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Soltani S, Jayedi A, Ghoreishy S, Mousavirad M, Movahed S, Jabbari M, Asoudeh F. Alcohol consumption and frailty risk: a dose-response meta-analysis of cohort studies. Age Ageing 2024; 53:afae199. [PMID: 39300899 DOI: 10.1093/ageing/afae199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 07/25/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND/AIMS While previous studies suggest that light-to-moderate alcohol consumption may reduce the frailty risk, the dose-response relationship is still under question. To address the knowledge gap, we conducted a systematic review and dose-response meta-analysis of cohort studies to examine the association of alcohol consumption with the risk of both prefrailty and frailty in adults. METHODS We searched MEDLINE (Ovid), PubMed and Scopus to identify relevant cohort studies published before 8 May 2024. The dose-response meta-analysis was performed to investigate the associations between alcohol drinking and the risk of developing pre-frailty and frailty. We used random-effects models to calculate pooled relative risks (RR) with 95% CIs. RESULTS We included nine cohort studies with 64 769 participants and 15 075 cases, of which eight studies were rated to have a serious risk of bias as assessed by the ROBINS tool. Based on our analysis, each 12 g increase in alcohol intake did not appear to be associated with risks of prefrailty (RR: 1.08, 95% CI 0.89, 1.31; I2 = 91%, n = 3; GRADE = very low) and frailty (RR: 0.94, 95% CI 0.88, 1.00; I2 = 63%, n = 9; GRADE = low). The nonlinear dose-response meta-analysis indicates a slight inverse association with frailty risk up to an alcohol intake of 20 grams per day, beyond which an upward trend is observed. CONCLUSION The inverse association found between moderate alcohol consumption and frailty risk appears to be stronger among older adults, which might be due to the lower and less popular alcohol consumption among older people than the general population. However, because this finding is based on low-quality evidence, more research is needed to develop specific dietary recommendations for alcohol consumption, particularly among young people.
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Affiliation(s)
- Sepideh Soltani
- Yazd Cardiovascular Research Center, Noncommunicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Jayedi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyedmojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Mousavirad
- Department of Physical Medicine & Rehabilitation, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Samira Movahed
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Maedeh Jabbari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Asoudeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
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Alexander T, Burnette CB, Cory H, McHale S, Simone M. The need for more inclusive measurement to advance equity in eating disorders prevention. Eat Disord 2024:1-19. [PMID: 38488765 PMCID: PMC11401964 DOI: 10.1080/10640266.2024.2328460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Eating disorder (ED) research and practice have been shaped by prevailing stereotypes about who EDs are most likely to affect. Subsequently, the field has prioritized the needs and concerns of affluent, cisgender, heterosexual, white girls and women to the exclusion of others, especially people marginalized based on their race, ethnicity, sexual orientation, and/or gender identity. However, EDs exist across diverse groups and actually occur with elevated prevalence in several marginalized groups. Growing research points to differences in the drivers of EDs in such groups (e.g. desire to attain the curvy rather than thin ideal; dietary restraint due to food insecurity rather than weight/shape concerns), yet tools typically used for screening and intervention evaluation do not capture eating pathology driven by such factors. In this commentary, we describe gaps in existing ED assessment tools and argue these gaps likely underestimate EDs among marginalized groups, bias who is invited, participates in, and benefits from ED prevention programs, and obscure potential group differences in the efficacy of such programs. We also discuss the potential of these ramifications to exacerbate inequities in EDs. Finally, we outline recommendations to overcome existing gaps in measurement and, consequently, advance equity in the realm of ED prevention.
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Affiliation(s)
- Tricia Alexander
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - C Blair Burnette
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Hannah Cory
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Health Promotion and Community Health, School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA
| | - Safiya McHale
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado Denver, Denver, CO, USA
| | - Melissa Simone
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado Denver, Denver, CO, USA
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Faint N, Coleman M, Spring B, Richardson A, Thornton A, Bacon D, Kumaradevan S, Gardiner FW. Western Australia remote aeromedical substance use disorders outcomes. Intern Med J 2024; 54:86-95. [PMID: 37255269 DOI: 10.1111/imj.16140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Substance use disorders (SUDs) cause significant harm to regional Australians, who are more likely to misuse alcohol and other drugs (AODs) and encounter difficulty in accessing treatment services. The primary aims of this study were to describe the demographics of patients aeromedically retrieved from regional locations and compare hospital outcomes with a metropolitan-based cohort. AIMS Retrospective case-controlled cohort study. Participants were aeromedically retrieved within Western Australia for SUDs between 1 July 2014 and 30 June 2019. Retrieved patients were case-matched based on age and hospital discharge diagnosis. Descriptive statistics and χ2 analysis were used to summarise the findings. RESULTS One hundred thirty-six (91.3%) aeromedical retrievals were found, with the majority being male (n = 95; 69.9%). These were case-matched to 427 metropolitan patients, the majority male (n = 321; 75.2%). Retrieved patients were more likely (all P < 0.05) Indigenous (odds ratio [OR], 9.35 [95% confidence interval (CI), 5.96-14.85]), unemployed (OR, 2.9 [95% CI, 1.41-6.80]), referred to a tertiary hospital (OR, 2.18 [95% CI, 1.24-3.86]) and to stay longer in hospital (OR, 1.08 [95% CI, 1.02-1.14]). DISCUSSION Findings highlight that unmarried and/or unemployed males were overrepresented in the retrieval group, with over half identifying as Indigenous. Regional variation in retrievals was noted, while amphetamine-type stimulants featured prominently in the retrieval cohort, who experienced longer hospital stays and more restrictive treatment. CONCLUSIONS Comparing clinical outcomes for retrieved regional patients experiencing SUDs, service design and delivery should focus on offering culturally safe care for Indigenous people, catering for regional health care catchment areas, while ideally adopting collaborative and integrated approaches between AODs and mental health services.
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Affiliation(s)
- Nicholas Faint
- Great Southern Mental Health Service, Western Australia Country Health Service, Perth, Western Australia, Australia
| | - Mathew Coleman
- Great Southern Mental Health Service, Western Australia Country Health Service, Perth, Western Australia, Australia
- The Rural Clinical School of Western Australia, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Breeanna Spring
- Public Health and Research, Royal Flying Doctor Service of Australia, Canberra, Australian Capital Territory, Australia
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Queensland, Brisbane, Australia
| | - Alice Richardson
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ashleigh Thornton
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Donna Bacon
- The Rural Clinical School of Western Australia, The University of Western Australia, Perth, Western Australia, Australia
- Geraldton Regional Aboriginal Service, Western Australia Country Health Service, Geraldton, Western Australia, Australia
| | - Santharajah Kumaradevan
- Public Health and Research, Royal Flying Doctor Service of Australia, Canberra, Australian Capital Territory, Australia
| | - Fergus W Gardiner
- The Rural Clinical School of Western Australia, The University of Western Australia, Perth, Western Australia, Australia
- Public Health and Research, Royal Flying Doctor Service of Australia, Canberra, Australian Capital Territory, Australia
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
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Goodon H, Czyrnyj C, Comaskey B, Gawaziuk J, Logsetty S, Spiwak R. Social determinants of alcohol-related traumatic injury in young adults: a scoping review protocol. BMJ Open 2023; 13:e074653. [PMID: 37989375 PMCID: PMC10668285 DOI: 10.1136/bmjopen-2023-074653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/02/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Limited research examines alcohol-related injury in the context of social determinants of health (SDoH) to guide effective intervention and prevention programmes. SDoH are non-medical factors that impact health such as income, housing and childhood environment. This scoping review aims to explore the role SDoH in childhood have in alcohol-related injury in young adults. METHODS AND ANALYSIS The scoping review process will be guided by the methodology framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews Guidelines (PRISMA-ScR). The PubMed and SCOPUS databases will be systematically searched. Studies of various designs and methodologies (published in English since 1 January 2000) that examine certain SDoH of interest in relation to alcohol-related injury in adults aged 18-25 years old will be considered for inclusion in this review. Two reviewers will screen all articles identified from the databases independently. Titles and abstracts will be reviewed based on the initial search and included if eligibility criteria are met. Duplicate articles will be removed and full texts will be examined to create a final list of included studies. Any disagreements on the inclusion of any articles will be resolved through discussion and consultation with a third reviewer if necessary. ETHICS AND DISSEMINATION As this research does not involve human subjects, ethics approval is not required. The results of this study will be summarised quantitatively through numerical counts and qualitatively through a narrative synthesis. The results from this review will address an important literature gap and inform the development of targeted prevention programmes for alcohol-related injury. REGISTRATION NUMBER This protocol is registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/MYEXA).
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Affiliation(s)
- Hunter Goodon
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cameron Czyrnyj
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brenda Comaskey
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Justin Gawaziuk
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarvesh Logsetty
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rae Spiwak
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
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Unnikrishnan R, Zhao Y, Chondur R, Burgess P. Alcohol-Attributable Death and Burden of Illness among Aboriginal and Non-Aboriginal Populations in Remote Australia, 2014-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7066. [PMID: 37998297 PMCID: PMC10671330 DOI: 10.3390/ijerph20227066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Harmful use of alcohol is a problem in the Northern Territory (NT), Australia. The aim of this study was to assess and compare alcohol-attributable deaths and the contribution of alcohol to the burden of disease and injury (BOD) among the Aboriginal and non-Aboriginal populations in the NT between 2014 and 2018. The alcohol-use data for adults aged 15+ years old in the NT population was taken from the 2016 National Drug Strategy Household Survey. BOD was measured in disability-adjusted life years (DALY) as part of the NT BOD study. Population-attributable fractions were derived to analyse deaths and BOD. Between 2014 and 2018, 673 Aboriginal and 392 non-Aboriginal people died of harmful use of alcohol, accounting for 26.3% and 12.9% of the total deaths in the Aboriginal and non-Aboriginal population, respectively. Alcohol caused 38,596 and 15,433 DALY (19.9% and 10.2% of the total), respectively, in the NT Aboriginal and non-Aboriginal population for the same period. The alcohol-attributable DALY rate in the Aboriginal population was 10,444.6 per 100,000 persons, six times the non-Aboriginal rate. This study highlights the urgent need to reduce harmful alcohol use in the NT, which disproportionately affects Aboriginal peoples in rural and remote areas.
