Category Archives: Alcohol
Binge drinking is an increasing concern in the United States. A recent report from the U.S. Centers for Disease Control and Prevention (CDC) finds that one in ten adult deaths is linked to binge drinking through illnesses the binge drinker contracts—such as hepatitis—or accidents that happen to the drinker or that he or she causes—including homicide and domestic abuse. The CDC defines binge drinking as five or more drinks in a row for males and four or more drinks in a row for females.
Binge drinking also remains a concern among young adults. A new report from the Johns Hopkins Bloomberg School of Public Health and the Boston University School of Public Health finds that liquor now trumps beer as the drink of choice for underage (ages 13 to 20) binge drinkers, likely because of increased marketing by alcohol companies.
“Spirit firms have taken a page from the beer playbook in their marketing to young people,” said David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at Johns Hopkins in a conversation with NewPublicHealth.
The report on youth binge drinking was published in the Journal of Substance Use and found that spirits accounted for 43.8 percent of binge episodes, while beer accounted for less than one-third (31.4 percent) of binge episodes. “The inclusion of some relatively expensive brands in the top twenty-five binge brand list suggests that variables other than price are driving youth brand preferences with respect to binge drinking,” said Jernigan.
“Binge drinking accounts for most of the alcohol consumed by youth in the United States, and is associated with a host of negative consequences, including drunk driving, sexual assaults and suicide,” according to Timothy Naimi, MD, MPH, a lead author of the study and an associate professor at the Boston University School of Public Health.
Study: Today’s Drugged Drivers More Likely to Mix Alcohol and Drugs, Have Taken Multiple Prescription Medicines
The profile of a drugged driver has changed substantially since 1993, according to a new study released today in the journal Public Health Reports, which shows that more drivers are now testing positive for prescription drugs, marijuana and multiple drugs.
“While we’ve seen a decrease over the years in motor vehicle fatalities involving people under the influence, the nature of those crashes is changing,” said study author Fernando Wilson, PhD, an associate professor at the University of Nebraska Medical Center.
The study examines trends in the characteristics of U.S. drivers who were involved in fatal crashes between 1993 and 2010 and tested positive for drugs. The study, funded by the Public Health Law Research program of the Robert Wood Johnson Foundation, was set up to investigate the relationship between state laws and the consumption of alcohol and other drugs in fatal car crashes. It found that the percentage of drugged drivers with three or more drugs in their system nearly doubled from 1993 to 2010, increasing from 11.5 percent to 21.5 percent.
“In 1993, about one in eight drivers were using multiple drugs concurrently. By 2010, it was closer to one in five. That’s a large increase in drug use,” Wilson said. “Beyond that, we’re also seeing more and more people using drugs and alcohol together. About 70 percent of drivers who tested positive for cocaine had also been consuming alcohol, and almost 55 percent of drivers who tested positive for cannabis also had alcohol in their systems.”
- Almost 60 percent of cannabis-only users were younger than 30 years.
- Thirty-nine percent of prescription drug users were 50 years old or older, which seems to be in line with an overall increase in the use of prescription drugs by Americans, and the older population in general.
“These trends are likely to continue into the future given the aging U.S. population, an increasing reliance on prescription medications by medical providers and increasing initiatives to legalize marijuana,” said Wilson. “However, it is unclear whether current state policies are completely up to the challenge of addressing the growing issue of drugged driving.”
NewPublicHealth recently spoke with Wilson about the study. He said he embarked on the research because of the tens of thousands of motor vehicle crashes each year and the need to figure out the most effective policies to curb distracted driving. According to Wilson, eighteen states have zero-tolerance laws for drugged drivers, but recent studies suggest that these laws may not be effective enough in decreasing traffic deaths.
This week Maryland became one of more than a dozen states to ban sales of grain alcohol, also known as extreme-strength alcohol. The drink, which includes the brand name Everclear, is 95 percent pure alcohol. It has no color, taste or smell and so easily mixes—without detection—into juices, soda and punch, making it an effective date rape tool, according to college health officials. And it’s cheap. A whole bottle can cost $15, which is a price easily shared among college or younger students.
