Alcohol’s Ripple Effect: Evidence Review Reveals Broad Harms to Women and Children

A sweeping evidence review published by RTI Press sheds new light on the extensive social harms caused not by individuals’ own alcohol use, but by the drinking of others—a public health burden that remains vastly underrecognized in global policy responses. Drawing on over 120 studies across multiple countries, the report synthesizes data on how alcohol consumption inflicts harms across interpersonal, familial, and societal domains, disproportionately affecting women and children.

The review categorizes alcohol’s secondhand harms into three principal domains: violence and aggression, including intimate partner violence (IPV); economic and emotional distress within families; and increased caregiving burdens, especially in the context of parental or partner drinking. Across all domains, women and children were found to suffer the most frequent and severe consequences.

One striking theme is the gendered nature of alcohol-related violence. Studies consistently report that women are more likely to be physically assaulted, sexually coerced, or psychologically abused by male partners who drink. These patterns held across low-, middle-, and high-income countries. Children, too, bear the brunt of alcohol-fueled domestic conflict. Multiple studies linked caregiver drinking with higher rates of neglect, maltreatment, and exposure to unsafe environments.

Economic harms also emerged as a recurring consequence. In both qualitative and quantitative research, families reported that a household member’s alcohol use often diverted limited resources from food, healthcare, or school fees, compounding the vulnerabilities of already impoverished settings. In several case studies, women described bearing dual burdens—managing financial strain while also assuming additional caregiving responsibilities due to a partner’s drinking-related incapacity.

While men were also found to experience harms from others’ drinking—including workplace aggression and public disturbances—their exposure was more likely to be episodic and occur outside the home. In contrast, women’s exposure was often chronic and deeply embedded within household dynamics.

Notably, the report emphasizes that these harms are not limited to “problem drinkers.” Even moderate alcohol use by household members can trigger cascading effects, particularly when layered upon structural inequities such as poverty, gender-based violence, and limited access to support services.

The authors argue that global alcohol policy has failed to adequately account for these secondhand harms. Current strategies overwhelmingly focus on individual-level consumption metrics and alcohol-related mortality, with little recognition of the broader social consequences. The review calls for a paradigm shift—urging policymakers to treat alcohol’s externalities as seriously as those of tobacco or air pollution.

Recommendations include strengthening legal protections against alcohol-related domestic violence, expanding access to family support and treatment services, and incorporating secondhand harms into national alcohol surveillance systems. The report also points to promising community-level interventions, such as women’s advocacy groups and alcohol-free safe spaces, that have shown early success in mitigating harms in high-burden areas.

By foregrounding the lived experiences of women and children impacted by others’ drinking, this review provides a sobering reminder that alcohol’s true toll reaches far beyond the drinker—and demands a more inclusive, equity-centered policy response.