericanAcademyofPediatrics,CommitteeonSubstanceAbuseandCommitteeon ChildrenwithDisabilities.2000.FetalalcoholsyndromeandalcoholSrelated neurodevelopmentaldisorders.pediatrics;106: , BaanR,StraifK,GrosseY,SecretanB,etal.onbehalfoftheWHOInternationalAgencyfor ResearchonCancerMonographWorkingGroup.Carcinogenicityofalcoholic beverages.lancet(oncol.8: , BoothBM,FengW.TheimpactofdrinkinganddrinkingconsequencesonshortSterm employmentoutcomesinatsriskdrinkersinsixsouthernstates.j(behavioral(health( Services(and(Research;29(2): , CaetanoR,KaplanMS,HuguetN,McFarlandBH,ConnerK,GiesbrechtNandNolteKB. AcuteAlcoholIntoxicationandSuicideAmongUnitedStatesEthnic/RacialGroups:Findings fromthenationalviolentdeathreportingsystem.alcoholism:clinicalandexperimental Research.PublishedonlinefirstFebruary5, CorraoG,BagnardiV,ZambonA,LaVecchiaC.AmetaSanalysisofalcoholconsumptionand theriskof15diseases.prev(med;38: , FeldmanSH,JonesKL,LindsayS,SlymenD,KlonoffSCohenH,KaoK,RaoS,andChambers C.PrenatalAlcoholExposurePatternsandAlcoholSRelatedBirthDefectsandGrowth Deficiencies:AProspectiveStudy.Alcoholism:ClinicalandExperimentalResearch,36: , KesmodelU,WisborgK,OlsenSF,HenriksenTB,SechlerNJ.Moderatealcoholintakein pregnancyandtheriskofspontaneousabortion.alcohol((alcoholism;37(1):87 92, MillerTR,TetiLO,LawrenceBA,andWeissHB.AlcoholinvolvementinhospitalSadmitted nonfatalsuicideacts.suicideandlifesthreateningbehavior,40(5):492s499, NaimiTS,LipscombLE,BrewerRD,ColleyBG.Bingedrinkinginthepreconceptionperiod andtheriskofunintendedpregnancy:implicationsforwomenandtheir children.pediatrics,(11(5): , NelsonDE,JarmanDW,RehmJ,GreenfieldTK,ReyG,KerrWC,MillerP,ShieldKD,YeY, andnaimits.alcoholsattributablecancerdeathsandyearsofpotentiallifelostinthe UnitedStates.AmericanJournalofPublicHealth,publishedonlineaheadofprintFebruary 14, RehmJ,GmelG,SeposCT,TrevisanM.AlcoholSrelatedmorbidityandmortality.Alcohol( Research(and(Health;27(1)39 51, SanapM,ChapmanMJ.Severeethanolpoisoning:acasereportandbriefreview.Crit(Care( Resusc;5(2): , ShultsRA,ElderRW,HungerfordDW,StrifeBJ,andRyanGW.Emergencydepartmentvisits foralcoholsrelatedunintentionaltraumaticinjuries,unitedstates,2001.journalofsafety Research,40(4):329S331,August TaylorB,IrvingHM,KanteresF,RoomR,BorgesG,andCherpitelC.Themoreyoudrink, theharderyoufall:asystematicreviewandmetasanalysisofhowacutealcohol consumptionandinjuryorcollisionriskincreasetogether.drugandalcoholdependence, 110(2010):108S116,

11 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN 15. WidomCS,HillerSSturmhöfelS.AlcoholAbuseasaRiskFactorforandConsequenceof ChildAbuse.AlcoholResearchHealth,25(1):52, WisconsinDepartmentofHealthServices.Wisconsinresidentdeathcertificates.Annual averagenumbers2002s WisconsinDepartmentofHealthServices.Wisconsinhospitalinpatientdischargedatabase WisconsinDivisionofMentalHealthandSubstanceAbuseServices.HumanServices ReportingSystemstaffdataquery WisconsinStatisticalAnalysisCenter,WisconsinOfficeofJusticeAssistance.Arrestsin Wisconsin WisconsinDepartmentofTransportation.2010WisconsinTrafficCrashFacts,SectionV: Alcohol CentersforDiseaseControlandPrevention.VitalSigns:BingeDrinkingPrevalence, Frequency,andIntensityAmongAdults UnitedStates,2010.MorbidityandMortality