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Affiliation(s)
| | - Yuejen Zhao
- Health Statistics & Informatics, Department of Health, Darwin, NT 0800, Australia
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Nambiar D, Bestman A, Srivastava S, Marten R, Yangchen S, Buse K. How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks. Int J Health Policy Manag 2023; 12:7451. [PMID: 38618791 PMCID: PMC10699821 DOI: 10.34172/ijhpm.2023.7451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/16/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND As the Sustainable Development Goals deadline of 2030 draws near, greater attention is being given to health beyond the health sector, in other words, to the creation of healthy societies. However, action and reform in this area has not kept pace, in part due to a focus on narrower interventions and the lack of upstream action on health inequity. With an aim to guide action and political engagement for reform, we conducted a thematic analysis of concepts seeking to arrive at healthy societies. METHODS This paper drew on a qualitative thematic analysis of a purposive sample of 68 documents including political declarations, reports, peer reviewed literature and guidance published since 1974. Three independent reviewers extracted data to identify, discuss and critique public policy levers and 'enablers' of healthy societies, the "how." RESULTS The first lever concerned regulatory and fiscal measures. The second was intersectoral action. The final lever a shift in the global consensus around what signifies societal transformation and outcomes. The three enablers covered political leadership and accountability, popular mobilization and the generation and use of knowledge. CONCLUSION Documents focused largely on technical rather than political solutions. Even as the importance of political leadership was recognized, analysis of power was limited. Rights-based approaches were generally neglected as was assessing what worked or did not work to pull the levers or invest in the enablers. Frameworks typically failed to acknowledge or challenge prevailing ideologies, and did not seek to identify ways to hold or governments or corporations accountable for failures. Finally, ideas and approaches seem to recur again over the decades, without adding further nuance or analysis. This suggests a need for more upstream, critical and radical approaches to achieve healthy societies.
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Affiliation(s)
- Devaki Nambiar
- The George Institute for Global Health, New Delhi, India
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Amy Bestman
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Robert Marten
- The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland
| | - Sonam Yangchen
- The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland
| | - Kent Buse
- The George Institute for Global Health, Imperial College London, London, UK
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Kilian C, Manthey J, Braddick F, López-Pelayo H, Rehm J. Social disparities in alcohol's harm to others: evidence from 32 European countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104079. [PMID: 37271071 DOI: 10.1016/j.drugpo.2023.104079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Alcohol use can cause harm not only to the person who consumes it but also to others. Prior research has found that these alcohol-attributable harms to others differ across socioeconomic groups, though several findings have been contradictory. The aim of this contribution was to study the role of individual-level and population-level income inequalities in alcohol's harm to others among women and men. METHODS Logistic regression analysis of cross-sectional survey data from 2021, covering 39,629 respondents from 32 European countries. Harms from others' drinking were defined as experiences of physical harm, involvement in a serious argument, or involvement in a traffic accident, due to another person's drinking, within the past year. We examined the association of individual-level income and country-specific income inequality (Gini index) with harms from a known person's or a stranger's drinking, adjusting for the respondent's age, daily drinking levels, and at least monthly risky single-occasion drinking. RESULTS At the individual level, people with lower incomes had 21% to 47% increased odds of reporting harms from a known person's drinking (women and men) or stranger's drinking (men only) than their same-gender counterparts in the highest income quintile. At the national level, countries with higher income inequality showed increased risks of harms from a known person's drinking among women (OR = 1.09, 95% confidence interval [CI]: 1.05 - 1.14), while among men the risk of harm from strangers' drinking decreased with higher income inequality (OR = 0.86, 95% CI: 0.81 - 0.92). These associations with income inequality were observed among respondents from all but the lowest income groups. CONCLUSION Alcohol can cause harm to others, with women and people with low incomes being disproportionally exposed to these harms. Alcohol control policies targeting high consumption levels, especially among men, as well as upstream policies to reduce inequalities, are needed to lower the health burden of alcohol beyond those who consume it.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Fleur Braddick
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Hugo López-Pelayo
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic, Barcelona, Spain
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Kilian C, Lemp JM, Probst C. Who benefits from alcohol screening and brief intervention? A mini-review on socioeconomic inequalities with a focus on evidence from the United States. Addict Behav 2023; 145:107765. [PMID: 37315509 DOI: 10.1016/j.addbeh.2023.107765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
Alcohol-attributable mortality contributes to growing health inequalities. Addressing hazardous alcohol use and alcohol use disorders through alcohol screening and brief intervention is therefore a promising public health strategy to improve health equity. In this narrative mini-review, we discuss the extent to which socioeconomic differences exist in the alcohol screening and brief intervention cascade, highlighting the example of the United States. We have searched PubMed to identify and summarize relevant literature addressing socioeconomic inequalities in (a) accessing and affording healthcare, (b) receiving alcohol screenings, and/or (c) receiving brief interventions, focusing predominantly on literature from the Unites States. We found evidence for income-related inequalities in access to healthcare in the United States, partly due to inadequate health insurance coverage for individuals with low socioeconomic status. Alcohol screening coverage appears to be generally very low, as is the probability of receiving a brief intervention when indicated. However, research suggests that the latter is more likely to be provided to individuals with low socioeconomic status than those with high socioeconomic status. Individuals with low socioeconomic status also tend to benefit more from brief interventions, showing greater reductions in their alcohol use. Once access to and affordability of healthcare is ensured and high coverage of alcohol screening is achieved for all, alcohol screening and brief interventions have the potential to enhance health equity by reducing alcohol consumption and alcohol-related health harms.
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Affiliation(s)
- Carolin Kilian
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Julia M Lemp
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Probst C, Buckley C, Lasserre AM, Kerr WC, Mulia N, Puka K, Purshouse RC, Ye Y, Rehm J. Simulation of Alcohol Control Policies for Health Equity (SIMAH) Project: Study Design and First Results. Am J Epidemiol 2023; 192:690-702. [PMID: 36702471 PMCID: PMC10423629 DOI: 10.1093/aje/kwad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/15/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Since about 2010, life expectancy at birth in the United States has stagnated and begun to decline, with concurrent increases in the socioeconomic divide in life expectancy. The Simulation of Alcohol Control Policies for Health Equity (SIMAH) Project uses a novel microsimulation approach to investigate the extent to which alcohol use, socioeconomic status (SES), and race/ethnicity contribute to unequal developments in US life expectancy and how alcohol control interventions could reduce such inequalities. Representative, secondary data from several sources will be integrated into one coherent, dynamic microsimulation to model life-course changes in SES and alcohol use and cause-specific mortality attributable to alcohol use by SES, race/ethnicity, age, and sex. Markov models will be used to inform transition intensities between levels of SES and drinking patterns. The model will be used to compare a baseline scenario with multiple counterfactual intervention scenarios. The preliminary results indicate that the crucial microsimulation component provides a good fit to observed demographic changes in the population, providing a robust baseline model for further simulation work. By demonstrating the feasibility of this novel approach, the SIMAH Project promises to offer superior integration of relevant empirical evidence to inform public health policy for a more equitable future.
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Affiliation(s)
- Charlotte Probst
- Correspondence to Dr. Charlotte Probst, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula-Franklin Street, Toronto, ON M5S 2S1, Canada (e-mail: )
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Morton Ninomiya ME, Almomani Y, Dunbar Winsor K, Burns N, Harding KD, Ropson M, Chaves D, Wolfson L. Supporting pregnant and parenting women who use alcohol during pregnancy: A scoping review of trauma-informed approaches. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057221148304. [PMID: 36744547 PMCID: PMC9905036 DOI: 10.1177/17455057221148304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alcohol is legalized and used for a variety of reasons, including socially or as self-medication for trauma in the absence of accessible and safe supports. Trauma-informed approaches can help address the root causes of alcohol use, as well as the stigma around women's alcohol use during pregnancy. However, it is unclear how these approaches are used in contexts where pregnant and/or parenting women access care. Our objective was to synthesize existing literature and identify promising trauma-informed approaches to working with pregnant and/or parenting women who use alcohol. A multidisciplinary team of scholars with complementary expertise worked collaboratively to conduct a rigorous scoping review. All screening, extraction, and analysis was independently conducted by at least two authors before any differences were discussed and resolved through team consensus. The Joanna Briggs Institute method was used to map existing evidence from peer-reviewed articles found in PubMed, CINAHL, PsycINFO, Social Work Abstracts, and Web of Science. Data were extracted to describe study demographics, articulate trauma-informed principles in practice, and gather practice recommendations. Thirty-six studies, mostly from the United States and Canada, were included for analysis. Studies reported on findings of trauma-informed practice in different models of care, including live-in treatment centers, case coordination/management, integrated and wraparound supports, and outreach-for pregnant women, mothers, or both. We report on how the following four principles of trauma-informed practices were applied and articulated in the included studies: (1) trauma awareness; (2) safety and trustworthiness; (3) choice, collaboration, and connection; and (4) strengths-based approach and skill building. This review advances and highlights the importance of understanding trauma and applying trauma-informed practice and principles to better support women who use alcohol to reduce the risk of alcohol-exposed pregnancies. Relationships and trust are central to trauma-informed care. Moreover, when applying trauma-informed practices with pregnant and parenting women who use alcohol, we must consider the unique stigma attached to alcohol use.
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Affiliation(s)
- Melody E Morton Ninomiya
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, ON, Canada,School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada,Melody E Morton Ninomiya, Department of Health Sciences, Wilfrid Laurier University, Rm. BA0546, 75 University Avenue West, Waterloo, ON N2L 3C5, Canada.
| | - Yasmeen Almomani
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | | | - Nicole Burns
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Kelly D Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada,School of Liberal Arts, Laurentian University, Sudbury, ON, Canada
| | - Megan Ropson
- Memorial University, St. John’s, NL, Canada,Labrador-Grenfell Health, Happy Valley-Goose Bay, NL, Canada
| | - Debbie Chaves
- Library, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Lindsay Wolfson
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada,Centre of Excellence for Women’s Health, Vancouver, BC, Canada
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Vuchinich RE, Tucker JA, Acuff SF, Reed DD, Buscemi J, Murphy JG. Matching, behavioral economics, and teleological behaviorism: Final cause analysis of substance use and health behavior. J Exp Anal Behav 2023; 119:240-258. [PMID: 36541360 DOI: 10.1002/jeab.815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
Howard Rachlin and his contemporaries pioneered basic behavioral science innovations that have been usefully applied to advance understanding of human substance use disorder and related health behaviors. We briefly summarize the innovations of molar behaviorism (the matching law), behavioral economics, and teleological behaviorism. Behavioral economics and teleological behaviorism's focus on final causes are especially illuminating for these applied fields. Translational and applied research are summarized for laboratory studies of temporal discounting and economic demand, cohort studies of alcohol and other drug use in the natural environment, and experimental behavioral economic modeling of health behavior-related public health policies. We argue that the teleological behavioral perspective on health behavior is conducive to and merges seamlessly with the contemporary socioecological model of health behavior, which broadens the contextual influences (e.g., community, economic, infrastructure, health care access and policy) of individuals' substance use and other health risk behaviors. Basic-to-applied translations to date have been successful and bode well for continued applications of basic science areas pioneered by Howard Rachlin and his contemporaries.