Banning extreme-strength alcohol is among several initiatives a growing number of states are taking to try to reduce college student deaths, injuries and assaults linked to campus alcohol use. A report published in September by The Maryland Collaborative to Reduce College Drinking and Related Problems, which was formed in 2013 to address problems associated with excessive alcohol consumption on ten college campuses across the state, found that alcohol use of any kind on campuses across the country each year results in 1,800 deaths; 600,000 injuries; 700,000 assaults by someone under the influence; and nearly 1 million rapes and sexual assaults.
Many states, including Maryland, have declared college campus drinking to be a public health emergency that goes well beyond the campus because of the noise, vandalism, car crashes and community injuries and deaths linked to campus drinking each year. Banning grain alcohol was the Maryland Collaborative’s first initiative because college students who are binge drinkers—a serious and dangerous issue on campuses, according to the U.S. Centers for Disease Control and Prevention (CDC)—are 36 times more likely to drink grain alcohol than are non-binge drinkers, according to David H. Jernigan, the director of the Center on Alcohol Marketing and Youth at Johns Hopkins' Bloomberg School of Public Health in Baltimore, Md.
But some research shows that banning extreme strength alcohol can actually exacerbate the problem by raising awareness of the drink to students who may not have been aware of it before. This can push students in search of grain alcohol to find other high-octane sources, such as privately made moonshine, which can be even more highly concentrated than commercially available grain alcohol and can contain other contaminants, said Laura Forbes, an associate professor of health education at the University of Alabama/Birmingham and chair of the American College Health Association’s Alcohol, Tobacco and Other Drugs Coalition.
According to Forbes, what is desperately needed is a campus culture change on alcohol just like the culture change that has reduced smoking on campus; many campuses bans tobacco use outright. Forbes said reaching that goal requires collaborations—such as the one in Maryland—that bring together campus administrators, businesses, student leaders, law enforcement, public health and the community.
“The way to change the culture,” she said, “is to start to have a conversation that with students about why they’re drinking and to include administrations, faculty, alumni and others in the talks.”
Forbes said the culture change won’t be a suddenly dry campus. “It will be incremental over time, but each campus has to start the change to where they want to move.”
- The Maryland Collaborative has released a best practices guide for reducing campus drinking that includes both individual and campus-wide interventions.
- The CDC recently updated its Alcohol and Public Health website, which now includes new infographics and links to videos, webinars, e-cards and podcasts, as well as a fact sheet on preventing excessive alcohol use, which highlights evidence-based strategies such as those recommended by the Community Preventive Services Task Force.
Too Few Disabled Adults Participate in Physical Activities
Working-age adults with disabilities who get no aerobic physical activity are 50 percent more likely to have a chronic disease such as cancer, diabetes, stroke or heart disease than are their active peers, according to a Vital Signs report released today by the U.S. Centers for Disease Control and Prevention (CDC). Most adults with disabilities are able to participate in physical activity, yet nearly half (47 percent) of them get no aerobic physical activity. An additional 22 percent aren’t active enough. However, only about 44 percent of adults with disabilities who saw a doctor in the past year got a recommendation for physical activity.
The key findings of the report include:
- Working-age adults with disabilities are three times more likely to have heart disease, stroke, diabetes or cancer than are adults without disabilities.
- Nearly half of adults with disabilities get no aerobic physical activity, an important protective health behavior to help avoid these chronic diseases.
- Inactive adults with disabilities were 50 percent more likely to report at least one chronic disease than were active adults with disabilities.
- Adults with disabilities were 82 percent more likely to be physically active if their doctor recommended it.
- The CDC recommends that adults with disabilities talk to their doctor about how much and what kind of physical activity is right for them, and that doctors and other health professionals recommend options that fit each disabled patients. The agency has created a resource page to help health professionals direct disabled patients to fitness options.
Read more on physical activity.
>>Bonus Link: Read a NewPublicHealth interview with James Rimmer, director of the National Center on Health, Physical Activity and Disability.
