New research shows an increased rate of hospitalizations for accidental injuries in urban areas after Washington State privatized their liquor sales. The study found an additional 17,498 hospitalizations in metropolitan-urban counties in the 2.5 years after Initiative 1183 was passed compared to neighboring Oregon. Non-metropolitan-urban and rural counties did not see their hospitalization rates change.
Initiative 1183 called for closing state-run liquor stores and allowing state licensing of private retailers. It led to a significant increase in the number of stores, growing from 330 before privatization to approximately 1600 afterward. It also resulted in the highest tax rate on spirits in the country. I-1183 came into effect in July 2012.
“It was surprising that hospitalization rates for accidental injuries increased despite the rise in liquor prices, which were substantially higher than before the initiative was passed. We expected higher prices might inhibit sales and consumption, so this result shows how strong of an influence the increased availability of liquor had,” said lead author Aryn Phillips, previously a fellow at the Alcohol Research Group and currently a postdoctoral researcher at the Northwestern University Feinberg School of Medicine. “We also found these hospitalization rates increased only in urban counties, which makes sense given the growth of liquor stores was really concentrated in cities after the initiative passed.”
Another unexpected finding was that privatization did not affect the hospitalization rate for liver cirrhosis and other alcohol-related chronic conditions unlike other studies have found. Phillips and colleagues speculate that privatization and its repercussions may have caused drinkers of all types to increase their alcohol consumption but only by small amounts. Minor increases could be enough to cause injuries—even one drink can double the risk of injury—but not enough to lead to chronic conditions, at least in the short term.
There are currently 17 states in the U.S. that control the sale of liquor, and in some cases, wine, at the wholesale level through government agencies, including Washington’s neighboring states of Oregon and Idaho. Grocers and other groups in some of these states often push for ending state controls.
“This is one of the first studies to look at adverse health outcomes from the dismantling of a statewide liquor control system,” Phillips added. “With more states in the U.S. considering privatization of alcohol sales, this work is critical to determine what the real cost of such a change might be. It’s not enough to only look at sales data – we need to understand how it impacts the health of individuals and the larger community.”
The study, published today in Addiction, used data from AHRQ Healthcare Cost and Utilization State Inpatient Database 2010-2014 and HHS Area Health Resource File 2010-2014 and compared 39 counties in Washington to 36 counties in Oregon over the 2.5 years following the passing of I-1183.
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To request a copy of the study and an interview with the study authors, please contact Diane Schmidt at dschmidt@arg.org or 707-889-8738.
Phillips, A. Z., Rodriguez, H. P., Kerr, W. C., Ahern, J. A. (2020). Washington’s liquor license system and alcohol-related adverse health outcomes. Addiction: doi:10.1111/add.15234