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Affiliation(s)
| | - Jalie A Tucker
- University of Florida and Center for Behavioral Economic Health Research, Gainesville, FL
| | | | - Derek D Reed
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, KS
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12
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MacKillop J, Agabio R, Feldstein Ewing SW, Heilig M, Kelly JF, Leggio L, Lingford-Hughes A, Palmer AA, Parry CD, Ray L, Rehm J. Hazardous drinking and alcohol use disorders. Nat Rev Dis Primers 2022; 8:80. [PMID: 36550121 PMCID: PMC10284465 DOI: 10.1038/s41572-022-00406-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 12/24/2022]
Abstract
Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspectives on AUDs apply a biopsychosocial framework that emphasizes the interplay of genetics, neurobiology, psychology, and an individual's social and societal context. There is strong evidence that AUDs are genetically influenced, but with a complex polygenic architecture. Likewise, there is robust evidence for environmental influences, such as adverse childhood exposures and maladaptive developmental trajectories. Well-established biological and psychological determinants of AUDs include neuroadaptive changes following persistent use, differences in brain structure and function, and motivational determinants including overvaluation of alcohol reinforcement, acute effects of environmental triggers and stress, elevations in multiple facets of impulsivity, and lack of alternative reinforcers. Social factors include bidirectional roles of social networks and sociocultural influences, such as public health control strategies and social determinants of health. An array of evidence-based approaches for reducing alcohol harms are available, including screening, pharmacotherapies, psychological interventions and policy strategies, but are substantially underused. Priorities for the field include translating advances in basic biobehavioural research into novel clinical applications and, in turn, promoting widespread implementation of evidence-based clinical approaches in practice and health-care systems.
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Affiliation(s)
- James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
- Homewood Research Institute, Guelph, ON, Canada.
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Neuroscience Institute, Section of Cagliari, National Research Council, Cagliari, Italy
| | - Sarah W Feldstein Ewing
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
- Department of Psychology and Behavioural Sciences, Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - John F Kelly
- Recovery Research Institute and Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Anne Lingford-Hughes
- Division of Psychiatry, Imperial College London, London, UK
- Central North West London NHS Foundation Trust, London, UK
| | - Abraham A Palmer
- Department of Psychiatry & Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Charles D Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Lara Ray
- Departments of Psychology and Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Campbell Family Mental Health Research Institute, PAHO/WHO Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health; Institute of Health Policy, Management and Evaluation; & Department of Psychiatry, University of Toronto (UofT), Toronto, Canada
- WHO European Region Collaborating Centre at Public Health Institute of Catalonia, Barcelona, Spain
- Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Zentrum für Interdisziplinäre Suchtforschung der Universität Hamburg (ZIS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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13
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Sadler RC, Wojciechowski TW, Trangenstein P, Harris A, Buchalski Z, Furr-Holden D. Linking Historical Discriminatory Housing Patterns to the Contemporary Alcohol Environment. APPLIED SPATIAL ANALYSIS AND POLICY 2022; 16:561-581. [PMID: 36532713 PMCID: PMC9734485 DOI: 10.1007/s12061-022-09493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/16/2022] [Indexed: 05/21/2023]
Abstract
Research on alcohol outlet density consistently shows greater disparities in exposure in disinvested communities. Likewise, structural racism via discriminatory housing practices has created many of the issues that beset contemporary disinvested neighborhoods. Little work, however, has examined the relationship between housing practices and alcohol outlet disparities. The central premise of our work is that these discriminatory and inequitable practices create distinctions in the alcohol environment, and that such disparities have implications for work on alcohol policy. Here we link alcohol outlet density with a spatial database examining redlining, blockbusting, and gentrification in Baltimore, Maryland, and Flint, Michigan (two cities with common experiences of urban disinvestment over the last 50 years). Standard measures are used to account for the impacts of neighborhood racial, socioeconomic, and housing composition in a multilevel model. Our findings highlight that gentrification and redlining are strongly associated with alcohol outlet density, while blockbusting is not. Gentrification and redlining also frequently co-occur in inner-urban areas, while the more suburban phenomenon of blockbusting rarely overlaps with either. These findings further contextualize nascent work on structural racism in housing that illustrates important disparities along the lines of these distinct practices. Future work should consider how legacy impacts of discriminatory housing patterns impact our communities today.
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Affiliation(s)
| | | | | | - Alan Harris
- Michigan State University, 200 E 1st St., Flint, MI 48502 USA
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14
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Davidson L, Piatkowski T, Pocuca N, Hides L. Modelling the Relationship Between Environmental and Social Cognitive Determinants of Risky Drinking Among Emerging Adults. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00978-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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15
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Yuen WS, Leung J, Man N, Chiu V, Gisev N, Livingston M, Degenhardt L, Farrell M, Pearson SA, Dobbins T, Dunlop A, Mattick RP, Peacock A. Age at first alcohol-related hospital separation or emergency department presentation and rate of re-admission: A retrospective data linkage cohort of young Australians. Drug Alcohol Rev 2022; 41:1577-1588. [PMID: 36054167 DOI: 10.1111/dar.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Alcohol is a leading risk factor for death and disease in young people. We compare age-specific characteristics of young people who experience their first ('index') alcohol-related hospitalisation or emergency department (ED) presentation, and whether age at index predicts 12-month rates of readmission. METHODS We used a retrospective linked-data cohort of 10,300 people aged 12-20 years with an index alcohol-related hospital and/or ED record in New South Wales, Australia from 2005 to 2013. Age group (early adolescent [12-14 years], late adolescent [15-17 years], young adult [18-20 years]) and diagnosis fields were used in logistic regression analyses and to calculate incidence rates with adjustment for year of index event, sex, socioeconomic disadvantage and residence remoteness. RESULTS People who experienced their index event in early adolescence (adjusted relative risk ratio [ARRR] 0.45 [95% confidence interval 0.39, 0.52]) or late adolescence (ARRR 0.82 [0.74, 0.90]) were less likely to be male compared to young adults. Early adolescents (ARRR 0.60 [0.51, 0.70]) and late adolescents (ARRR 0.84 [0.76, 0.93]) were less likely to have a hospitalisation index event. Early adolescents (adjusted incidence rate ratio 1.40 [1.15, 1.71]) and late adolescents (adjusted incidence rate ratio 1.16 [1.01, 1.34]) were more likely than young adults to have a subsequent 12-month non-poisoning injury ED presentation. DISCUSSION AND CONCLUSIONS We identified preventable hospital events in young people who have previously experienced an alcohol-related ED presentation or hospitalisation, with age-specific characteristics and outcomes that can be used to inform future health policy and service planning.
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Affiliation(s)
- Wing S Yuen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Vivian Chiu
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | | | - Adrian Dunlop
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
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16
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Schelleman-Offermans K, Vieno A, Stevens GWJM, Kuntsche E. Family affluence as a protective or risk factor for adolescent drunkenness in different countries and the role drinking motives play. Soc Sci Med 2022; 311:115302. [PMID: 36113211 DOI: 10.1016/j.socscimed.2022.115302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
AIMS Previous research has shown mixed results (positive, negative or no effects) regarding socio-economic disparities in adolescent drunkenness. This study investigates whether family affluence is differently associated with frequency of adolescent drunkenness in traditional countries, at a later diffusion of innovation adopter stage according to the Theory of Diffusions of Innovations by Rogers (2003), compared with more progressive countries at a more advanced stage. Furthermore, we investigated as to whether differences in this association can be explained by differences in adolescent drinking motives. METHODS This study used data from the 2009/2010 survey of the Health Behaviour in School-aged Children (HBSC) study, including 25,566 alcohol-using adolescents aged 11-19 years old from 11 European countries. The Global Innovativeness Index was used to classify countries in progressive or more traditional countries. Multi-level regression analyses and structural equation modelling were conducted. FINDINGS In traditional countries, family affluence showed a positive association with adolescent frequency of drunkenness. A higher endorsement of social (drinking to celebrate an event) and enhancement motives (drinking to increase moods) by adolescents with a higher family affluence mediated this positive association between family affluence and frequency of drunkenness. In progressive countries, family affluence was negatively associated with frequency of drunkenness. In these countries, a higher endorsement of coping drinking motives by adolescents with a lower family affluence mediated this association. CONCLUSION A country's diffusion of innovation stage (i.e., traditional vs. progressive) seems to shape the direction of the association between family affluence and adolescent drunkenness including the psychological pathways that explain these socio-economic inequalities. This is most likely due to a quicker and smoother adoption of the new 'low drunkenness norms' ('it is not cool to drink to get drunk') in progressive countries and among adolescents with a higher family affluence.
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Affiliation(s)
- Karen Schelleman-Offermans
- Department of Work and Social Psychology, Maastricht University, PO Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands.
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research (CAPR), La Trobe University, 360 Collins Street, Melbourne, Australia.