HHS: Quality Improvement Efforts Saved 15,000 Lives, $4B in Health Spending
New data from the U.S. Department of Health and Human Services (HHS) indicates that quality improvements to the country’s health care system helped prevent nearly 15,000 deaths in hospitals, avoid 560,000 patient injuries and saved approximately $4 billion in health spending from 2011 to 2012. The preliminary data also indicates an overall nine percent decrease in hospital-acquired infections over that period. “We applaud the nationwide network of hospital systems and providers that are working together to save lives and reduce costs,” said HHS Secretary Kathleen Sebelius. “We are seeing a simultaneous reduction in hospital readmissions and injuries, giving patients confidence that they are receiving the best possible care and lowering their risk of having to be readmitted to the hospital after they get the care they need.” Read more on HHS.
AAP: Drunk Driving Remains a Significant Safety Threat for U.S. Children
Despite improvements in safety efforts and the data, motor vehicle crashes remain a leading cause of death for U.S. children and in approximately 20 percent of the deaths at least one of the drivers is legally drunk, according to a new study in the journal Pediatrics. Researchers examined National Highway Traffic Safety Administration data of children under age 15 who were killed in a traffic crash between 2001 and 2010. The study determined that child deaths with an alcohol-impaired driver decreased by 41 percent over that period, with a total of 2,344 victims. Researchers also determined that 61 percent of impaired drivers were unrestrained at the time of the crash and one-third did not have a valid driver’s license. The researchers said that communities need to “urge states and communities to target efforts at protecting children from impaired drivers and increasing use of age- and size-appropriate restraints for child passengers,” according to a release from the American Academy of Pediatricians. Read more on alcohol.
One in Four Teen Births Are Among Younger Teens Ages 15 to 17
While births to younger teens ages 15 to 17 years have declined, they still represent over a quarter of teen births and nearly 1,700 births a week, according to this month’s Vital Signs, the monthly health indicator report from the U.S. Centers for Disease Control and Prevention (CDC). “Although we have made significant progress reducing teen pregnancy, far too many teens are still having babies,” said CDC Director Tom Frieden, MD, MPH. “Births to younger teens pose the greatest risk of poor medical, social and economic outcomes. Efforts to prevent teen childbearing need to focus on evidence-based approaches to delaying sexual activity and increasing use of the most effective methods of contraception for those teens who are sexually active.” Read more on sexual health.
Study: Rural Girls Get More Daily Exercise than Those in Suburban, Urban Communities
While the level of urbanicty—whether they live in rural, suburban or urban communities—does not seem to affect boys’ levels of moderate-to-vigorous physical activity, there is a noticeable effect for girls, according to a new study in the American Journal of Preventive Medicine. Researchers determined that girls from rural areas are 4.6 times more likely than those in suburban areas and 2.8 times more likely than those in urban areas to exceed the national physical activity recommendation of 60 or more minutes of moderate-to-vigorous physical activity each day. The study tracked the daily activity of a random selection of 1,354 youth in 20 counties in North Carolina. Read more on physical activity.
Study: Mentions of Alcohol Brands in Popular Music Increase Youth Alcohol Use
The average young person in the United States hears approximately eight alcohol brand names each day while listening to music, increasing the risk they will use and abuse alcohol, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Using information collected from more than 3,400 males and females ages 15 to 23, researchers determined that the average youth in that age group listens to 2.5 hours of music per day, with 3-4 brand mentions each hour. Lisa Henriksen, senior research scientist at the Stanford Prevention Research Center, called the findings “worrisome” in a release. "It would be foolish to think that the alcohol industry is unaware of and uninvolved with alcohol-brand mentions in music," said Henriksen. "The strategy of associating products with hip culture and celebrities who are attractive to youth comes straight from a playbook written by the tobacco industry." Approximately 39 percent of U.S. teens are current drinkers and about 22 percent are binge drinkers, according to the U.S. Centers for Disease Control and Prevention. Read more on alcohol.
