NEW YORK (Reuters Health) - When British Columbia partially privatized alcohol sales in 2002, the number of privately-owned liquor stores in the Canadian province quickly rose. And that may have been accompanied by a rise in alcohol-related deaths, a new study finds.
Researchers say the findings raise concerns about the public health impact of privatizing alcohol sales -- a move being considered by a number of Canadian and U.S. jurisdictions that currently restrict liquor sales to government-run stores.
Looking at 89 local areas of British Columbia, the researchers found that the number of private alcohol retailers rose by 40 percent between 2003 and 2008, while the liters of alcoholic beverages sold at those stores each year shot up 84 percent.
Meanwhile, the number of government-run stores in the province declined slightly.
And for every extra private store per 1,000 people in a community, the study found, the local alcohol-related death rate rose by 27.5 percent.
The findings, reported in the journal Addiction, do not prove that privatization is to blame.
However, "there is a strong, robust relationship" between the increase in private retailers and alcohol-related deaths, said lead researcher Tim Stockwell, of the University of Victoria in British Columbia.
The implication, he told Reuters Health, is that Canadian provinces should "think twice" before going further down to the path of privatization. Some provinces still have a government monopoly on all alcohol sales (including liquor, beer and wine), while others have some degree of privatization.
The findings also have relevance for the U.S., Stockwell said, as some states currently control the sale of liquor (although not beer and wine).
The study has already made news in Virginia, where the governor is promoting a plan to privatize the state's government-owned liquor stores. Opponents have pointed to the results of Stockwell's study, arguing that privatization could be a danger to public health.
But a researcher not involved in the study urged caution in interpreting the findings.
Dr. Rebecca Goldin, an associate professor of mathematical sciences at George Mason University in Fairfax, Virginia, pointed to some weaknesses in the analysis.
The key one, she told Reuters Health, is that as the concentration of government-owned alcohol stores rose in an area, alcohol-related deaths actually declined. Each additional government store corresponded to a 57-percent reduction in local alcohol-related deaths.
"You would expect to see that more stores would correspond to more deaths," even if they were government-run, said Goldin, who is also director of research for STATS -- a non-profit watchdog group affiliated with George Mason that looks at how statistics are reported in the media.
By the study authors' reasoning, Goldin said, opening more government-run liquor stores in a local area -- and making more alcohol available -- would save lives.
"I think this calls the authors' conclusions into question," she said.
Goldin also wonders whether private retailers were drawn to neighborhoods with certain demographics. "Are private stores more attracted to certain areas? You could have demographic reasons driving this."
The findings are based government data for 89 distinct local "health areas" in British Columbia. Across those communities, the study found, an average of eight out of every 10,000 people died of an alcohol-related cause each year between 2003 and 2008.
Alcohol-related deaths included any death with "alcohol" listed on the death certificate -- including causes like alcohol poisoning and drunk driving as well as chronic conditions related to drinking, like liver cirrhosis.
Province-wide, the annual alcohol-related death rate actually dipped somewhat in the latter years of the study period.
But within local health areas, the researchers found a correlation between the concentration of private liquor stores and alcohol-related deaths.
According to Stockwell, private stores may present a particular public-health risk because -- unlike government stores - their pricing is tailored to their customer base. If they are in a low-income area, for example, they may offer cut-rates on certain types of alcohol popular with their clientele.
In addition, he said, investigations using young-looking secret shoppers have found that private retailers are less likely than government ones to check I.D.
According to Goldin, the findings do indicate that alcohol consumption in British Columbia has increased since privatization.
But whether that has translated into more deaths is still in question, she said. "I don't think this study is helpful in answering that."
SOURCE: bit.ly/ftVQLZ Addiction, online January 18, 2011.