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17
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Xu Y, Geldsetzer P, Manne-Goehler J, Theilmann M, Marcus ME, Zhumadilov Z, Quesnel-Crooks S, Mwalim O, Moghaddam SS, Koolaji S, Karki KB, Farzadfar F, Ebrahimi N, Damasceno A, Aryal KK, Agoudavi K, Atun R, Bärnighausen T, Davies J, Jaacks LM, Vollmer S, Probst C. The socioeconomic gradient of alcohol use: an analysis of nationally representative survey data from 55 low-income and middle-income countries. Lancet Glob Health 2022; 10:e1268-e1280. [PMID: 35961350 PMCID: PMC9582994 DOI: 10.1016/s2214-109x(22)00273-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Alcohol is a leading risk factor for over 200 conditions and an important contributor to socioeconomic health inequalities. However, little is known about the associations between individuals' socioeconomic circumstances and alcohol consumption, especially heavy episodic drinking (HED; ≥5 drinks on one occasion) in low-income or middle-income countries. We investigated the association between individual and household level socioeconomic status, and alcohol drinking habits in these settings. METHODS In this pooled analysis of individual-level data, we used available nationally representative surveys-mainly WHO Stepwise Approach to Surveillance surveys-conducted in 55 low-income and middle-income countries between 2005 and 2017 reporting on alcohol use. Surveys from participants aged 15 years or older were included. Logistic regression models controlling for age, country, and survey year stratified by sex and country income groups were used to investigate associations between two indicators of socioeconomic status (individual educational attainment and household wealth) and alcohol use (current drinking and HED amongst current drinkers). FINDINGS Surveys from 336 287 participants were included in the analysis. Among males, the highest prevalence of both current drinking and HED was found in lower-middle-income countries (L-MICs; current drinking 49·9% [95% CI 48·7-51·2] and HED 63·3% [61·0-65·7]). Among females, the prevalence of current drinking was highest in upper-middle-income countries (U-MIC; 29·5% [26·1-33·2]), and the prevalence of HED was highest in low-income countries (LICs; 36·8% [33·6-40·2]). Clear gradients in the prevalence of current drinking were observed across all country income groups, with a higher prevalence among participants with high socioeconomic status. However, in U-MICs, current drinkers with low socioeconomic status were more likely to engage in HED than participants with high socioeconomic status; the opposite was observed in LICs, and no association between socioeconomic status and HED was found in L-MICs. INTERPRETATION The findings call for urgent alcohol control policies and interventions in LICs and L-MICs to reduce harmful HED. Moreover, alcohol control policies need to be targeted at socially disadvantaged groups in U-MICs. FUNDING Deutsche Forschungsgemeinschaft and the National Center for Advancing Translational Sciences of the US National Institutes of Health.
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Affiliation(s)
- Yuanwei Xu
- School of Economics and Management, Gottfried Wilhelm Leibniz University of Hannover, Hannover, Germany; Faculty of Management and Economics, Ruhr University Bochum, Bochum, Germany.
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Jen Manne-Goehler
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA; Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michaela Theilmann
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Maja-E Marcus
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
| | | | - Sarah Quesnel-Crooks
- Non-Communicable Diseases, Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago
| | | | - Sahar Saeedi Moghaddam
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sogol Koolaji
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khem B Karki
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ebrahimi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Krishna K Aryal
- Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
| | | | - Rifat Atun
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Global Health and Social Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Till Bärnighausen
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Boston, MA, USA; Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany; Africa Health Research Institute, Somkhele, South Africa
| | - Justine Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK; Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa; Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Security, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.
| | - Charlotte Probst
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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18
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Employment Status and Alcohol-Attributable Mortality Risk-A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127354. [PMID: 35742600 PMCID: PMC9224380 DOI: 10.3390/ijerph19127354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/30/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022]
Abstract
Being unemployed has been linked to various health burdens. In particular, there appears to be an association between unemployment and alcohol-attributable deaths. However, risk estimates presented in a previous review were based on only two studies. Thus, we estimated updated sex-stratified alcohol-attributable mortality risks for unemployed compared with employed individuals. A systematic literature search was conducted in August 2020 using the following databases: Embase, MEDLINE, PsycINFO, and Web of Science. The relative risk (RR) of dying from an alcohol-attributable cause of death for unemployed compared with employed individuals was summarized using sex-stratified random-effects DerSimonian-Laird meta-analyses. A total of 10 studies were identified, comprising about 14.4 million women and 19.0 million men, among whom there were about 3147 and 17,815 alcohol-attributable deaths, respectively. The pooled RRs were 3.64 (95% confidence interval (CI): 2.04–6.66) and 4.93 (95% CI 3.45–7.05) for women and men, respectively. The findings of our quantitative synthesis provide evidence that being unemployed is associated with an over three-fold higher risk of alcohol-attributable mortality compared with being employed. Consequently, a global public health strategy connecting brief interventions and specialized care with social services assisting those currently unemployed is needed.
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19
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Ameratunga S, Rasanathan K. Securing investments to realise the social and economic rights of adolescents. Lancet 2022; 399:e32-e33. [PMID: 28433258 DOI: 10.1016/s0140-6736(17)30992-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 04/06/2017] [Indexed: 11/21/2022]
Affiliation(s)
- Shanthi Ameratunga
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
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20
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Bonander C, Nilsson A, Björk J, Blomberg A, Engström G, Jernberg T, Sundström J, Östgren CJ, Bergström G, Strömberg U. The value of combining individual and small area sociodemographic data for assessing and handling selective participation in cohort studies: Evidence from the Swedish CardioPulmonary bioImage Study. PLoS One 2022; 17:e0265088. [PMID: 35259202 PMCID: PMC8903292 DOI: 10.1371/journal.pone.0265088] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/23/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives
To study the value of combining individual- and neighborhood-level sociodemographic data to predict study participation and assess the effects of baseline selection on the distribution of metabolic risk factors and lifestyle factors in the Swedish CardioPulmonary bioImage Study (SCAPIS).
Methods
We linked sociodemographic register data to SCAPIS participants (n = 30,154, ages: 50–64 years) and a random sample of the study’s target population (n = 59,909). We assessed the classification ability of participation models based on individual-level data, neighborhood-level data, and combinations of both. Standardized mean differences (SMD) were used to examine how reweighting the sample to match the population affected the averages of 32 cardiopulmonary risk factors at baseline. Absolute SMDs >0.10 were considered meaningful.
Results
Combining both individual-level and neighborhood-level data gave rise to a model with better classification ability (AUC: 71.3%) than models with only individual-level (AUC: 66.9%) or neighborhood-level data (AUC: 65.5%). We observed a greater change in the distribution of risk factors when we reweighted the participants using both individual and area data. The only meaningful change was related to the (self-reported) frequency of alcohol consumption, which appears to be higher in the SCAPIS sample than in the population. The remaining risk factors did not change meaningfully.
Conclusions
Both individual- and neighborhood-level characteristics are informative in assessing study selection effects. Future analyses of cardiopulmonary outcomes in the SCAPIS cohort can benefit from our study, though the average impact of selection on risk factor distributions at baseline appears small.
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Affiliation(s)
- Carl Bonander
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Anton Nilsson
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Lund University, Lund, Sweden
- Centre for Economic Demography, Lund University, Lund, Sweden
| | - Jonas Björk
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Johan Sundström
- Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Ulf Strömberg
- Department of Research and Development, Region Halland, Halmstad, Sweden
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21
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Carels C, Florence M, Adams S, Sinclair DL, Savahl S. Youths' Perceptions Of The Relation Between Alcohol Consumption And Risky Sexual Behaviour in the Western Cape, South Africa: A Qualitative Study. CHILD INDICATORS RESEARCH 2022; 15:1269-1293. [PMID: 35079296 PMCID: PMC8773401 DOI: 10.1007/s12187-022-09913-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
The purpose of this study is to explore the factors that youth identify as contributing to alcohol consumption, and more specifically its relation to risky sexual behaviour among youth. We employed an exploratory qualitative method using focus group discussions with 34 young people between the ages of 18-25-years-old in low socio-economic status communities in the Western Cape province of South Africa. Data were analyzed thematically utilizing Braun and Clarke's (2006) six-step thematic analysis process. We identified two thematic domains pertaining to alcohol consumption and risky sexual behaviour, namely individual and social factors, each comprising three themes. The individual factors thematic domain comprises intrapersonal influences, employment and educational attainment; while the social factors thematic domain includes interpersonal influences, social influences, and hope for the future. Youth living in low socio-economic status communities were thought to be at greater risk of alcohol misuse and subsequent risky behaviour, given the political and social history of marginalisation, systematic oppression, and social inequality. To address alcohol use and risky sexual behavior among youth, we recommend interventions with adolescents, parents or guardians, and the community. More specifically, interventions aimed at adolescents should focus on the transition to young adulthood. Interventions with parents should focus on their role in modelling and potentially regulating alcohol consumption. Finally, community interventions should centre on drinking behaviors, levels of drinking, what constitutes harmful drinking, and how to identify when treatment and recovery support is likely to be required.
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Affiliation(s)
- Cassandra Carels
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
| | - Maria Florence
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
| | - Sabirah Adams
- Centre for Higher Education Development, Language Development Group, University of Cape Town, Cape Town, South Africa
| | - Deborah Louise Sinclair
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Shazly Savahl
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
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22
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Boyd J, Sexton O, Angus C, Meier P, Purshouse RC, Holmes J. Causal mechanisms proposed for the alcohol harm paradox-a systematic review. Addiction 2022; 117:33-56. [PMID: 33999487 PMCID: PMC8595457 DOI: 10.1111/add.15567] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/17/2020] [Accepted: 04/28/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS The alcohol harm paradox (AHP) posits that disadvantaged groups suffer from higher rates of alcohol-related harm compared with advantaged groups, despite reporting similar or lower levels of consumption on average. The causes of this relationship remain unclear. This study aimed to identify explanations proposed for the AHP. Secondary aims were to review the existing evidence for those explanations and investigate whether authors linked explanations to one another. METHODS This was a systematic review. We searched MEDLINE (1946-January 2021), EMBASE (1974-January 2021) and PsycINFO (1967-January 2021), supplemented with manual searching of grey literature. Included papers either explored the causes of the AHP or investigated the relationship between alcohol consumption, alcohol-related harm and socio-economic position. Papers were set in Organization for Economic Cooperation and Development high-income countries. Explanations extracted for analysis could be evidenced in the empirical results or suggested by researchers in their narrative. Inductive thematic analysis was applied to group explanations. RESULTS Seventy-nine papers met the inclusion criteria and initial coding revealed that these papers contained 41 distinct explanations for the AHP. Following inductive thematic analysis, these explanations were grouped into 16 themes within six broad domains: individual, life-style, contextual, disadvantage, upstream and artefactual. Explanations related to risk behaviours, which fitted within the life-style domain, were the most frequently proposed (n = 51) and analysed (n = 21). CONCLUSIONS While there are many potential explanations for the alcohol harm paradox, most research focuses on risk behaviours while other explanations lack empirical testing.