Some Will Be Able to Enroll After March 31 Affordable Care Act Deadline
Some people will be able to enroll for coverage under the Affordable Care Act after the official enrollment deadline of March 31, according to new guidelines expected to be issued by the Obama administration. The new guidelines would allow people had previously tried to enroll by were prevented by systems problems such as technical difficulties, according to Reuters. "Open enrollment ends March 31. We are preparing for a surge in enrollment, and if consumers are in line on the 31st and can't finish, we won't shut the door on them. To be clear, if you don't have health insurance and do not start to sign up by the deadline, you can't get coverage again until next year," said U.S. Department of Health and Human Services spokeswoman Joanne Peters in a statement. Read more on the Affordable Care Act.
Study: Alcohol-Related Vehicle Crashes Greatly Underreported
Alcohol is a far greater factor in U.S. motor vehicle deaths than has been reported, according to a new study in the Journal of Studies on Alcohol and Drugs. Using Fatality Analysis Reporting System (FARS) data from the U.S. National Highway Traffic Safety Administration, researchers determined that in the decade from 1999 to 2009 while only a little more than 3 percent of the death certificates for traffic deaths included alcohol as a contributing cause, about 21 percent of the deaths were legally drunk. Approximately 450,000 Americans were killed in traffic crashes during the period. The time that it takes coroners to take and process blood alcohol tests could be a reason for the underreported figures. Ralph Hingson, Sc.D., of the U.S. National Institute on Alcohol Abuse and Alcoholism, said the vast discrepancy demonstrates the need for more reliable data. "We need to have a handle on what's contributing to the leading cause of death among young people," he said in a release. "You want to know how big the problem is, and if we can track it. Is it going up, or going down? And what policy measures are working?" Read more on alcohol.
NIH Identifies Genetic Markers Tied to Stroke, Cardiovascular Disease
Researchers and the National Institutes of Health have identified a genetic variant linked to increased risk for stroke, as well as a metabolic pathway tied to several common diseases, which taken together could improve how doctors identify and treat major diseases. “Our findings have the potential to identify new targets in the prevention and treatment of stroke, cardiovascular disease and many other common diseases,” said Stephen R. Williams, PhD, a postdoctoral fellow at the University of Virginia Cardiovascular Research Center and the University of Virginia Center for Public Health Genomics, Charlottesville. The genetic markers were found through the analysis of nearly 5,000 genomes. The results were published in the journal PLoS Genetics. About 600,000 Americans die of heart disease each year—one in every four deaths—and stroke is the fourth-leading cause of death in the United States. Read more on heart health.
New Report on US Cancer Care Finds Significant Cost and Quality Challenges
A new report from the American Association of Clinical Oncology (ASCO) finds that several factors including an aging population and poor lifestyle habits in the United States have resulted in an increase in annual cancer cases at the same time many smaller oncology practices are closing because of financial pressures. "We're facing a collection of challenges, each one of which could keep cancer treatment advances out of reach for some individuals," said ASCO President Clifford A. Hudis, MD.
ASCO’s recommendations include:
- Support for novel cancer care delivery efforts.
- Development of new healthcare delivery and payment models to help ensure the viability of small community practices while encouraging high-quality care.
- Support for quality initiatives that will speed up dissemination of cancer treatment breakthroughs and changes.
Read more on cancer.
Spring Break Highlights Dangers of Binge Drinking
The average male Spring Breaker reports drinking 18 alcoholic drinks per day during the week-long festivity, while the average female reports up to 10 drinks, according to the American College of Health. Five or more drinks within two hours qualify as “binge drinking” for men and four or more qualifies for women. Each year 1,825 college students ages 18-24 die from alcohol-related unintentional injuries, with alcohol poisoning among the biggest causes. Signs of alcohol poisoning include irregular breathing, vomiting, confusion and unconsciousness, and should be met with an immediate trip to the emergency room.
Among the other unintentional injuries:
- Assault — More than 690,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.
- Sexual Abuse — More than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape.
- Injury — 599,000 students between the ages of 18 and 24 receive unintentional injuries while under the influence of alcohol.
Read more on alcohol.