WeeklyReport;61(1):14S19, NationalInstituteofAlcoholAbuseandAlcoholism.NIAAAcouncilapprovesdefinitionof bingedrinking.niaaa(newsletter,(3:3, Bouchery,E.E.,Henrick,J.H.,Sacks,J.J.,Simon,C.J.,Brewer,R.D.EconomicCostsof ExcessiveAlcoholConsumptionintheU.S.,2006.AmericanJournalofPreventiveMedicine, 41(5):516S524, UnitedStatesBureauofLaborStatistics.ConsumerPriceIndexInflationCalculator. Availableathttp://data.bls.gov/cgiSbin/cpicalc.pl. 25. NewMexicoDepartmentofHealth,EpidemiologyandResponseDivision(2009)The HumanandEconomicCostofAlcoholAbuseinNewMexico,2006.NewMexico Epidemiology2009(10). 26. WhelanR,JosephsonA,HolcomeJ.TheEconomicCostsofAlcoholandDrugAbusein Oregonin MinnesotaDepartmentofHealth.TheHumanandEconomicCostofAlcoholUsein Minnesota.(January2004,updatedMarch2006) 28. WisconsinDepartmentofHealthServices.BehavioralRiskFactorSurveillanceSystem. a.thebingedrinkingratefrom2007wasusedtodeterminethenumberofbingedrinkers intheunitedstates. b.bingedrinkingratesfrom2006s2008wereusedforcountyanalysisduetosmallsample sizesandavailableweights.bingedrinkingratesfrom2006s2008wereusedforstate analysistobeconsistentwithcountyanalyses. 29. UnitedStatesCensusBureau:AmericanFactFinder.2010populationestimates. 30. CentersforDiseaseControlandPrevention,AlcoholSRelatedDiseaseImpactSoftware (ARDI),availableathttps://apps.nccd.cdc.gov/ardi/Homepage.aspxSARDIisanonline applicationthatprovidesnationalandstateestimatesofalcoholsrelatedhealthimpacts, includingdeathsandyearsofpotentiallifelost(ypll).theseestimatesarecalculatedfor 54acuteandchroniccausesusingalcoholSattributablefractions. 31. WisconsinDepartmentofRevenue.AnnualFiscalReport:BudgetaryBasis

12 THEBURDENOFEXCESSIVEALCOHOLUSEINWISCONSIN Appendix1 PrevalenceofBingeDrinkingandProportionofBingeDrinkersbyCounty Prevalencereferstothepercentageofadults,ages18+,whoreportbingedrinking. Proportionreferstothecontributionofeachcountytothestate soverallprevalence. Prevalence Proportion Prevalence Proportion Adams 22% 0.4% Marathon 22% 2.2% Ashland 26% 0.3% Marinette 25% 0.8% Barron 26% 0.9% Marquette 21% 0.3% Bayfield 18% 0.2% Menominee 34% 0.1% Brown 25% 4.7% Milwaukee 21% 15.0% Buffalo 23% 0.2% Monroe 26% 0.9% Burnett 17% 0.2% Oconto 33% 1.0% Calumet 38% 1.4% Oneida 19% 0.6% Chippewa 20% 1.0% Outagamie 30% 4.0% Clark 23% 0.6% Ozaukee 17% 1.1% Columbia 29% 1.3% Pepin 19% 0.1% Crawford 25% 0.3% Pierce 31% 1.0% Dane 25% 9.6% Polk 26% 0.9% Dodge 24% 1.7% Portage 20% 1.1% Door 25% 0.6% Price 21% 0.2% Douglas 25% 0.9% Racine 25% 3.7% Dunn 18% 0.6% Richland 17% 0.2% EauClaire 30% 2.4% Rock 24% 2.9% Florence 28% 0.1% Rusk 16% 0.2% FondduLac 22% 1.7% St.Croix 25% 1.5% Forest 22% 0.2% Sauk 22% 1.0% Grant 28% 1.1% Sawyer 25% 0.3% Green 23% 0.6% Shawano 21% 0.7% GreenLake 16% 0.2% Sheboygan 32% 2.8% Iowa 24% 0.4% Taylor 28% 0.4% Iron 29% 0.1% Trempealeau 26% 0.6% Jackson 17% 0.3% Vernon 28% 0.6% Jefferson 23% 1.5% Vilas 15% 0.3% Juneau 18% 0.4% Walworth 21% 1.7% Kenosha 19% 2.4% Washburn 16% 0.2% Kewaunee 32% 0.5% Washington 23% 2.3% LaCrosse 17% 1.5% Waukesha 18% 5.4% Lafayette 17% 0.2% Waupaca 24% 1.0% Langlade 29% 0.5% Waushara 21% 0.4% Lincoln 23% 0.5% Winnebago 24% 3.2% Manitowoc 27% 1.7% Wood 19% 0.1% 10