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Affiliation(s)
- Jennifer Boyd
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Olivia Sexton
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Robin C. Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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23
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Probst C, Lange S, Kilian C, Saul C, Rehm J. The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk-a systematic review and meta-analysis. BMC Med 2021; 19:268. [PMID: 34736475 PMCID: PMC8569998 DOI: 10.1186/s12916-021-02132-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/16/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. METHODS We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). RESULTS We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70-2.59], 50th: 3.43 [2.67-4.49], 75th: 4.43 [3.62-5.50], 100th: 4.50 [3.26-6.40]; men: 25th: 2.34 [1.98-2.76], 50th: 4.22 [3.38-5.24], 75th: 5.87 [4.75-7.10], 100th: 6.28 [4.89-8.07]. CONCLUSIONS The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.
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Affiliation(s)
- Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada.
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, 69120, Heidelberg, Germany.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187, Dresden, Germany
| | - Celine Saul
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, 69120, Heidelberg, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187, Dresden, Germany
- Dalla Lana School of Public Health, University of Toronto, M5T 3 M7, Toronto, ON, Canada
- Centre for Interdisciplinary Addiction Research, University of Hamburg, 20246, Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation, 125009
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24
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Swan JE, Aldridge A, Joseph V, Tucker JA, Witkiewitz K. Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment. J Psychoactive Drugs 2021; 53:394-403. [PMID: 34727839 DOI: 10.1080/02791072.2021.1986243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants' study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants' alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery.
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Affiliation(s)
- Julia E Swan
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Arnie Aldridge
- Behavioral Health Financing, Economics and Evaluation Department, RTI International, Research Triangle Park, NC, USA
| | - Verlin Joseph
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Jalie A Tucker
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
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25
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Askgaard G, Fleming KM, Crooks C, Kraglund F, Jensen CB, West J, Jepsen P. Socioeconomic inequalities in the incidence of alcohol-related liver disease: A nationwide Danish study. LANCET REGIONAL HEALTH-EUROPE 2021; 8:100172. [PMID: 34557856 PMCID: PMC8454885 DOI: 10.1016/j.lanepe.2021.100172] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background There is socio-economic inequality in total alcohol-related harm, but knowledge of inequality in the incidence of specific alcohol-related diseases would be beneficial for prevention. Registry-based studies with nationwide coverage may reveal the full burden of socioeconomic inequality compared to what can be captured in questionnaire-based studies. We examined the incidence of alcohol-related liver disease (ALD) according to socioeconomic status and age. Methods We used national registries to identify patients with an incident diagnosis of ALD and their socioeconomic status in 2009-2018 in Denmark. We computed ALD incidence rates by socioeconomic status (education and employment status) and age-group (30-39, 40-49, 50-59, 60-69 years) and quantified the inequalities as the absolute and relative difference in incidence rates between low and high socioeconomic status. Findings Of 17,473 patients with newly diagnosed ALD, 78% of whom had cirrhosis, 86% had a low or medium-low educational level and only 20% were employed. ALD patients were less likely to be employed in the 10 years prior to diagnosis than controls. The incidence rate of ALD correlated inversely with educational level, from 181 (95% CI, 167-197) to 910 (95% CI, 764-1086) per million person-years from the highest to the lowest educational level. By employment status, the incidence rate per million person-years was 211 (95% CI, 189-236) for employed and 3449 (95% CI, 2785-4271) for unemployed. Incidence rates increased gradually with age leading to larger inequalities in absolute numbers for older age-groups. Although ALD was rare in the younger age-groups, the relative differences in incidence rates between high and low socioeconomic status were large for these ages. The pattern of socioeconomic inequality in ALD incidence was similar for men and women. Interpretation This study showed substantial socioeconomic inequalities in ALD incidence for people aged 30-69 years. Funding The study was supported by grants from the Novo Nordisk Foundation (NNF18OC0054612) and the Research Fund of Bispebjerg Hospital.
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Affiliation(s)
- Gro Askgaard
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Medical Department, Section of Gastroenterology and Hepatology, Zealand University Hospital, Køge, Denmark.,Center for Clinical Research and Prevention, Frederiksberg University Hospital, Copenhagen, Denmark
| | - Kate M Fleming
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.,Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Colin Crooks
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, and the University of Nottingham, Nottingham, United Kingdom
| | - Frederik Kraglund
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Camilla B Jensen
- Center for Clinical Research and Prevention, Frederiksberg University Hospital, Copenhagen, Denmark
| | - Joe West
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, and the University of Nottingham, Nottingham, United Kingdom
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
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26
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Greene N, Johnson RM, Rosen J, German D, Cohen JE. Exploring the relationship between the alcohol policy environment and nondiscrimination laws: Implications for binge drinking disparities among LGB adults in the United States. Drug Alcohol Depend 2021; 225:108749. [PMID: 34049096 PMCID: PMC8282708 DOI: 10.1016/j.drugalcdep.2021.108749] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Alcohol policies reduce population-level binge drinking; however, they may not reduce binge drinking disparities between different populations. We examined the association between the alcohol policy environment and binge drinking among Lesbian, Gay and Bisexual (LGB) and heterosexual adults in the presence and absence of state laws protecting LGB people from discrimination. METHODS The 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS) provided information about individual-level binge drinking, sexual identity, and individual-level covariates. The Alcohol Policy Scale (APS) score measures the strength of the alcohol policy environment. Presence of state-level nondiscrimination protections based on sexual orientation came from the Movement Advancement Project. Logistic regression models were used to test whether nondiscrimination statutes modified the association between the alcohol policy environment and binge drinking and whether this interaction differed for LGB and heterosexual adults. RESULTS Among women, a 10 percentage-point increase in APS score was significantly associated with 7% lower odds of binge drinking in states with inclusive nondiscrimination laws (aOR: 0.93 [95% CI: 0.89-0.97; p = 0.0003]) but was not associated with binge drinking in states without inclusive laws (aOR: 0.98 [95% CI: 0.93-1.03] p = 0.4781). Moreover, binge drinking disparities comparing lesbian/bisexual women with heterosexual women were narrower in states with inclusive nondiscrimination laws. No significant association was found among men. CONCLUSIONS Binge drinking disparities between lesbian and heterosexual women are negligible in states with inclusive laws and strong alcohol policy environments. Inclusive nondiscrimination laws are an indicator of less structural stigma directed at lesbian and bisexual women.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Renee M. Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 624 N. Broadway Street, Baltimore, MD 21205
| | - Joanne Rosen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Joanna E. Cohen
- Department of Health, Behavior and Society; Bloomberg School of Public Health, Johns Hopkins University; 624 N. Broadway Street, Baltimore, MD 21205
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27
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Sturgiss E, Gunatillaka N, Ball L, Lam T, Nielsen S, O'Donnell R, Barton C, Skouteris H, Tam CWM, Jacka D, Mazza D, Russell G. Embedding brief interventions for alcohol in general practice: a study protocol for the REACH Project feasibility trial. BJGP Open 2021; 5:BJGPO.2021.0037. [PMID: 33910916 PMCID: PMC8450877 DOI: 10.3399/bjgpo.2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/18/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Alcohol is a major source of harm in Australia that disproportionately affects low-income communities. Alcohol brief interventions (ABIs) combine an assessment of a person's alcohol use with advice to reduce health risks. Despite their effectiveness, ABIs are not routinely performed by clinicians. This article presents a protocol for a feasibility trial of pragmatic implementation strategies and a new set of resources to support clinicians to complete ABIs in Australian general practices. AIM To explore the facilitators and barriers to increasing the uptake of ABIs in primary care, including acceptability, reach, adoption, fidelity, and sustainability. DESIGN & SETTING A mixed-methods evaluation of the uptake of ABIs in general practice clinics serving low-income communities in Melbourne, Australia. The approach is informed by the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). METHOD The implementation strategies and resources will be trialled in five general practices over 12 months. The primary outcome will be change in the proportion of adult patients with a complete alcohol history in their electronic medical records. Baseline data collection includes a practice survey to describe practice routines for ABIs and de-identified patient medical record data on completed alcohol histories (repeated at 3, 6, 9, and 12-months post-intervention). Survey and interview data will also be collected from clinicians, patients, and primary health network staff to assess acceptability and feasibility of the intervention. CONCLUSION The study will explore how the implementation strategies and resources can improve alcohol screening and management among low-income patients in general practice.
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Affiliation(s)
- Elizabeth Sturgiss
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Nilakshi Gunatillaka
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Lauren Ball
- Menzies Health Institute Queensland and School of Allied Health Sciences, Griffith University, Brisbane, Queensland, Australia
| | - Tina Lam
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Victoria, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Victoria, Australia
| | - Renee O'Donnell
- Health and Social Care Unit, NHMRC CRE in Health in Preconception and Pregnancy (CRE HiPP), School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Chris Barton
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, NHMRC CRE in Health in Preconception and Pregnancy (CRE HiPP), School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, The University of Warwick, Coventry, UK
| | - Chun Wah Michael Tam
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- School of Population Health, Faculty of Medicine, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - David Jacka
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Victoria, Australia
- Monash Health, Melbourne, Victoria, Australia
| | - Danielle Mazza
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Grant Russell
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
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28
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Boyd J, Bambra C, Purshouse RC, Holmes J. Beyond Behaviour: How Health Inequality Theory Can Enhance Our Understanding of the 'Alcohol-Harm Paradox'. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6025. [PMID: 34205125 PMCID: PMC8199939 DOI: 10.3390/ijerph18116025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022]
Abstract
There are large socioeconomic inequalities in alcohol-related harm. The alcohol harm paradox (AHP) is the consistent finding that lower socioeconomic groups consume the same or less as higher socioeconomic groups yet experience greater rates of harm. To date, alcohol researchers have predominantly taken an individualised behavioural approach to understand the AHP. This paper calls for a new approach which draws on theories of health inequality, specifically the social determinants of health, fundamental cause theory, political economy of health and eco-social models. These theories consist of several interwoven causal mechanisms, including genetic inheritance, the role of social networks, the unequal availability of wealth and other resources, the psychosocial experience of lower socioeconomic position, and the accumulation of these experiences over time. To date, research exploring the causes of the AHP has often lacked clear theoretical underpinning. Drawing on these theoretical approaches in alcohol research would not only address this gap but would also result in a structured effort to identify the causes of the AHP. Given the present lack of clear evidence in favour of any specific theory, it is difficult to conclude whether one theory should take primacy in future research efforts. However, drawing on any of these theories would shift how we think about the causes of the paradox, from health behaviour in isolation to the wider context of complex interacting mechanisms between individuals and their environment. Meanwhile, computer simulations have the potential to test the competing theoretical perspectives, both in the abstract and empirically via synthesis of the disparate existing evidence base. Overall, making greater use of existing theoretical frameworks in alcohol epidemiology would offer novel insights into the AHP and generate knowledge of how to intervene to mitigate inequalities in alcohol-related harm.
