Using Epidemiological Data to Help Focus Alcohol-Related Prevention in New Mexico

Transcription

1 Using Epidemiological Data to Help Focus Alcohol-Related Prevention in New Mexico CSTE Pre-Conference Workshop June 9, 2013 Jim Roeber Alcohol Epidemiologist Substance Abuse Epidemiology Program Epidemiology and Response Division New Mexico Department of Health

2 Presentation overview Broadening the focus: using data to redefine the problem and broaden the focus of prevention efforts Sharpening the focus: using data to support effective prevention strategies

3 Broadening the focus of alcohol-related prevention in New Mexico

4 Broadening the focus of alcohol-related prevention Baseline focus of state prevention efforts: Major alcohol-related problem: DWI and motor vehicle crashes Major target population/behavior: Underage drinking (UAD) Major form of problem drinking : Alcoholism Major form of prevention: Individual behavior change Major source of evidence: Brand of the month

5 Major alcohol-related problem from DWI to all alcohol-related outcomes

6 Major target population from UAD to alcohol issues across the life span Average Annual Alcohol-Attributable Deaths By Age, New Mexico, More than 90% of deaths

7 Major target population from UAD to alcohol issues across the life span Alcohol-Attributable Years of Potential Life Lost By age group, New Mexico, ,912 21,650 9,262 Source: CDC ARDI YPLL are average annual

8 Major form of problem drinking... from alcoholism to binge drinking Prevalence of Excessive Drinking by Category Adults 18 and older, New Mexico, Any Excessive Drinking 14.4 Binge Drinking 5.1 Heavy Drinking Impaired Driving Alcohol Dependence Source: Woerle S, Roeber J, Landen M. Prevalence of alcohol dependence among excessive drinkers in New Mexico. Alcohol Clin Exp Res Feb;31(2):293-8

9 Major form of problem drinking... from alcoholism to binge drinking Prevalence of Past-Year Alcohol Dependency New Mexico, 2002 All Adults Binge Drinking Adults 2% 98% 8% 92% Dependent Non-Dependent Dependent Non-Dependent Source: Woerle S, Roeber J, Landen M. Prevalence of alcohol dependence among excessive drinkers in New Mexico. Alcohol Clin Exp Res Feb;31(2):293-8

10 Major risk behavior from binge prevalence to binge frequency/intensity Past Month Binge Drinking Characteristics Adults Age 18+, by Gender, New Mexico, Source: BRFSS

11 Major risk behavior from binge intensity to high intensity binge drinking Source: NMDOH states with a lower prevalence of binge drinking might still include subgroups that binge drink with high intensity Binge Drinking Vital Signs

12 Source: NMDOH Major risk behavior from binge intensity to high intensity binge drinking

13 Major focus of prevention activity from behavior change to environmental change Alcohol-Attributable Death Rates By county, NM, , and US, 2009 Alcohol outlet density is an environmental factor that is limited by statute Source: BVRHS, UNM-GPS Rates are per 100,000, age-adjusted to the US 2000 standard population

14 Source: New Mexico Regulation and Licensing Department Actual versus allowed number of liquor licenses [New Mexico Statute] 60-6A-18. LIMITATION ON NUMBER OF LICENSES A. The maximum number of licenses to be issued shall be as follows: (1) in incorporated municipalities, not more than one dispenser's or one retailer's license...for each two thousand inhabitants or major fraction thereof

15 Actual versus allowed number of liquor licenses Percent difference for Local Option Districts > 10,000 population New Mexico, 2012 [New Mexico Statute] 60-6A-18. LIMITATION ON NUMBER OF LICENSES A. The maximum number of licenses to be issued shall be as follows: (1) in incorporated municipalities, not more than one dispenser's or one retailer's license...for each two thousand inhabitants or major fraction thereof Source: New Mexico Regulation and Licensing Department