13 The Burden of Excessive Alcohol Use in Wisconsin Annual economic cost of excessive alcohol use in Wisconsin 6.8 BILLION What We Pay For 1,2 We All Pay 1,2 6.8 billion 6.8 billion 2.9 billion Lost Productivity Alcohol tax collection falls short 2.9 billion Taxpayers 1% 2.0 billion Premature Death Wisconsin collected 2.8 billion Excessive Drinkers and their Families 56 million in alcohol taxes in million Healthcare less than 1% of the 6.8 billion in economic costs attributed to 649 million Criminal Justice 418 million Motor Vehicle 90 million Other excessive alcohol use. 1.1 billion Others in Society (including health insurers, employers) Consequences of Excessive Alcohol Use In 2011, excessive alcohol consumption contributed to at least: - 1,529 deaths 4-48,578 hospitalizations 5 How We Got Here High Consumption Wisconsin s annual alcohol consumption is 28% higher than the national average. 9 28% - 46,583 treatment admissions 6-60,221 arrests 7-5,751 motor vehicle crashes 8 For more details, please refer to the full report, available online at #1 in Binge Drinking Wisconsin ranks highest among all states in binge drinking, an important risk factor for alcohol related injuries and deaths. 9 Binge drinking = 5+ drinks on an occasion for men; 4+ drinks for women. Excessive alcohol use in Wisconsin costs 1,200 per person

14 Suggested Citation Black PD, Paltzer J. The Burden of Excessive Alcohol Use in Wisconsin. University of Wisconsin Population Health Institute, March References and Notes 1 Wisconsin total and categorical economic estimates were derived from the national estimate established in Bouchery, E.E., Henrick, J.H., Sacks, J.J., Simon, C.J., Brewer, R.D. Economic Costs of Excessive Alcohol Consumption in the U.S., American Journal of Preventive Medicine, 41 (5): , Wisconsin Bureau of Labor Statistics. Consumer Price Index Inflation Calculator. Available at The calculator was used to inflate estimates to 2012 dollars. 3 Wisconsin Department of Revenue. Annual Fiscal Report: Budgetary Basis Wisconsin Department of Health Services. Wisconsin resident death certificates. Annual average numbers Wisconsin Department of Health Services. Wisconsin hospital inpatient discharge database Wisconsin Division of Mental Health and Substance Abuse Services. Human Services Reporting System staff data query Wisconsin Statistical Analysis Center, Wisconsin Office of Justice Assistance. Arrests in Wisconsin Wisconsin Department of Transportation Wisconsin Traffic Crash Facts, Section V: Alcohol Wisconsin Department of Health Services. Behavioral Risk Factor Surveillance System. Binge drinking rates from were used for county analysis due to small sample sizes and available weights (county-specific weights were not available for data). Binge drinking rates from were used for state analysis to be consistent with county analyses. For questions regarding this report, please contact Penny Black at pdblack@wisc.edu For questions regarding what to do with this report, please contact Paul Krupski at pkrupski@healthfirstwi.org Funding for this project was provided by the University of Wisconsin School of Medicine and Public Health from the Wisconsin Partnership Program. 2013