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Affiliation(s)
- Jennifer Boyd
- School of Health and Related Research, The University of Sheffield, S1 4DA Sheffield, UK;
| | - Clare Bambra
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, NE2 4HH Newcastle upon Tyne, UK;
| | - Robin C. Purshouse
- Department of Automatic Control and Systems Engineering, The University of Sheffield, S1 3JD Sheffield, UK;
| | - John Holmes
- School of Health and Related Research, The University of Sheffield, S1 4DA Sheffield, UK;
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29
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Oliveira LCD, Cordeiro L, Soares CB, Campos CMS. Práticas de Atenção Primária à Saúde na área de drogas: revisão integrativa. SAÚDE EM DEBATE 2021. [DOI: 10.1590/0103-1104202112920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo deste estudo foi o de identificar e analisar as práticas voltadas ao consumo prejudicial de drogas na Atenção Primária à Saúde. Trata-se de Revisão integrativa que buscou estudos nas fontes Medline e Lilacs utilizando os termos ‘Atenção Primária à Saúde’ e ‘Redução do Dano’. Como resultado, incluiram-se 52 estudos, analisados de acordo com os arcabouços teóricos que orientam as práticas em saúde. Tais estudos foram sintetizados em três categorias empíricas: comportamento de risco, que incluiu intervenção breve, programas para prevenir e diminuir o uso de drogas, entre outros; fatores determinantes, que incluiu visitas domiciliares, práticas grupais e organizacionais; e necessidades em saúde, que incluiu práticas educativas emancipatórias. Conclui-se que, majoritariamente, os estudos abordam o uso de drogas pela categoria risco, com proposição de práticas para adaptação social. As intervenções relativas aos determinantes promovem a saúde, propondo melhorias em ambientes de vida e trabalho. Práticas críticas às relações sociais estabelecidas pelo complexo das drogas são minoritárias e envolvem complexidade operacional.
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30
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Fontes Marx M, London L, Harker N, Ataguba JE. Assessing Intertemporal Socioeconomic Inequalities in Alcohol Consumption in South Africa. Front Public Health 2021; 9:606050. [PMID: 34046383 PMCID: PMC8144322 DOI: 10.3389/fpubh.2021.606050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This paper assesses changes in the socioeconomic inequality in alcohol consumption by exploring whether alcohol consumption (current and binge drinkers) is more prevalent among the wealthier (pro-rich) or poorer (pro-poor) group over time. Methods: Data come from the 2008, 2010/11, 2012, and 2014/15 waves of the National Income Dynamics Study (NIDS). Various equity stratifiers (sex, age, race, and rural/urban) are used to analyze the prevalence of alcohol consumption and to investigate differences in socioeconomic inequalities. Changes in socioeconomic inequality in alcohol consumption between 2008 and 2014/15 were also assessed using the concentration index. Results: Current drinkers were more concentrated among richer South Africans, while binge drinkers were concentrated among the poorer population. For current drinkers, irrespective of sex, race, age, and urban, socioeconomic inequality in alcohol consumption had become less pro-rich between 2008 and 2014/15; while inequality in binge drinking, outside of the Asian/Indian and rural categories, had become less pro-poor between 2008 and 2014/15. Conclusion: The results show evidence that binge drinking is a bigger problem among those of low-SES, young individuals, male and African populations. This paper concludes that the SA government should continue to push forward policies aiming to reduce the prevalence of binge drinking.
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Affiliation(s)
- Mayara Fontes Marx
- Health Economics Department, School of Public Health and Family Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - Leslie London
- Health and Human Rights Programme, School of Public Health and Family Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - Nadine Harker
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - John E Ataguba
- Health Economics Department, School of Public Health and Family Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
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Calnan S, Davoren MP. College students’ perspectives on an alcohol prevention programme and student drinking – A focus group study. NORDIC STUDIES ON ALCOHOL AND DRUGS 2021; 39:301-321. [PMID: 35720519 PMCID: PMC9152229 DOI: 10.1177/14550725211007078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 11/15/2022] Open
Abstract
Aim: While there is considerable research on the efficacy of interventions designed to reduce alcohol consumption and related harms among college students, there is limited research on students’ own perspectives on such interventions. This qualitative study aimed to address this gap by examining college students’ perspectives in the context of an alcohol prevention programme for college students in Ireland. Methods: Focus groups were used as the means of data collection, and participants were selected using purposive sampling based on two criteria – type/location of college and category of student. A total of eight focus groups were conducted at two institutions taking part in the programme. Participants comprised four categories of student: undergraduates, mature students, international students and students who were members of clubs or societies. Results were analysed through the lens of a social-ecological framework. Results: The study findings indicated that students perceived alcohol as being endemic to college life and wider society. As a result, many of the students were sceptical or ambivalent regarding the potential efficacy of alcohol prevention programmes. Despite the perceived pervasiveness of alcohol, the study pointed to heterogeneity in drinking practices among the participants. Moreover, the study participants expressed divergent views when asked whose responsibility it was to control student alcohol consumption. Conclusions: Viewing the findings through a social-ecological lens, students seemed to collectively acknowledge the different layers of influence on student drinking, acknowledging the complex nature of this issue. Providing a greater variety of leisure spaces, including alcohol-free environments, was viewed particularly favourably by the student participants in terms of solutions proposed.
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32
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Moan IS, Halkjelsvik T. Socio-demographic differences in alcohol-related work impairment. Addiction 2021; 116:771-779. [PMID: 32707598 DOI: 10.1111/add.15202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/03/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The costs of alcohol-related presenteeism (being at work in an impaired state due to alcohol use) have been estimated as substantially larger than the costs of alcohol-related absenteeism. Past studies indicate that employees with lower socio-economic status experience more alcohol-attributable problems than employees in higher socio-economic strata. We aimed to estimate the prevalence of alcohol-related presenteeism among Norwegian adults and its association with sex, age, income and education. DESIGN AND SETTING Annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2016-19) among Norwegian adults. PARTICIPANTS A total of 5430 full- and part-time employees aged 16-79 years; 53% were men. MEASUREMENTS The main outcome was self-reported 12-month occurrence of work impairment due to alcohol use the previous day. Main predictors were income and education obtained from national registries, age and gender. A secondary outcome variable was self-reported alcohol-related absenteeism. FINDINGS The 12-month prevalence of alcohol-related work impairment was 8.7%, 95% confidence interval (CI) = 7.9, 9.4. Adjusted risk ratios (RR) indicated a higher risk for men compared with women (RR = 1.26, 95% CI = 1.06, 1.50) and higher risk for young employees (e.g. less than 26 years compared with 55+, RR = 7.64, 95% CI = 4.88, 11.95). The risk increased as a function of higher education (in order of increasing education, RR = 1.12, 95% CI = 0.87, 1.45; RR = 1.64, 95% CI = 1.26, 2.12; RR = 2.19, 95% CI = 1.63, 2.95). The risk was estimated as lower in the middle-income categories compared with the lowest (RR = 0.76, 95% CI = 0.58, 1.00, RR = 0.89, 95% CI = 0.66, 1.20, RR = 0.94, 95% CI = 0.68, 1.29) and higher for employees with the highest income (RR = 1.04, 95% CI = 0.73, 1.48; RR = 1.47, 95% CI = 1.09, 2.00). CONCLUSIONS In Norway, the risk of alcohol-related work impairment for employees in the highest education category is approximately twice that of employees with secondary education or less. Except for employees in the lowest income category, who had a higher risk than those in the middle-income categories, higher income is associated with increased risk of work impairment. Being younger and male are also associated with increased risk of alcohol-related work impairment.
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Affiliation(s)
- Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Torleif Halkjelsvik
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Greene N, Johnson RM, German D, Rosen J, Cohen JE. State-Level Alcohol Environments and Sexual Identity Disparities in Binge Drinking in the Behavioral Risk Factor Surveillance System. LGBT Health 2021; 8:190-200. [PMID: 33538642 DOI: 10.1089/lgbt.2020.0182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Purpose: Binge drinking disparities by sexual identity are well documented. Stronger alcohol policy environments reduce binge drinking in the general population. We examined whether state-level alcohol policy environments have the same association with binge drinking among lesbian, gay, and bisexual (LGB) adults as among heterosexual adults. Methods: Binge drinking, sexual identity, and demographic characteristics were extracted from the 2015 to 2018 Behavioral Risk Factor Surveillance System. The strength of the alcohol policy environment was measured by using the Alcohol Policy Scale (APS) score. We estimated the association between APS score and binge drinking by using logistic regression and included an interaction term between APS score and sexual identity. Results: The interaction between APS score and sexual identity was not significant, and findings differed between women and men. Among women, a higher APS score was associated with lower odds of binge drinking (adjusted odds ratio [aOR]: 0.96, 95% confidence interval [CI]: 0.94-0.99). Differences in binge drinking by sexual identity remained after adjusting for individual and state-level factors (e.g., the percentage of LGB adults in the state). Compared with heterosexual women, the odds of binge drinking were 43% higher (aOR: 1.43, 95% CI: 1.17-1.75) among lesbian women and 58% higher (aOR: 1.58, 95% CI: 1.40-1.79) among bisexual women. A higher APS score was not associated with binge drinking among men. Conclusion: Stronger state-level alcohol policy environments were associated with lower binge drinking among women. Lesbian and bisexual women were still more likely to engage in binge drinking compared with heterosexual women even in states with stronger alcohol policy environments.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Renee M Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joanne Rosen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Correlates of Alcohol Consumption Among a Socially-Disadvantaged Population in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239074. [PMID: 33291767 PMCID: PMC7730564 DOI: 10.3390/ijerph17239074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 01/04/2023]
Abstract
Alcohol consumption at a level exceeding existing recommendations is one of the leading risk factors for death and disability worldwide. The aim of the study was to identify correlates of alcohol drinking among a socially-disadvantaged population in Poland. The cross-sectional study covered 1644 adult social assistance beneficiaries from the Piotrkowski district (rural area in central Poland). A detailed questionnaire filled in during a face-to-face interview allowed for the collection of socio-demographic, lifestyle-related (including alcohol consumption) and health status data. About 42% of the participants, including 67% of the men and 30% of the women, exceeded the recommended level of alcohol consumption. In the adjusted model, the men tended not to follow recommendations for alcohol consumption more frequently than the women (OR = 4.5, p < 0.001). The higher odds of not following alcohol-related recommendations were also observed for the subjects declaring having a permanent or temporary job compared to the unemployed participants (OR = 1.2, p = 0.04). A lower healthy lifestyle index (indicating an unhealthy lifestyle related to a diet, body mass index (BMI), physical activity, and tobacco smoking) was associated with not following recommendations for alcohol consumption (OR = 1.1, p = 0.04). Our study indicates that being men, having a permanent or a temporary job, and coexistence of other unfavorable lifestyle-related factors are important correlates of not following recommendations for alcohol consumption among the beneficiaries of government welfare assistance.
