Although widely considered a disastrous period in American history, the prohibition movement of the early 20th century may have led to increased longevity for those born in places where alcohol was banned, according to a study co-authored by Jason Fletcher of the La Follette School of Public Affairs at UW-Madison.
As the first study to research the long-term effects of prohibition on longevity, this paper adds to the understanding of the longer-term costs of alcohol exposure during pregnancy. This comes as we approach the 90th anniversary of the repeal of prohibition on December 5, 2023. It also comes at a time when the rate of women who drink during pregnancy has recently increased from 9.2 percent in 2011 to 11.3 percent in 2018, according to the study. According to a 2022 CDC report, that number now stands at nearly 14%.
Using advanced analytical methods and data from the prohibition era, this study provides important nuance to the assessment of prohibition’s effects on public health and could have important implications for policies aimed at reducing maternal alcohol use.
“Researchers now understand that exposures during pregnancy, due to interruptions to fetal development, can have long term cascading effects on later-life health,” Fletcher says. “Modern evaluation tools and new data opportunities allow us to look back at policies from 100 years ago to assess their long-term impact in ways we’ve never been able to do before.”
Fletcher and his co-author, Hamid Noghanibehambari from Austin Peay State University and an affiliate of UW-Madison’s Center for Demography of Health and Aging, used Social Security Administration death records from 1975-2005 that were linked to the 1940 US census. They identified counties of residence and determined whether alcohol sales were legal or prohibited at the time of birth.
Because parts of the country became involuntarily “dry” at different times between 1900-1930, it served as a natural experiment for investigating these effects. Fletcher and Noghanibehambari were able to compare the old-age longevity of individuals who were exposed to prohibition laws during their early-life and childhood to those who were not.
They found that being born in a county that was forced to be dry through statewide or federal alcohol prohibition correlated with roughly 0.17 additional years of longevity during old age. Taking other factors into account, such as the likelihood of women drinking during pregnancy at a time when little was known about the dangers of maternal alcohol consumption, they calculated that prohibition may have resulted in an average of 1.7 additional years for those born in counties where alcohol was banned.
To better understand the size of this observed increase in longevity, the study also compared these results with the overall change in life expectancy for Americans born between 1900-1930. Overall, this group experienced a sharp and unprecedented increase of about 11.8 years in life expectancy due to factors such as improvements in medical technology and increases in income and welfare. The effect of 1.7 years due to exposure to the temperance movement is equivalent to nearly 15% of the overall life expectancy improvements of those born at this time.
Along with recent studies that suggest that lowering alcohol availability due to prohibition reduced mortality, decreased drug-related crime, and improved child health, this research helps shed light on the effects of alcohol policy on public health.
Fletcher is a leader in the emerging field of social genomics and this new paper is part of a larger research agenda that connects early life conditions and mortality. He was recently awarded the prestigious 2023 Guggenheim Fellowship to further this research.