16 San Juan McKinley

17 Navajo Nation Zuni Pueblo

18 San Juan McKinley

19 The major form of evidence from brand of the month to solid science

20 Sharpening the focus of alcohol-related prevention in New Mexico

21 Easy to Get Alcohol Bernalillo County, 2009 SOURCE: YRRS 21

22 Alcohol Source Bernalillo County, 2009 SOURCE: YRRS 22

23 Alcohol Source Bernalillo County, 2009 Enhanced enforcement of laws prohibiting sales to minors SOURCE: YRRS 23

24 What Can You Do? Law Enforcement Public + Awareness Increased perception of risk of sanction Reduced sales/provision to minors Enhanced enforcement of laws prohibiting sales to minors Encourage local law enforcement to enforce minimum legal drinking age (MLDA) law to conduct party patrols Do media advocacy to maximize effect of law enforcement Get stories in newspaper, 24 on local radio

25 Drinking Location Bernalillo County, 2009 SOURCE: YRRS 25

26 Drinking Location Social Host Liability Bernalillo County, 2009 SOURCE: YRRS 26

27 What Can You Do? %20workshop%203%206% pdf Pass social host liability ordinance Learn about strategy e.g., Jim Mosher Talk with other communities (Espanola, Moriarty, Santa Fe) Plan a campaign Once the ordinance is passed, enforce and publicize 27

28 Increasing the price of tobacco reduces youth smoking 42% federal tax increase 28

29 Increasing the price of alcohol reduces alcohol-related chronic disease deaths -11% -29% Increases in alcohol excise tax rates were associated with immediate and sustained reductions in alcohol-related disease mortality in Alaska Effects of Alcohol Tax Increases on Alcohol-Related Disease Mortality in Alaska: Time-Series Analyses from 1976 to Wagenaar AC, Maldonado-Molina MM, Wagenaar BH. Am J Public Health

30 What Can You Do? Increase the price of alcohol Learn about local liquor tax option from other communities (e.g., McKinley County) Learn about state alcohol excise tax initiatives from other coalitions (e.g., Santa Fe Underage Drinking Prevention Alliance) Partner with other state and local coalitions 30

31 2011 DWI Hotspot Map* * Red dot indicates > 26.5% of crashes were alcohol-involved; size indicates wrecks Source: DWI Resource Center # 1 DWI hotspot: Louisiana and Central 31 Based on crashes occurring between 7 pm and 5 am, Sunday to Saturday,

32 2011 DWI Hotspot Map* # 1 DWI hotspot: Louisiana and Central * Red dot indicates > 26.5% of crashes were alcohol-involved; size indicates wrecks Source: DWI Resource Center 32 Based on crashes occurring between 7 pm and 5 am, Sunday to Saturday,

33 Center on Alcohol Marketing and Youth (CAMY) resources: Michael Sparks presentation: Departments/North_Carolina_Coalition_Initiative/Reducing %20Alcohol%20Outlet%20Density%20Training%20-%20NC %206%2012.pdf What Can You Do? Regulate alcohol outlet density Learn more, e.g., CAMY resources; Michael Sparks/CADCA Learn NM statutes and your own local ordinances Talk with communities that have done this (e.g., ABQ) Identify alcohol outlet density issues in your community Determine and pursue best 33 available approach

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35 Conclusions Epidemiological data can help broaden the focus of alcohol-related prevention, at the state and local level In New Mexico, such data have been used to promote a broader focus on: All alcohol-related problems (vs. DWI) Across the life span (vs. underage only) Excessive consumption (vs. alcohol dependence) Drinking patterns (e.g., binge intensity) and their implications for prevention Epidemiological data and prevention science findings can help sharpen the focus of alcohol-related prevention efforts, by suggesting effective state and local strategies for alcohol-related prevention

36 Acknowledgements NMDOH: Michael Landen, Toby Rosenblatt, Dan Green CDC: Bob Brewer, Dafna Kanny

37 Thank You! Any Questions? Jim Roeber