Mass Analysis Confirms Link Between Bullying, Suicidal Thoughts
A new review of 43 previous studies seems to confirm the link between bullying and an increase in suicidal thoughts, with cyber bullying linked the most strongly. The study appears in JAMA Pediatrics and included data on approximately 350,000 youths. Approximately half of students in grades 4-12 report being bullied within the previous month, with one-third saying they were bullies themselves. While the new analysis does not demonstrate causation, it does indicate a more complex connection, perhaps even showing that kids with suicidal thoughts in the first place are more likely to be bullied. Read more on violence.
Minimum Alcohol Prices Could Help Low-income, High-risk Drinkers
Setting a minimum price for alcohol would have a positive impact on low-income, high-risk drinkers, but little effect on low-income, moderate drinkers, according to a new study in The Lancet. British researchers at the University of Sheffield utilized a computer model to assess the impact of a 73 cents per unit of alcohol minimum on different demographics, finding it would have the greatest positive impact—reducing the amount of alcohol consumption—on the 5 percent of the population defined as high-risk drinkers. "Our study finds no evidence to support the concerns highlighted by government and the alcohol industry that minimum unit pricing would penalize responsible drinkers on low incomes,” said study co-author Petra Meier, director of the Sheffield Alcohol Research Group. “Instead, minimum unit pricing is a policy that is targeted at those who consume large quantities of cheap alcohol. By significantly lowering rates of ill health and premature deaths in this group, it is likely to contribute to the reduction of health inequalities." Read more on alcohol.
Smoking Linked to Most Common Type of Breast Cancer
Adding yet another health risk to the use of tobacco, smoking is linked to an increased risk for the most common type of breast cancer, according to a new study in the journal Cancer. Researchers at the Fred Hutchinson Cancer Research Center in Seattle conducted a population-based study of 778 patients, ages 20-44, with estrogen receptor positive breast cancer (the most common type) and 182 patients with triple-negative breast cancer; there were 938 cancer-free controls. They found that women who were current or recent smokers and had been smoking a pack a day for at least 10 years had a 60 percent increased risk of estrogen receptor positive breast cancer. "The health hazards associated with smoking are numerous and well known. This study adds to our knowledge in suggesting that with respect to breast cancer, smoking may increase the risk of the most common molecular subtype of breast cancer but not influence risk of one of the rarer, more aggressive subtypes," said Christopher Li, MD, PhD. Read more on cancer.
Low Testosterone Drugs Can Double Heart Attack Risk in Some Men
Ads asking men about their “low T”—or low testosterone levels—have become so common of late that in 2013 sales of the testosterone gel Androgel exceeded those of Viagra. However, a recent study indicates that men under the age of 65 with a history of heart disease see their heart attack risk double shortly after beginning testosterone therapy. The joint study from the UCLA Fielding School of Public Health, the National Institutes of Health and Consolidated Research Inc. appears in the journal PLOS ONE. Researchers decided to perform this larger study after three smaller studies raised concerns about the connection. "We decided to investigate cardiovascular risks of this therapy in a large health care database since these previous studies were modest in size and only focused on men 65 and older," said the study's senior author, Sander Greenland, MD, a professor of epidemiology at the UCLA Fielding School of Public Health and a professor of statistics in the UCLA College of Letters and Science. "Our study allowed us to examine cardiovascular risk in men under the age of 65 and to replicate the findings in men over 65." Read more on heart health.
USDA: Americans Are Eating Healthier
A new report from the U.S. Department of Agriculture finds that American diets improved between 2005 and 2010. The report, which relied on responses to the National Health Examination and Nutrition Survey, found that American adults are making better use of available nutrition information; consuming fewer calories coming from fat and saturated fat; consuming less cholesterol; and eating more fiber. Daily calorie intake declined by 78 calories per day between 2005 and 2010. The report also found declines in calories from total fat (3.3 percent), saturated fat (5.9 percent), and intake of cholesterol (7.9 percent). Overall fiber intake increased by 1.2 grams per day (7.5 percent). Read more on nutrition.