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Okan O, Rowlands G, Sykes S, Wills J. Shaping Alcohol Health Literacy: A Systematic Concept Analysis and Review. Health Lit Res Pract 2020; 4:e3-e20. [PMID: 31935296 PMCID: PMC6960007 DOI: 10.3928/24748307-20191104-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/18/2019] [Indexed: 11/20/2022] Open
Abstract
Background: This study uses an innovative methodology to understand the implications of applying the emerging concept of health literacy to other contexts using the example of alcohol. Methods: An evolutionary concept analysis combined with the principles and standards of the systematic review process enables a rigorous analysis of the conceptual representation of alcohol health literacy. Key Results: Alcohol health literacy includes a wide range of attributes that encompass many different health literacies beyond simply the capacity to understand alcohol-related harms and use that information in decision-making. Alcohol health literacy empowers people to understand alcohol marketing and messages and how alcohol information is distributed through social networks. It is an outcome of media-related alcohol education, and its consequences include health action skills and realistic expectancies of alcohol. Discussion: The focus on health literacy, which emphasizes not only individual skills but also draws attention to the social determinants of alcohol use and how alcohol health literacy is shaped by social networks and interactions, provides important lessons for alcohol health promotion interventions. Health literacy when applied to alcohol includes many different domains and the innovative method used here provides a framework to develop interventions that build health literacy in different contexts. [HLRP: Health Literacy Research and Practice. 2020;4(1):e3–e20.]
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Affiliation(s)
- Orkan Okan
- Address correspondence to Orkan Okan, Interdisciplinary Centre for Health Literacy Research, P.O. Box 10 01 31, Bielefeld University, D-33501 Bielefeld, Germany;
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Abstract
INTRODUCTION Alcohol-related harm is a major public health concern and appears to be particularly problematic in rural and remote communities. Evidence from several countries has shown that the prevalence of harmful alcohol use and alcohol-attributable hospitalisations and emergency department visits are higher in rural and remote communities than in urban centres. The extents of this rural-urban disparity in alcohol-related harm as well as the factors that mediate it are poorly understood. The objective of this scoping review is to synthesise the international research on the factors that influence the prevalence or risk of alcohol-related harm in rural and remote communities. This will help to clarify the conceptual landscape of rural and remote alcohol research and identify the gaps in knowledge that need to be addressed. METHODS AND ANALYSIS This scoping review will access published literature through search strategies developed for Medline, PsycINFO, Embase, CINAHL and Sociological Abstracts. There will be no date, country or language restrictions placed on the search. Title and abstract, followed by full-text screening, will be conducted by two independent reviewers to evaluate all identified articles against a set of prespecified inclusion and exclusion criteria. Data from selected articles will be extracted and compiled into a final manuscript that adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist guidelines. ETHICS AND DISSEMINATION The results of this review will be helpful in guiding future research on rural and remote alcohol use and alcohol-related harm, which will inform more effective, evidence-based public health strategies to reduce alcohol-related harm in rural and remote communities. The results will be disseminated via field-specific conference presentations and peer-reviewed publication.
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Affiliation(s)
- Erik Loewen Friesen
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
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Roche AM, Harrison NJ, Chapman J, Kostadinov V, Woodman RJ. Ageing and Alcohol: Drinking Typologies among Older Adults. J Aging Health 2020; 32:1486-1497. [PMID: 32583701 DOI: 10.1177/0898264320936953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: Alcohol consumption and harms among older people are increasing. We examined different demographic characteristics and drinking patterns among an older population. Methods: Secondary analyses of nationally representative Australian data; subjects aged 50+ years (N = 10,856). Two-step cluster analysis was performed to identify demographic groups and alcohol consumption behaviours. Results: Three groups were identified: Group 1 (older, unmarried, and lived alone): >65 years, moderate drinkers, poorest health, psychological distress, social disadvantage, smokers, illicit drug users, and more frequent previous alcohol treatment. Group 3 (older married): >65 years, good health, low psychological distress, less likely to drink at risky levels, and one in five drank daily. Group 2 (younger married): 50-64 years, mostly employed, highest proportion of risky drinkers and of 5+ standard drinks per session, and liberal drinking attitudes with most concern from others about their drinking. Discussion: These demographic typologies can inform targeted prevention efforts for an estimated 1.3 million adults older than 50 years drinking at risky levels.
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Affiliation(s)
- Ann M Roche
- 1065Flinders University, Adelaide, Australia
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Probst C, Kilian C, Sanchez S, Lange S, Rehm J. The role of alcohol use and drinking patterns in socioeconomic inequalities in mortality: a systematic review. LANCET PUBLIC HEALTH 2020; 5:e324-e332. [DOI: 10.1016/s2468-2667(20)30052-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 12/21/2022]
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Hines S, Carey TA, Hirvonen T, Martin K, Cibich M. Effectiveness and appropriateness of culturally adapted approaches to treating alcohol use disorders in Indigenous people: a mixed methods systematic review protocol. JBI Evid Synth 2020; 18:1100-1107. [PMID: 32813364 DOI: 10.11124/jbisrir-d-19-00040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The objective of this review is to investigate the effectiveness and appropriateness of culturally adapted approaches for treating alcohol use disorders in Indigenous peoples in Canada, New Zealand, Australia, and the USA. INTRODUCTION Poor and disadvantaged people, particularly those who are Indigenous, suffer more health effects due to alcohol misuse and are therefore subject to more law enforcement actions. Analyses have identified strategies for improving health services for Indigenous people; chief among these is culturally safe care specifically tailored to the context. Alcohol addiction is a chronic relapsing condition that usually requires ongoing treatment, so it is vital that treatment therapies are appropriate, meaningful, and effective. Many evidence-based therapies for substance abuse have not been specifically designed for or tested in Indigenous and First Nations communities. This absence of cultural considerations may be a contributor to the failure of these programs to engage with clients and successfully influence their behavior. INCLUSION CRITERIA This review will consider qualitative and quantitative studies of any methodology, published in any language after 1998. Studies including adult and/or adolescent participants in inpatient or outpatient alcohol treatment programs described as being adapted to meet cultural needs will be considered. METHODS This review will use the convergent segregated approach to mixed methods reviews. A range of databases will be searched, including MEDLINE, CINAHL, Embase, and PsycINFO. Two reviewers will critically appraise and extract data from studies meeting the inclusion criteria. Qualitative research findings will, where possible, be pooled using JBI SUMARI with the meta-aggregation approach, and quantitative studies will, where possible, be pooled in statistical meta-analysis using JBI SUMARI. The JBI convergent segregated approach to mixed methods reviews will be followed.
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Affiliation(s)
- Sonia Hines
- The Centre for Remote Health: A JBI Affiliated Group
- Flinders Northern Territory, Alice Springs, Australia
| | | | - Tanja Hirvonen
- The Centre for Remote Health: A JBI Affiliated Group
- Flinders Northern Territory, Alice Springs, Australia
| | - Kathleen Martin
- The Centre for Remote Health: A JBI Affiliated Group
- Flinders Northern Territory, Alice Springs, Australia
| | - Mikaela Cibich
- The Centre for Remote Health: A JBI Affiliated Group
- Flinders Northern Territory, Alice Springs, Australia
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Abstract
Drinking alcohol with coworkers is a common practice in many occupational cultures. This practice may produce negative consequences for some employees. Objectives: We estimate the prevalence of a set of negative consequences of work-related alcohol use and identify risk factors associated with experience of harm from coworkers' drinking. Methods: In an online survey, Norwegian employees (n = 3596) aged 20-69 reported whether they had experienced the following due to coworkers' drinking the past 12 months: (a) felt excluded, (b) experienced unwanted sexual attention, (c) been physically harmed, and (d) been verbally abused. Each outcome was regressed on socio-demographics (age, gender, education, and income), job characteristics (flexibility and autonomy), respondents' alcohol use, and perceived intoxication frequency in work contexts for a typical coworker (perceived coworker intoxication frequency). Results: The 12-month prevalence of experiencing any of the negative consequences was 18%. Having felt excluded (10.7%) and experienced unwanted sexual attention (7.0%) were more common than being verbally abused (4.8%) or physically harmed (1.9%). Perceived coworker intoxication frequency was strongly associated with all outcomes. Respondents' own drinking frequency predicted being verbally abused, being physically harmed, and experiencing unwanted sexual attention. Women experienced less physical harm and more unwanted sexual attention than men. Prevalence also varied by age, education, income, and job characteristics. Conclusions: Each year, approximately one-sixth of Norwegian employees experience harm from their coworkers' drinking. The frequency of intoxication in work contexts is strongly associated with harm to others.
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Affiliation(s)
- Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Torleif Halkjelsvik
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Freeman T, Baum F, Mackean T, Ziersch A, Sherwood J, Edwards T, Boffa J. Case study of a decolonising Aboriginal community controlled comprehensive primary health care response to alcohol-related harm. Aust N Z J Public Health 2019; 43:532-537. [PMID: 31577862 DOI: 10.1111/1753-6405.12938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 06/01/2019] [Accepted: 08/01/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches. METHODS Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users. RESULTS The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people's control, providing culturally safe services, addressing racism, and advocating to government and industry. CONCLUSIONS This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health. Implications for public health: Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.
