From “Alcohol, Society and the State” to “Broken Spirits” to...

  • P. Sulkunen


The alcohol policy doctrine that emerged during the era when modern welfare states were consolidated resulted from a battle between two options: the medical model and the epidemiological total consumption framework. This development was described and analysed in Alcohol, Society and the State. It saw the medical model as an alternative to and a competitor with alcohol control, meaning A any government measure to the purchase, production, or trade of alcoholic beverages @. Alcohol control as an instrument of prevention was grounded in what I here call the population argument — a public health theory that sets priority on rates of problems in a population rather than their individual determination. It further argues that rates of problems depend on rates of exposure, i.e. availability and consumption. Even if the practical implications of the population argument have nowhere been fully implemented, the argumentation became dominant among experts. This paper discusses the reasons why the epidemiological approach is compatible with welfare state thinking, and why its legitimacy depends on the social philosophy that underlies it, rather than technical or evidence-based considerations. This connection between the epidemiological approach and welfare state thinking is discussed in the context the changing Nordic ideas and power structures in Broken Spirits. The conclusion is that the epidemiological approach is experiencing difficulties to the extent to which the legitimacy of the welfare state is weakened.

Key words

alcohol control epidemiology population total consumption welfare state 


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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • P. Sulkunen
    • 1
  1. 1.Department of SociologyUniversity of HelsinkiFinland

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