Alcohol and Men's Health

Males have consistently had higher rates of alcohol-related deaths and hospitalisations than females have. It is estimated, for example, that in Australia, males accounted for approximately 70% of:

• the 3290 alcohol-related deaths in 1997;
• the 72,302 alcohol-related hospitalisations in 1996/97; and
• the 403,795 alcohol-related hospital bed-days in 1996/97.

Research shows that for men:

• Drinking up to an average of between 3-4 standards drinks per day holds no more risk of premature death than non-drinking.
• Drinking above 6 standard drinks per day is associated with significant risk of harm in the short term.
• The greater the amount of alcohol consumed, the higher the risk.
• Maximum health benefits for the heart can be gained from between 1-2 standard drinks a day, for men aged 40-45 years and older.
• It has been calculated that about 4% of male deaths are alcohol-related, with the main causes of such deaths being alcoholic liver cirrhosis, road injury, stroke, suicide and alcohol dependence.
• Other health concerns include alcohol-related violence, with alcohol-related assaults being one of the main causes of male hospitalisation.

The main acute and chronic alcohol-related conditions in Australian males

Information from records of alcohol-related deaths and hospitalisations can be divided into:

• Chronic conditions (conditions associated with long-term alcohol misuse) accounted for:
  • 60% of the 2,296, alcohol-related, male deaths in 1997, with the main causes being alcoholic liver cirrhosis, stroke and alcohol dependence;
  • 35% of the 49,499 alcohol-related, male hospitalisations in 1996/97, especially for alcohol dependence.
• Acute conditions (that is, conditions associated with intoxication) accounted for:
  • 40% of the 2,296 alcohol-related, male deaths in 1997, especially road injuries and suicide; and with road injuries accounting for the highest number of person-years of life lost (28% of all alcohol-related male deaths for 1997);
  • 65% of the 49,499 alcohol-related male hospitalisations in 1996/97, especially falls, assaults and road injuries.

Associations between alcohol, acute harm, and male risk levels

Alcohol is a major cause of road injury in Australia, and on average, it has been calculated that between 1990-1996, over 70% of people with serious alcohol-related road injuries were male, while only 56% of people with non-alcohol-related road injuries were male.

• Male motorists are more frequently involved in alcohol-related road fatalities. In 1992, 47% of male drivers in single vehicle fatalities (4 times more than for females) and 12% (2.5 times more than for females) in multiple vehicle fatalities were intoxicated. Those men at particularly high risk include men under 25 years of age, particularly those living in country regions, blue collar or unemployed males, and middle-aged males with very high blood alcohol concentration (BAC).

Alcohol is a major contributing cause of violence in Australia, and in 1998/99, 74% of the 8,661 hospital admissions for alcohol-related assaults were male.

Heavy drinking is a major risk factor for suicide and suicidal behaviour, and this is of particular concern in Australia, given the high and rising suicide rates in young adult men:

• Of the 264 alcohol-related suicide deaths in Australia in 1997, 86% were male.

Alcohol is an added risk factor for injury and death during activities such as swimming, diving, surfing, boating, water skiing and fishing, and accounts for 32% of drownings in males aged 15-29 years.

To minimise risks in the short and longer term, and gain any longer-term benefits, the NHMRC has set the alcohol drinking guidelines for men at:

• an average of no more than 4 standard drinks a day, and no more than 28 standard drinks over a week;
• not more than 6 standard drinks in any one day;
• one or two alcohol-free days per week.

Men should note, too, that:

• These drinks should be spread over several hours, and consumed at a moderate rate of no more than 2 drinks in the first hour and 1 per hour thereafter, to minimise intoxication.
• The levels set in these guidelines may be too high for men of below-average body size.
• These guidelines assume that the drinker is not on medication, does not have a family history of alcohol-related problems or a condition that is made worse by drinking, and is not about to undertake any activity involving risk or a degree of skill, including driving, flying, water sports, skiing, or using complex or heavy machinery.
• Alcohol can help to prevent heart disease from about 40-45 years of age for males, but the maximum benefit can be gained by a low level of drinking, of approximately 1-2 standard drinks per day for men. However, alcohol is not necessary to achieve this health benefit, as it can be obtained equally effectively by using other strategies, preferably in combination, such as stopping smoking, increasing exercise, improving diet, and taking small quantities of aspirin.

Adapted from:
Australian Department of Health and Ageing, Australian Alcohol Guidelines Fact Sheets www.alcoholguidelines.gov.au

Principal source:
National Health and Medical Research Council (NHMRC) (2001). Australian Alcohol Guidelines: Health Risks and Benefits. NHMRC, Canberra.

Other sources:
Alcohol in Australia: Issues and Strategies. (2001) Commonwealth Department of Health and Aged Care, Canberra.

Chikritzhs T, Jonas H, Heale P, Dietze P, Hanlin K and Stockwell T (1999). Alcohol-caused deaths and hospitalisations in Australia, 1990-1997. National Alcohol Indicators Bulletin No. 1, December.

Chikritzhs t, Stockwell T, Heale P, Dietze P and Webb M (2000). Trends in alcohol-related road injury in Australia, 1990-97. National Alcohol Indicators Bulletin No. 2, May.

Matthews S, Chikritzhs T, Catalanos P, Stockwell T and Donath S (2002). Trends in alcohol-related violence in Australia, 1991/92-1999/00. National Alcohol Indicators Bulletin No. 5, April.

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