Alcohol Use and Mortality in Mexico

There is a well-crafted and important paper by Gretchen Stevens and coauthors on the leading causes of death and their attributable factors in Mexico in the June 2008 issue of PLoS Medicine. Here's the punchline:

Mexico is at an advanced stage in the epidemiologic transition, with the majority of the disease and injury burden from noncommunicable diseases. A unique characteristic of the epidemiological transition in Mexico is that overweight and obesity, high blood glucose, and alcohol use are responsible for larger burden of disease than other noncommunicable disease risks such as tobacco smoking. The Southern region is least advanced in the epidemiological transition and suffers from the largest burden of ill health in all disease and injury groups.

Alcohol use holds the plurality share of all deaths among men, with obesity and high blood glucose (separately) close behind. This is certainly different than the pattern in the United States: alcohol abuse comes in a fairly distant third behind tobacco use and diet/physical inactivity. Myself and several others I spoke to regarding this were rather surprised by the Mexican statistics: we hear so much about Mexico being on its way becoming the world's fattest nation, but little about its' alcohol use. Perhaps another example of a single issue hijacking the policy agenda?

Interestingly, alcohol use appears to be responsible for a non-trivial percentage of female deaths as well (though this number is well below obesity and associated metabolic conditions). Sadly, the authors of the paper point out that much of it may be secondary to abuse from men who abuse alcohol.

As with the literature in the United States, I wonder if there are studies using Mexican data that use time and cross-sectional variation in alcohol laws to identify the causal impacts of public policy (via alcohol use) on domestic violence, crime, etc. A quick Google search on this revealed little. However, I did find this interesting piece by Manuela Angelucci, examining the relationship between income and alcohol use and use related violence towards women. To identify the causal effect of income, the paper uses shocks from (then) randomly assigned access to the Oportunidades conditional cash transfer program (which pay women for meeting targets in child and household health, education, etc) and weather and natural disaster shocks that affect rural households. She finds that the marginal peso accruing to women leads to significant decreases in their partners' alcohol use and violent behavior. The effect of a shock to the partners income is minimal. Yet another good example of why public transfers of cash to women accrues much greater benefits to households than does targeting men.