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Biomedical subjects

Ralph W Hingson

Publications and source records attributed to Ralph W Hingson.

4 recordsLinked to original sources

Underage drinking: frequency, consequences, and interventions.

OBJECTIVES: To examine the frequency of underage drinking, driving after drinking and alcohol-related crashes, trends in these behaviors, and promising interventions. METHODS: We examined drinking and drinking- and-driving behaviors reported in the United States in the 2001 U.S. National Household Survey of Drug Abuse, the Centers for Disease Control and Prevention 2001 Youth Risk Behavior Survey, the 1992 National Longitudinal Alcohol Epidemiologic Study, and the 1999 National Survey of Drinking and Driving conducted for the National Highway Traffic Administration. We also examined the 1999 European School Survey Project on Alcohol and Other Drugs. Alcohol-related fatal crashes were examined from the U.S. Fatality Analysis Reporting System. Evaluation of interventions to reduce teenage drinking and driving after drinking were reviewed. RESULTS: In the United States, 19% of youth ages 12-20 consumed five or more drinks on an occasion in the past 30 days. Although European nations have lower legal drinking ages (16-18) than in the United States (21), similar proportions engage in underage drinking. In two-thirds of European countries, a greater percentage of 15-16 year-olds drank five or more drinks on an occasion in the past month than in the United States. In both the United States and Europe, the earlier people begin to drink, the greater the likelihood of developing alcohol dependence and other alcohol-related problems, including alcohol-related crash involvement, during adolescence and adult years. During the past 20 years alcohol-related traffic deaths among people younger than 21 have been cut in half in the United States, but progress has halted since 1995 and the problem is still large. Interventions shown by research to reduce alcohol-related crashes among youth include raising the legal drinking age to 21, zero tolerance laws, and some interventions that are family, school, or community based. CONCLUSIONS: Despite research showing that a variety of interventions can reduce underage drinking and alcohol-related crash fatalities, the frequency of these behaviors remains high and the average age of drinking initiation is declining in the United States. Efforts are needed to enhance publicized enforcement of underage drinking laws. Comprehensive community interventions that include enforcement of these laws also are needed.

Accidents, Traffic↗

Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24.

OBJECTIVE: This report estimates the numbers of 18-24 year old United States college students who annually experience alcohol-related deaths, injuries and other health problems. METHOD: We examined traffic and unintentional injury deaths in 1998 reported by the National Highway Traffic Safety Administration and the Centers for Disease Control (CDC). We also examined results of national coroner studies, Department of Education college enrollment data, the National Household Survey on Drug Abuse (NHSDA), the CDC National College Health Risk Behavior Survey and the Harvard School of Public Health College Alcohol Survey (CAS). All survey participants were ages 18-24: 6,930 college and 12,394 noncollege respondents in the NHSDA survey; 3,077 college students in the CDC survey; and 12,217 full-time 4-year college students in the CAS. Based on the number and proportion of 18-24 year olds enrolled in college, data on alcohol involvement in injury deaths among 18-24 year olds and survey responses, we calculated the numbers of 18-24 year old alcohol-related injury deaths and other health problems. RESULTS: We estimate that over 1,400 students aged 18-24 and enrolled in 2- and 4-year colleges died in 1998 from alcohol-related unintentional injuries, including motor vehicle crashes. According to surveys conducted in 1999, in the preceding year, over 2 million of the 8 million college students in the United States drove under the influence of alcohol and over 3 million rode with a drinking driver. Over 500,000 full-time 4-year college students were unintentionally injured under the influence of alcohol and over 600,000 were hit or assaulted by another student who had been drinking. CONCLUSIONS: There is an urgent need for expanding prevention and treatment programs, to reduce alcohol-related harm among U.S. college students and other young adults.

Accidents, Traffic↗

Comprehensive community interventions to promote health: implications for college-age drinking problems.

OBJECTIVE: This article reviews comprehensive community interventions that sought to reduce (1) cardiovascular disease risks; (2) smoking; (3) alcohol use disorders, alcohol-related injury and illicit drug use; or (4) sexual risk taking that could lead to HIV infection, sexually transmitted disease and pregnancy. METHOD: Comprehensive community programs typically involve multiple city government agencies as well as private citizens and organizations and use multiple intervention strategies such as school-based and public education programs, media advocacy, community organizing, environmental policy changes and heightened enforcement of existing policies. This review focused on English-language papers published over the past several decades. RESULTS: Some programs in each of the four problem areas achieved their behavioral and health goals. The most consistent benefits were found in programs targeting behaviors with immediate health consequences such as alcohol misuse or sexual risk taking. Results were less consistent when consequences of targeted behaviors were more distant in time such as cardiovascular risks and smoking. Also, programs that targeted youth to prevent them from starting new health-compromising behaviors tended to be more successful than programs aimed at modifying preexisting habits among adults. Programs that combined environmental and institutional policy change with theory-based education programs were the most likely to be successful. Finally, programs tailored to local conditions by the communities themselves tended to achieve more behavior change than programs imported from the outside. CONCLUSIONS: Comprehensive community intervention approaches may have considerable potential to reduce college-age drinking problems, especially given the success of these programs in reducing alcohol-related problems and in preventing health-compromising behaviors among youth.

Alcoholism↗

Injury among detoxification patients: alcohol users' greater risk.

BACKGROUND: Little information exists about serious injury in alcohol or drug abusers who seek detoxification. This study examined injury prevalence, and the impact of alcohol use on injury, among alcohol- and drug-dependent persons. METHOD: We enrolled patients at a detoxification unit into a prospective cohort study and performed follow-up interviews to determine the prevalence of injury. Baseline and follow-up (6, 12, 18, and 24 month) data were examined separately by using multivariate logistic regression to determine factors associated with self-reported episodes of serious injury. The main independent variable was self-reported first and second substances of choice at admission: alcohol only, drug only, or both. RESULTS: Overall, 24% of the 470 subjects reported at least one instance of serious injury over the 6-month period before detoxification. Similarly, approximately 20% of subjects had serious injury during each 6-month follow-up period. Injury in the past 6 months was highest among the 63% of subjects who reported alcohol as a drug of choice (28-29% vs. 16% for drug only), even after we controlled for potential confounders. Analysis of 2-year follow-up data revealed a similar association, after we controlled for baseline injury and alcohol consumption. CONCLUSIONS: Injury is a serious problem for a substantial proportion of patients who undergo detoxification, particularly those with alcohol dependence. This marked risk for serious injury persisted for 24 months after detoxification. Patients at detoxification, particularly those with alcohol problems, represent a high-risk population for injury that may benefit from interventions to reduce these preventable complications.

Adult↗