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Alcohol As a Risk Factor For Injury

Alcohol As a Risk Factor For Injury. Intermediate Injury Prevention Course August 23-26, 2011 Billings, MT. Alcohol As a Risk Factor for Injury.

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Alcohol As a Risk Factor For Injury

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  1. Alcohol As a Risk Factor For Injury Intermediate Injury Prevention Course August 23-26, 2011 Billings, MT

  2. Alcohol As a Risk Factor for Injury • Goal: To understand the role that alcohol plays as a risk factor for injury, and it’s impact Nationally as well as among American Indians and Alaska Natives. • Objectives: • Describe What We Know • Review Injury Data and Trends • Understand factors which place American Indians and Alaska Natives at increased risk of alcohol-related injury

  3. Alcohol, Injury, and American Indians Common Belief: Alcohol is the cause of all problems in Indian country. True or False: • Alcohol is the leading risk factor for injuries. • The solution to injury is to abolish alcohol • Males have the greatest injury problem • The solution to injury is to eliminate males

  4. PublicHealth Approach • Prevention Implement & Evaluate Programs • What Works? Find what Prevents the Problem • Who, What? Identify Risk Factors • Surveillance Define the Problem Source: National Center for Injury Prevention and Control, CDC

  5. Alcohol and Injury • What Percent of American Indian and Alaska Native Deaths Are Alcohol-Related? • Homicide — 85% • Suicide — 75% • Motor Vehicle — 73-65% • Pedestrian — 84% Sources: May P, The Epidemiology of Alcohol Abuse Among American Indians: the Mythical and Real Properties. The Primary Care Provider, Volume 20, March 1995, Indian Health Service; . Ethnicity and Alcohol-Related Fatalities, 1990-1994, by Voas RB and Tipetts AS, National Highway Traffic Safety Administration, 1999.

  6. American Indian Youth Risk Behavior Survey, 1997 1997 BIA/CDC Youth Risk Behavior Survey, students in grades 9-12: • 48% Rode with Drinking Drivers • 21% Drove after Drinking • 37% Rarely/Never used Seat Belts • 15% Attempted Suicide

  7. Odds of Causing a Motor Vehicle Crash by BAC RF Borkenstein, The Role of the Drinking Driver in Traffic Accidents. Alcohol, Drugs and Behavior 1974; 2 (suppl) 8-32.

  8. Alcohol-Related Traffic Fatalities, 1982-2000, U.S. 30,000 25,000 20,000 Number of Fatalities 15,000 10,000 5,000 0 2005 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year Source: NHTSA, Fatality Analysis Reporting System

  9. Impact of Alcohol-impaired Driving, U.S. Each Year: • 115 million episodes • Each DUI arrest: 1000-2000 not arrested • 16,000 deaths • 310,000 injuries

  10. Are We Making a Difference? Percent of Alcohol-Related Motor Vehicle Deaths, Native Americans and All US Races Source: NHTSA FARS Query system 2002: http://www-fars.nhtsa.dot.gov/; and Ethnicity and Alcohol-Related Fatalities, 1990-1994, by Voas RB and Tipetts AS, National Highway Traffic Safety Administration, 1999.

  11. In 2000, only 12% of those American Indians killed in alcohol-related motor vehicle crashes were wearing seat belts Source: NHTSA. FARS data, 2000.

  12. Risky Alcohol UseMeans Costly Health Problems

  13. Alcohol and American Indians • In small groups of 2-3, discuss what you know are factors that place American Indians/Alaska Natives at high risk for alcohol-related injury death. Take into consideration age, drinking style, environment, and gender.

  14. Alcohol and American Indians Risk Factor: Age • American Indians Overall are Younger • Median age of 24 vs. 33 for all US Races. • All Youth Engage More in Risky Behaviors • The large proportion of young AI/AN places a large segment of the population at risk

  15. Alcohol and American Indians Risk Factor: Drinking Style • In some Tribes, fewer adults drink than in the general US population, and a substantial proportion of Indian people do not drink, especially older adults. • Among AI/AN Who Do Drink—2-3 times Greater Prevalence of Problem Drinking • Indian Males 15-35 Often “Binge” Drink with High BACs. • High BACs Often Lead to Severe Injury

  16. Alcohol and American Indians Risk Factor: Environment • About Half of All American Indians Live in Rural Environments • Long Distances to Advanced Trauma Care • Risky Environments Such as Driving Long Distances at Night, Walking, and Boating Combined with High BACs Often Lead to Fatal Outcomes

  17. Alcohol and American Indians Risk Factor: Gender • More Indian Men Drink Than Women • Young Indian Men More Likely to Engage in Excessive Binge Drinking With High BACs • Indian Male Injury Death Rates are 2 to 5 Times Greater Than Female Rates • Indian Females Are at Higher Risk of Alcohol-Related Death than Non-Indian Women.

  18. Intervening in the Presence of Alcohol • Gallup Protective Custody Program • Highway Lighting Projects: Whiteriver, Gallup, Sells, others • Float coat programs in Alaska • Reduce Alcohol Availability--Policy • Legislation and Enforcement of Laws

  19. Intervening in the Presence of Alcohol Na’nizhoozhi Center • Protective Custody Program, Gallup, NM • Intoxicated people picked up off streets and housed up to 3 days • Reduces potential pedestrian injuries, hypothermia deaths, and violence • Alcohol detoxification and treatment provided

  20. Intervening in the Presence of Alcohol Pedestrian Lighting Projects • Successful street lighting projects in Whiteriver, AZ, Gallup, NM, Sells, AZ, and others • Allow drivers to see pedestrians at night, even if intoxicated and walking in roadway • Which of the Three “Es” is this approach?

  21. Intervening in the Presence of Alcohol Float Coat Programs • Alaska’s rivers are the “highways” of Native village life. • The use of float coats and life jackets can save lives even in alcohol-related boating incidents. Photo Source: Ryan Hill

  22. Who Controls Alcohol Policy? • Bootleggers • Border Towns • Tribal Council

  23. Alcohol Policy Considerations • Long history of prohibition of American Indians and alcohol. American Indians could not legally buy alcohol until 1953. • Many tribes today are still “Dry” and don’t allow alcohol on the reservation.

  24. Alcohol Policy Considerations Buzz Group Discussion (5-7 min) List policy considerations (pros and cons) of tribes legalizing the sale of alcohol - ”Wet” and “Dry”. Half the class take the Wet policy and other half Dry.

  25. Alcohol and InjurySummary • There are ways to be involved in reducing alcohol-related injuries in your community • Alcohol is a complex problem requiring multi-disciplined approach and community empowerment • Not just a police and court system problem

  26. Alcohol Resources • The Epidemiology of Alcohol Abuse Among American Indians: The Mythical and Real Properties by Dr. Philip May was published in the IHS Primary Care Provider, March, 1995, and can be found at: • http://www.ihs.gov/publicinfo/publications/healthprovider/issues/IHSProMar2.asp#alcohol

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