Binge Drinking Frequency Predicted by Veteran Status and the Interaction between Hispanic Ethnicity and Veteran Status

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1 Binge Drinking Frequency Predicted by Veteran Status and the Interaction between Hispanic Ethnicity and Veteran Status Paul Preczewski, Robert Bossarte, Hua He, Xin Tu VA Center for Excellence for Suicide Prevention

2 Drinking Among Veterans Numerous studies (currently and previously) point to military service, particularly in conflict, as a predictor of increased alcohol consumption. (Boscarino, 1981; Bradley et al. 2001; Stahre et al., 2009) Veteran status is less well established as a predictor, remarkably. Alcohol consumption being the third leading behavioral cause of death in the US (Mokdad et al., 2004), the VA is particularly concerned about lasting negative drinking habits among US Veterans Our mission is to at every level of care promote healthy lifestyles, increasing comfort and quality of life among Veterans

3 Drinking Problems Finding increased alcohol consumption alone to be vague for the purposes of understanding and helping our population, we break problem drinking into two major categories for this study: 1) Binge Drinking (having > 4-f/5-m drinks per drinking occasion) 2) Maximum drinks on one maximum drinking occasion

4 Notion of Veteran Status Epidemiologically, we also seek to reduce Veteran status to its components. For example Women Ethnic Groups Age (specific time of service in conflict) SES/Employment We are in fact trying to move away from the category of Veteran alone for the purpose of research, health care, and interventions.

5 Our Approach Accordingly, we build large models with large samples, infusing many predictor variables, to try to better understand health problems affecting Veterans, moving away from the notion of Veteran status alone and targeting specific Veteran groups and experiences. This approach is yielding robust and often unique results.

6 This Study We began this study asking: 1) Controlling for many known predictors of problematic alcohol consumption, do we still see military service or Veteran status predicting binge and maximum drinking? 2) What populations among Veterans are at increased risk?

7 Methods Using BRFSS 2008 data (n=414,509), we ran zero inflated/truncated Poisson regression controlling for known binge and maximum drinking predictors to evaluate Veteran status and sub-group prediction of our drinking outcomes. Establishing significant predictors, we then reran the models with sub-group interaction terms with Veteran status.

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10 Results When controlling for age, sex, race, body mass index, children, marriage, education level, income, employment status, and self-reported poor health, Veteran status significantly predicts binge drinking frequency (p=.035) and does not significantly predict maximum reported drinking (p=.628).

11 Results The combination of reporting Hispanic ethnicity and Veteran status was a significant predictor of both binge drinking frequency and maximum drinks reported (p=.032, p=.029). This was the only significant sub-population interaction other than other for ethnicity.

12 Results Hispanic-Veteran status, in terms of binge drinking frequency, entirely reverses the significantly negative (healthy) relationship between allpopulation Hispanics and binge drinking frequency.

13 Hispanic Reversal

14 Conclusions Controlling for nearly know predictors of binge drinking, Veteran status stands as a predictor of binge drinking but not maximum drinking on maximum drinking occasions. Remarkably, this is novel. Hispanic Veterans binge and problem drink more than Hispanic non-veterans to a degree of full reversal of the (healthy) negative Hispanic prediction of drinking by these two measures.

15 Implications and directions Research alcohol enculturation process of Hispanics serving in military units what s going on? Underway: provide specific and targeted within-culture support to Hispanic Veterans (and others at increased risk such as low social support*) Move away from the Veteran-status-only view of drinking problem prediction.