Toasting Prohibition's end: Turns out this 'failure' led to longer life spans | Opinion
At a time of increasing drinking during pregnancy, it's worth taking smaller lessons from a century-old public policy failure.
Today marks the 90th anniversary of the federal repeal of Prohibition. The ratification of the 21st amendment to the US constitution ended a nearly 14-year nationwide ban on the manufacture, sale and transportation of alcohol that is widely considered to have been a disaster. Famously, Americans across the country poured into the streets (and their beer glasses) to celebrate.
Although this was the most extreme case – a “noble experiment” is how some called Prohibition at the time – policies around alcohol access and use continue to be of significant interest in Wisconsin and beyond.
Nowadays, the focus is often on drunken driving laws and the associated public policy issue of reducing motor vehicle fatalities. There are also concerns about minors abusing alcohol and the dangerous repercussions of that timeless problem. And new issues continue to arise, such as the Wisconsin Legislature’s controversial new measure creating new alcohol regulations for wedding barns. Suffice it to say, policymakers, activists, researchers, and everyday citizens are constantly thinking about ways to balance our love of alcohol with public health and safety.
Impact of alcohol on health, longevity significant
But how effective are these policies? What are the long-term effects of policy shifts? Social scientists like those of us at UW-Madison’s La Follette School of Public Affairs engage these critical questions in policy analysis when evaluating benefits and costs of potential policies. Sometimes, the long history of major policy changes – like prohibition, for example – allows us to look far into the past to accomplish this. But social science is only as good as the data and tools available.
Until recently, research questions addressing historic phenomena were hindered by limited data and analytical tools. Thankfully, major changes have taken place recently in our ability and our conventions for policy analysis. These changes have allowed us to research the effects of policies like prohibition in ways we could only dream of previously.
Our ability to conduct richer analyses has greatly benefitted from the emergence of “big data,” which allows us to find effects of policies that are paradoxically vanishingly small and huge: modest effects at the individual level that matter a great deal at the population level. Extending a single person’s life by one month is a small (and often very expensive) effect in cases of cancer, whereas increasing the longevity of the US elderly population by one month would be an excellent achievement of public health. Some estimates place our total expansion of life after age 65 over the past 100 years in the ballpark of four years in life expectancy, so one month is not too shabby in these terms.
In addition to big data, we also now believe that there are “critical periods” of development during our lifetimes, where exposures (good or bad) can have disproportionate effects on longevity. For example, exposures to toxicants “in utero” may shape the biological programming that unfolds over decades of our lives, eventually leading our bodies to fall apart at faster rates than would otherwise happen.
All of this brings me back to prohibition. In light of these new big data tools and a growing awareness of what contributes to longevity during these critical periods of life, we can actually look back at a massive policy intervention like prohibition to address important public health concerns of today. For example, the rate of women who drink during pregnancy has increased in the last decade. According to a 2022 CDC report, nearly 14% of pregnant women in the US now report drinking.
Prohibition extended Americans lives by 2 months on average
To that end, a co-author and I recently examined the long-term effects of being born during Prohibition versus during times of alcohol access. It turns out, the “noble experiment” was genuinely an excellent natural experiment for social scientists. Through the lens of big data (millions of death records and places of birth) and critical periods (in-utero exposure), we found evidence that prohibition may have led to increased longevity for those born in places where alcohol was banned – perhaps contributing as much as two months of extended life on average.
We attribute this primarily to alcohol exposure during pregnancy at a time when little was known about the risks of drinking while pregnant. Even so, only a fraction of pregnant people drank alcohol. Taking this into consideration, the full effect of reducing exposure to alcohol in utero grows to over one and a half years of longevity — much more than a “modest” effect.
By no means am I advocating for another round of prohibition. That would likely get me run out of Wisconsin. Additionally, these results are not a full analysis — you’d want to take our excellent course in cost-benefit analysis at La Follette for that. But this research does illustrate how policy effects – and analyses – do not stop after the first year, or even decade, of a policy. We can continue to learn from our past. In fact, we can do it better than ever now with the new tools and skills at our disposal.
We also need to recognize the importance of counting the benefits and the costs over a lifetime and taking a longer, more comprehensive view of policies. It’s what we aim to teach the next generation of students involved in policy questions at La Follette.
It may seem silly to think that we can take policy lessons from a century-old failure. But at a time of increasing drinking during pregnancy, it’s worth taking smaller lessons from Prohibition. Banning alcohol outright was undoubtedly a disaster, but targeted policies aimed at reducing in-utero exposure to alcohol is certainly a “noble experiment” worth pursuing.
Jason Fletcher is a Professor of Public Affairs at UW-Madison’s La Follette School of Public Affairs with appointments in Applied Economics and Population Health Sciences. Heis a leading scholar in the emerging field of social genomics and his current research examines connections between early life conditions and mortality. He wasawarded the prestigious 2023 Guggenheim Fellowship to further this research.