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Affiliation(s)
- Toby Freeman
- Southgate Institute for Health, Society and Equity, Flinders University, South Australia
| | - Fran Baum
- Southgate Institute for Health, Society and Equity, Flinders University, South Australia
| | - Tamara Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, South Australia
| | - Anna Ziersch
- Southgate Institute for Health, Society and Equity, Flinders University, South Australia
| | - Juanita Sherwood
- National Centre for Cultural Competency, University of Sydney, New South Wales
| | - Tahnia Edwards
- Central Australian Aboriginal Congress, Northern Territory
| | - John Boffa
- Central Australian Aboriginal Congress, Northern Territory
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Sharpe S, Kool B, Whittaker R, Lee AC, Reid P, Civil I, Ameratunga S. Effect of a text message intervention on alcohol-related harms and behaviours: secondary outcomes of a randomised controlled trial. BMC Res Notes 2019; 12:267. [PMID: 31088559 PMCID: PMC6518739 DOI: 10.1186/s13104-019-4308-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/08/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Mobile Health approaches show promise as a delivery mode for alcohol screening and brief intervention. The 'YourCall' trial evaluated the effect of a low-intensity mobile phone text message brief intervention compared with usual care on hazardous drinking and alcohol-related harms among injured adults. This paper extends our previously published primary outcome analysis which revealed a significant reduction in hazardous drinking associated with the intervention at 3 months, with the effect maintained across 12 months follow-up. The objective of the current study was to evaluate the effect of the intervention on alcohol-related harms and troubles and help-seeking behaviours (secondary outcomes) at 12-months follow-up. RESULTS A parallel two-group, single-blind, randomised controlled trial was conducted in 598 injured inpatients aged 16-69 years identified as having medium-risk hazardous drinking. Logistic regression models applied to 12-month follow-up data showed no significant differences between intervention and control groups in self-reported alcohol-related harms and troubles and help-seeking behaviours. Although this text message intervention led to a significant reduction in hazardous alcohol consumption (previously published primary outcome), changes in self-reported alcohol-related harms and troubles and help seeking behaviours at 12-months follow up (secondary outcomes) were small and non-significant. TRIAL REGISTRATION ACTRN12612001220853. Retrospectively registered 19 November 2012.
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Affiliation(s)
- Sarah Sharpe
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Bridget Kool
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, and Waitemata District Health Board, Auckland, New Zealand
| | - Arier C. Lee
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Papaarangi Reid
- Te Kupenga Hauora Māori, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ian Civil
- Trauma Service, Auckland City Hospital, Auckland, New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
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Roche A, Kostadinov V, Cameron J, Pidd K, McEntee A, Duraisingam V. The development and characteristics of Employee Assistance Programs around the globe. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2018. [DOI: 10.1080/15555240.2018.1539642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ann Roche
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Victoria Kostadinov
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Jacqui Cameron
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Ken Pidd
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Alice McEntee
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Vinita Duraisingam
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
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Swahn MH, Culbreth R, Tumwesigye NM, Topalli V, Wright E, Kasirye R. Problem Drinking, Alcohol-Related Violence, and Homelessness among Youth Living in the Slums of Kampala, Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1061. [PMID: 29882915 PMCID: PMC6025561 DOI: 10.3390/ijerph15061061] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/25/2022]
Abstract
This paper examines problem drinking, alcohol-related violence, and homelessness among youth living in the slums of Kampala—an understudied population at high-risk for both alcohol use and violence. This study is based on a cross-sectional survey conducted in 2014 with youth living in the slums and streets of Kampala, Uganda (n = 1134), who were attending Uganda Youth Development Link drop-in centers. The analyses for this paper were restricted to youth who reported current alcohol consumption (n = 346). Problem drinking patterns were assessed among youth involved in alcohol-related violence. Mediation analyses were conducted to examine the impact of homelessness on alcohol-related violence through different measures of problem drinking. Nearly 46% of youth who consumed alcohol were involved in alcohol-related violence. Problem drinkers were more likely to report getting in an accident (χ² = 6.8, df = 1, p = 0.009), having serious problems with parents (χ² = 21.1, df = 1, p < 0.0001) and friends (χ² = 18.2, df = 1, p < 0.0001), being a victim of robbery (χ² = 8.8, df = 1, p = 0.003), and going to a hospital (χ² = 15.6, df = 1, p < 0.0001). For the mediation analyses, statistically significant models were observed for frequent drinking, heavy drinking, and drunkenness. Interventions should focus on delaying and reducing alcohol use in this high-risk population.
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Affiliation(s)
- Monica H Swahn
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, P.O. Box 3984 Atlanta, GA 30302-3984, USA.
| | - Rachel Culbreth
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, P.O. Box 3984 Atlanta, GA 30302-3984, USA.
| | - Nazarius Mbona Tumwesigye
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala 00256, Uganda.
| | - Volkan Topalli
- Department of Criminal Justice and Criminology, Andrew Young School of Policy Studies, Georgia State University, P.O. Box 3992, Atlanta, GA 30302-3992, USA.
| | - Eric Wright
- Department of Sociology, College of Arts and Science, Georgia State University, P.O. Box 5020, Atlanta, GA 30302-5020, USA.
| | - Rogers Kasirye
- Uganda Youth Developmental Link, P.O. Box 12659, Kampala 00256, Uganda.
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Kim YM, Delen D. Critical assessment of health disparities across subpopulation groups through a social determinants of health perspective: The case of type 2 diabetes patients. Inform Health Soc Care 2017; 43:172-185. [PMID: 29035610 DOI: 10.1080/17538157.2017.1364244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Studies on diabetes have shown that population subgroups have varying rates of medical events and related procedures; however, existing studies have investigated either medical events or procedures, and hence, it is unknown whether disparities exist between medical events and procedures. PURPOSE The objective of this study is to investigate how diabetes-related medical events and procedures are different across population subgroups through a social determinants of health (SDH) perspective. METHODS Because the purpose of this manuscript is to explore whether statistically significant health disparities exist across population subgroups regarding diabetes patients' medical events and procedures, group difference test methods were employed. Diabetes patients' data were drawn from the Cerner Health Facts® data warehouse. RESULTS The study revealed systematic disparities across population subgroups regarding medical events and procedures. The most significant disparities were connected with smoking status, alcohol use, type of insurance, age, marital status, and gender. CONCLUSIONS Some population subgroups have higher rates of medical events and yet receive lower rates of treatments, and such disparities are systematic. Socially constructed behaviors and structurally discriminating public policies in part contribute to such systematic health disparities across population subgroups.
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Affiliation(s)
- Yong-Mi Kim
- a School of Library and Information Studies , University of Oklahoma, Schusterman Center , Tulsa , OK , USA
| | - Dursun Delen
- b Center for Health Systems Innovation (CHSI), Spears School of Business , Oklahoma State University , Tulsa , OK , USA
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Ameratunga S, Kool B, Sharpe S, Reid P, Lee A, Civil I, Smith G, Thornton V, Walker M, Whittaker R. Effectiveness of the YourCall™ text message intervention to reduce harmful drinking in patients discharged from trauma wards: protocol for a randomised controlled trial. BMC Public Health 2017; 17:48. [PMID: 28068978 PMCID: PMC5223477 DOI: 10.1186/s12889-016-3967-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 12/20/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Behavioural brief interventions (BI) can support people to reduce harmful drinking but multiple barriers impede the delivery and equitable access to these. To address this challenge, we developed YourCall™, a novel short message service (SMS) text message intervention incorporating BI principles. This protocol describes a trial evaluating the effectiveness of YourCall™ (compared to usual care) in reducing hazardous drinking and alcohol related harm among injured adults who received in-patient care. METHODS/DESIGN Participants recruited to this single-blind randomised controlled trial comprised patients aged 16-69 years in three trauma-admitting hospitals in Auckland, New Zealand. Those who screened positive for moderately hazardous drinking were randomly assigned by computer to usual care (control group) or the intervention. The latter comprised 16 informational and motivational text messages delivered using an automated system over the four weeks following discharge. The primary outcome is the difference in mean AUDIT-C score between the intervention and control groups at 3 months, with the maintenance of the effect examined at 6 and 12 months follow-up. Secondary outcomes comprised the health and social impacts of heavy drinking ascertained through a web-survey at 12 months, and further injuries identified through probabilistic linkage to national databases on accident insurance, hospital discharges, and mortality. Research staff evaluating outcomes were blinded to allocation. Intention-to-treat analyses will include assessment of interactions based on ethnicity (Māori compared with non-Māori). DISCUSSION If found to be effective, this mobile health strategy has the potential to overcome current barriers to implementing equitably accessible interventions that can reduce harmful drinking. TRIAL REGISTRATION Universal Trial Number (UTN) U1111-1134-0028. ACTRN12612001220853 . Submitted 8 November 2012 (date of enrolment of first participant); Version 1 registration confirmed 19 November 2012. Retrospectively registered.
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Affiliation(s)
- Shanthi Ameratunga
- Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand.
| | - Bridget Kool
- Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Sarah Sharpe
- Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Papaarangi Reid
- Te Kupenga Hauora Māori, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Arier Lee
- Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Ian Civil
- Department of Surgery, Auckland City Hospital, 2 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Gordon Smith
- West Virginia University School of Public Health, 1 Medical Center Drive, PO Box 9190, Morgantown, WV, 26506-9190, USA
| | - Vanessa Thornton
- Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland, 1640, New Zealand
| | - Matthew Walker
- North Shore Hospital, Shakespeare Road, Takapuna, Auckland, 0622, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
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Roche A, Nicholas R. Workforce development: An important paradigm shift for the alcohol and other drugs sector. DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.1080/09687637.2016.1262823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ann Roche
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia
| | - Roger Nicholas
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia
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Horton K, Friel S, de Leeuw E, McKeone C, Bolam B. Fair Foundations for health equity. Health Promot Int 2016; 30 Suppl 2:ii2-7. [PMID: 26420809 DOI: 10.1093/heapro/dav091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Raitasalo K, Holmila M. Practices in alcohol education among Finnish parents: Have there been changes between 2006 and 2012? DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.1080/09687637.2016.1183587] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kirsimarja Raitasalo
- Department of Alcohol, Drugs and Addiction, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Marja Holmila
- Department of Alcohol, Drugs and Addiction, National Institute for Health and Welfare (THL), Helsinki, Finland
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