Addiction and inequality

I am in Adelaide attending an NCETA (National Centre on Training and Addiction) Summer School ‘A Fair Go for All? Policy Responses to Alcohol, Drug and Gambling Issues’. The intent is to look at links between social inequality and various addictions.

A lot of the people present have come from the field of population health. Much of their analyses take the form of large numbers of bivariate graphs between a target variable Y (e.g. extent of addiction) and some explanatory variable X (e.g. some index of social inequality). If any type of relationship exists geometrically then the language used suggests that X causes Y.

There is no economic analysis at all. Some type of addiction (e.g. addiction to gambling) is identified as a problem of concern and measures are then discussed to eliminate the problem. No benefits are attached to the activity at all. It is a far more illiberal approach than even I could ever accept.

On the inequality issue the discussion has been very disappointing. Even if it is accepted that activities such as smoking, drinking alcohol and gambling do involve social costs, a difficulty is that measures to deal with such issues – hefty taxes on cigarettes and gambling or restrictions on the supply of gambling outlets will have highly inequitable effects on the socially disadvantaged. This leads to some peculiar arguments – for example that the poor should give up smoking because it is an expensive drain on their budget. That it is expensive because of hefty taxes is not even mentioned.

The population health school needs to learn some statistical technique and some economics.

Have I got value from the discussions? Yes I have. The main benefit for me is that it forces me to reassess my own somewhat illiberal views on the types of demerit goods this conference is on about. You can always learn and if you are honest you should be prepared to adjust your views.

In addition there were two very good papers – descriptive papers by Wayne Hall on alcohol and inequality and by Michael Gossop on nicotine dependence and inequality. I also liked a paper by the ANU’s Richard Eckersley on social determinants on health. He linked addiction problems to findings in happiness research and to individualist ethics in a way I found interesting. (The effort was dulled a bit at the end of the day by a loquacious, Marxist, dope-smoking public health enthusiast who stretched this idea to a ludicrous exaggeration).

The good papers are all apparently available at the NECTA website.

But the best part of my day was a great Italian meal at Parlamento Bistro on North Terrace. The seafood Zuppa soup was close to divine! Despite the great food and the few good papers today I won’t wait around for the first session tomorrow – the value-added is not enough.