The American issue. [volume] (Westerville, Ohio) 1912-19??, 1931-06-01


RATE RISE AFTER PROHIBITION?
Without question lax enforc m ent
caused more liquor drinking and in con-
sequences more alcoholism deaths, but that
Is far from being the whole story. There
never was such proportionate increase
in alcoholic deaths as the Metropolitan
figures suggest; disqualification, politics
and hostile public officials helped to ex-
aggerate the reported rise
DECENTRALIZATION OF ALCOHOLIC
DISEASE
Next to the deaths from alcoholism re-
ported by the coroners and medical ex-
amlnerS the largest number come from
the free beds of the hospitals Before pro-
hibition drunkenness was regarded as
vice and very few hospitals would accept
either chronic or acute alcoholic patients.
Since then alcoholism has been regarded
more and more as disease Almost all
public hospitals now accept without pro-
test cases of alcoholism and some of them
take in "plain drunks." BY no means do
hospitals truthfully report all their deaths
from alcoholism but they are much more
likely to report them than doctors in their
private practice. This of course, would
artlflcially increase the reported rate.
POLITICS AND DEATHS FROM
ALCOHOLISM
The increase in deaths from alcoholism
was most marked in cities and states
where there was organized, official and po-
Itical hostility to prohibition. This was
most noticeable in cities like New York
and Baltimore and in the state of Mary
land. When Mr.. Smith was a candidate
for president and was vigorously assert
ing the failure of prohibition some of his
official friends in New York city, in order
- Ii
number of deaths in that city from alco-
holism than the bureau of the federal
census which has duplicates of all death
certificates, allotted to the entire state.
They padded the returns by the simple
eXpedient of transferring large number
of deaths from cirrhosiS Of the liver over
to the alcoholism column. When these
deaths were put back in the column where
they belonged, or when the two causes of
death were added together the reported
startling increase in alcoholic disease
completely disappeared
Public health officers and insurance
companies have used increasing pressure
in recent years to secure truthful certi-
ficates for the causes of all deaths To the
extent that their efforts have succeeded
they have resulted in more reported
deaths from alcoholism.
HOW SHOULD THE DEATH RATE FOR
ALCOHOLISM BE AUGMENTED?
The prevailing practice, when persons
die from alcoholism, is not to report the
primary cause but the secondary malady,
brought about by alcoholism, which was
the immediate cause of DEATH The COM
monest of these reported secondary causes
of death are dilation of the heart hard
ening of the arteries, Bright's disease and
cirrhosis of the liver. The first three of
these ailments cannot be SO well used as
indices of alcoholic disease because they
are also important diseases of old age.
Whether by cause or through coinci-
dence there came with national prollibi-
ton sudden fall of the general death
rate amounting in several very wet states
to twenty-five per cent; so that the de-
crease in deaths from these diseases due
to less drinking would alternately be
counter-ba1anced by steadily increasing
number of deaths from these diseases due
to increased longevity.
CIRRHOSIS OF THE LIVER A BETTER
INDEX THAN ALCOHOLISM
Cirrhosis of the liver is usually only
another name for alcoholism and while
there is so much stigma attached to the
disease that many doctory will not report
it; however many do report it and the
certificates represent persons from all So
cia1 strata; thus it affords more reliable
table than that for any other alcoholic
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