Anna Buckner Alcohol Epidemiologist Utah Department of Health

Transcription

1 Anna Buckner Alcohol Epidemiologist Utah Department of Health

2 Overview of excessive alcohol use and related harms Describe environmental prevention policy strategies Provide an example of how a coalition or other local entity might utilize the strategies in their own community

3 An alcohol epidemiologist studies: patterns of alcohol use, abuse, and dependence the development of alcohol problems factors that are associated with an increased risk or susceptibility Utah Objectives Build capacity Promote evidence based strategies Provide expertise and guidance Source: National Institute on Alcohol Abuse and Alcoholism, Module 1: Epidemiology of Alcohol Problems in the United States (2005)

4

5 Excessive Alcohol Use Includes: Source: Centers for Disease Control and Prevention, CDC Excessive alcohol use is associated with many health and social harms, including liver cirrhosis, certain cancers, heart disease, unintentional injuries, violence, and fetal alcohol spectrum disorder.

6 Excessive alcohol use accounts for 1 of 10 deaths among workingage adults in the United States. Binge drinking is the most common form of excessive alcohol use. 9 of 10 adults who binge drink are not alcohol dependent. Effective strategies for preventing excessive drinking are available but underused. *CDC, At A Glance 2016, Excessive Alcohol Use: Preventing a Leading Risk for Death, Disease, and Injury

7

8 Behavioral Risk Factor Surveillance System (BRFSS) Alcohol consumption, binge drinking/heavy drinking, binge drinking-intensity/frequency, type/place/price of alcohol consumed Utah Emergency Department Encounter Database, Bureau of Emergency Medical Services Alcohol attributable emergency department visits Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics Alcohol attributable hospitalizations Utah Death Certificate Database, Office of Vital Records and Statistics Alcohol attributable mortality

9

10

11 Leading Causes of Death Leading Causes of Death by Crude Rate, Deaths Per 100,000 Population Number of Deaths Heart Disease ,566 Cancer ,091 Unintentional injuries ,172 Alzheimer's disease Stroke Chronic lower respiratory diseases Suicide Diabetes Influenza and pneumonia Kidney Disease Source: Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health.

12 Estimated Cause Alcohol Attributable Deaths Suicide 130 Motor-vehicle traffic crashes 83 Alcoholic Liver Disease 116 Poisoning (not alcohol) 111 Fall injuries 70 Alcohol dependence syndrome 58 Liver cirrhosis unspecified 59 Homicide 23 Alcohol Poisoning 29 Alcohol Abuse 13 All Other 79 Total Deaths 771

13

14

15 Screening and brief interventions for excessive alcohol use. Enforce laws that prohibit alcohol sales to minors. Hold alcohol retailers liable for harms related to the sale of alcoholic beverages to minors and intoxicated patrons (dram shop liability). Maintain existing limits on the days and hours when alcohol is sold. Increase the price of alcohol. Avoid further privatization of alcohol sales in states with government operated or contracted liquor stores. Limit the number of retail alcohol outlets that sell alcoholic beverages in a given area.

16 Nelson et al / Am J Prev Med 2013;45(1):19 28

17

18 Alcohol outlet density is defined as the number of physical locations in which alcoholic beverages are available for purchase either per area or per population

19 High alcohol outlet density is an environmental risk factor for excessive drinking High alcohol outlet density has been associated with underage drinking, violent crime, child abuse and neglect, suicide, and traffic deaths Higher risk of excessive drinking and related harms caused by: Increased access to alcohol Price competition among alcohol outlets Patronage by nonresidents, person who travel to the cluster The social aggregation of binge drinkers in a small geographic area

20 Differences in alcohol outlet density and alcohol taxes accounted for about half of the overall effect that the alcohol policy environment had on binge drinking among adults Alcohol outlet density can vary substantially among states and communities Identifying high alcohol outlet density can help liquor control agencies manage the issuance of liquor licenses or increase enforcement of liquor laws in a particular area. Surveillance data on alcohol outlet density can be used to evaluate the relationship between alcohol outlet density and various social harms among communities Source: CDC Guide for Measuring Alcohol Outlet Density 2017

21 Reduce excessive alcohol consumption Reduce consumption by high risk groups (e.g., underage drinkers) Reduce specific alcohol attributable harms Identify hot spots to target liquor law enforcement Managing the issuance of new alcohol licenses in cluster areas Monitor changes in alcohol outlet density over time Assess disparities in alcohol outlet density among communities Conducting alcohol policy research, such as linking harms to alcohol outlet density Evaluating policy and prevention efforts A combination of these purposes

22 On-Premise- Alcohol is consumed where it is sold (restaurants, bars etc.) Off-Premise-Alcohol is purchased and then consumed elsewhere (state liquor stores, grocery stores, gas stations etc.)

23 During the most recent occasion, where were you when you did most of your drinking? Any Alcohol Use Binge Drinkers At your home 65.9% 61.0% At another person's home 12.8% 20.3% At a restaurant 11.8% 2.9% At a banquet hall 0.3% 0.4% At a bar 4.9% 9.3% At a club 0.7% 1.2% At a public place 3.5% 4.9% Total on-premise 21.2% 18.7% Total off-premise 78.7% 81.3% During the most recent occasion, where had most of the alcohol you consumed been purchased? Any Alcohol Use Binge Drinkers From a grocery store 31.6% 40.4% From a restaurant 12.2% 2.3% From a banquet hall 0.2% 0.0% From a bar 5.3% 10.2% From a club 0.6% 1.5% From a state liquor store 47.6% 42.2% From an alcohol package agency 0.5% 0.6% From a fair or sporting event 0.6% 1.2% From another state 1.5% 1.6% Source: Utah Behavioral Risk Factor Surveillance System 2013

24

25

26

27

28 This presentation was supported by Cooperative Agreement Number NU58DP from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

29 Anna Buckner