ACEP Emergency Care Report Card Gives Public Health a ‘C’
Public health and injury prevention received a “C” grade in the new "America's Emergency Care Environment: A State-by-State Report Card." The nation overall received a “D” in the American College of Emergency Physicians report, which looks at the conditions and policies under which emergency care is being delivered, not the quality of the care. Public health and prevention was one of five categories of 136 total measures used to grade the quality of emergency care, along with access to emergency care; quality and patient safety; medical liability and environment; and disaster preparedness. Read more on access to health care.
Mental Health Problems in Middle Aged and Older Adults May be Underreported
A new study by researchers at the Johns Hopkins School of Public Health and published in JAMA Psychiatry finds than the number of people in middle and old age with mental health disorders may be higher than previously thought. The study was based on a survey of just over 1,000 adults who were part of a long-term longitudinal study. The participants were asked questions about mental health disorders and then were also given an assessment for the disorders by health professionals. The survey found that while the responders underreported mental health issues, they were fairly accurate when reporting physical health problems. Read more on mental health.
New Interventions Needed to Reduce Underage Drinking
Strategies recommended by the Surgeon General to reduce underage drinking have shown promise when put into practice, according to scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The approaches include nighttime restrictions on young drivers and strict license suspension policies; partnerships between college campuses and the community; and routine screening by doctors to identify and counsel underage drinkers. However, Ralph Hingson, SCD, director of NIAAA's Division of Epidemiology and Prevention Research says that “while progress has been made in addressing underage drinking, the consequences still remain unacceptably high. We must continue research to develop new interventions and implement existing strategies that have been shown to be effective.” According to Hingson, new research areas could include more studies of the effects of alcohol on the developing brain, legal penalties for providing alcohol to minors and parent-family alcohol interventions. Preliminary NIAAA research also shows that interventions aimed at strengthening family relationships in the middle-school years can have a lasting effect on students’ drinking behavior. Underage drinking is linked to 5,000 injury deaths per year, poor academic performance, potential damage to the developing brain, and risky sexual behavior. Read more on alcohol.
HHS: Guides, Tools to Improve Safe Use of EHRs
The U.S. Department of Health and Human Services (HHS) has released a new set of guides and interactive tools to assist health care providers in more safely using and managing electronic health information technology products, such as electronic health records (EHRs). The resources—which include checklists, practice worksheets and recommended practices to assess and optimize the safe use of EHRs—are available at HealthIT.gov. Each guide is available as an interactive online tool or a downloadable PDF. The new tools are part of HHS’s plan to implement its Health IT Patient Safety Action and Surveillance Plan, released last July. Read more on technology.
Traumatic Brain Injury Linked to Higher Risk of Early Death
Traumatic brain injury (TBI) is linked to a higher risk of premature death, according to a new study in the journal JAMA Psychiatry. Researchers from the University of Oxford, United Kingdom, analyzed the records of all patients born in 1954 or later in Sweden who were diagnosed with TBI from 1969 to 2009, finding an increased risk of dying among patients who survived six months after TBI compared to those without TBI, with the risk remaining for years afterward. In particular, the study found an increased risk of death from external causes such as suicide, injury and assault, also was higher. “Current clinical guidelines may need revision to reduce mortality risks beyond the first few months after injury and address high rates of psychiatric comorbidity and substance abuse,” wrote the study authors. Read more on mental health.
Heavy Drinking During Middle Age Can Cause Earlier Memory Loss in Men
Heavy drinking during middle age can bring on earlier deterioration of memory, attention and reasoning skills in men, according to a new study in the journal Neurology. Researchers studied data on 5,000 men and 2,000 women whose alcohol consumption was assessed three times over a 10-year period before also taking three tests of memory, attention and reasoning, with the first test happening at the average age of 56. They found that men who drank at least 2.5 servings of alcohol a day experienced mental declines between 1.5 and 6 years earlier than the other participants. "Heavy alcohol consumption is known to be detrimental for health, so the results were not surprising...they just add that [it's] also detrimental for the brain and the effects can be observed as [early] as 55 years old," said study author Severine Sabia, a research associate in the department of epidemiology and public health at University College London. Read more on alcohol.