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Commentary: Community environment tied to chemical use

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On March 26, the Robert Wood Johnson Foundation and University of Wisconsin released the United States’ County Health Rankings. The rankings are based on a model of population health utilizing several factors such as health behaviors, clinical care, social and economic factors and physical environment.

The recent reports provides important information about how the Chemical Health Initiative of Goodhue County can improve behavioral health outcomes for families.

The report identifies Goodhue County as 43rd out of 87 Minnesota counties for overall population health.

There are two important areas that place Goodhue County in the top 20 of Minnesota counties: overall quality of life and clinical care.

But the behavioral health factor that remains problematic for Goodhue County is excessive drinking.

Binge drinking and heavy drinking rates have been significantly higher in Goodhue County than in other Minnesota counties in past rankings and it appears that this trend is continuing. Excessive drinking reflects the percent of adults that report either binge drinking (defined as consuming more the four alcohol beverages for women or five alcohol beverages for men on a single occasion in the past 30 days). Heavy drinking is defined as drinking more than one (women) or two (men) drinks per day on average.

The connection between excessive drinking and health outcomes is clear. “Excessive drinking is a risk factor for a number of adverse health outcomes such as alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence, and motor vehicle crashes,” as the County Health Rankings research states.

But adverse health outcomes are not the only problems created by high rates of excessive drinking within a county. CADCA, a national organization that provides research and special support services to the Substance Abuse and Mental Health Administration of the federal government reports that excessive alcohol consumption is now the third-leading preventable cause of death in the United States annually.

CADCA describes excessive alcohol consumption at the population level as “carrying a heavy economic burden, including health care costs, property damage, alcohol-related crime and delinquency, and lost productivity.” In fact, CADCA reports that the cost of excessive alcohol consumption in this country has grown to $223.5 billion annually.

It is easy to understand why the rates of excessive drinking by adults in Goodhue County are cause for serious concern for all sectors of our communities – including our schools.

While the CHI is demonstrating highly favorable outcomes in terms of Goodhue County’s student drug and alcohol usage rate trends, continued high excessive drinking rates for the adult population will play a direct and detrimental effect on the future rates of students’ drug and alcohol use. Research conducted by the Research Center at the University of Pennsylvania concludes that in rural communities it is the characteristics of the community environment that predicts youth problem behavior.

This means that in rural communities, families individually cannot completely control the outcomes of their children’s chemical health. The community environment will play a critical role in whether or not our children will develop substance use disorders and/or alcohol or drug related problem behavior.

The ramifications of this research must give Goodhue County community members increased incentive to pay close attention to the environments we are creating for our children. If excessive drinking rates for Goodhue County adults continue to be significantly higher than other Minnesota counties, we need to expect that drug and alcohol use by adolescents will also increase.

Recent research in brain science, sociology and medicine confirm this important message: the impact of environment upon our children’s growth and development is significant.

The CHI of Goodhue County has been working over eight years to promote community prevention policies, practices and procedures that are proven to have favorable outcomes for effecting environmental changes. Examples of these changes at the population level are

•social host ordinances passed by our Goodhue County municipalities;

•city ordinances across Goodhue County that require mandatory seller/server training to reduce over-service of alcohol to adults, and to reduce illegal alcohol sales to minors;

•development of a seller/server training online training program for liquor licensees in Goodhue County;

•sticker shock campaigns in Goodhue County communities warning adults of the criminal penalties for purchasing alcohol for minors;

•letters to families with graduating seniors explaining the benefits of having alcohol-free celebrations;

•community town hall meetings to provide forums for discussion about alcohol-related crime and delinquency;

•websites that provide up-to-date research and information for adults looking for chemical dependency evaluation and intervention services;

•zero-alcohol-procurement training for Goodhue County law enforcement officers;

•a Chemical Health Sunday initiative that assists our Goodhue County churches and faith-based organizations in providing education and awareness about chemical health to congregants and parishioners each year;

•collection and publication of student data on drug and alcohol usage rates, age of onset, types of drugs, perception of harm, and other important core measures as identified by federal guidelines.

There is much more work to be done in our Goodhue County communities to help lower our rates of excessive drinking by adults.

Research studies support the use of screening and brief intervention tools as an effective strategy for identifying unhealthy alcohol use by adults. These screening tools can be utilized by emergency room personnel as well as family physicians to educate adults about the health outcomes associated with their levels of alcohol consumption. The Academy of Pediatrics has recently recommended that health care providers conduct these same types of alcohol screenings with child and adolescent patients at all office visits.

CADCA’s research indicates that more than half of all self-reported binge-drinking episodes occur in a bar or restaurant. Business owners and servers in Goodhue County both work hard to avoid over-service.

But public awareness campaigns and education initiatives for community members to highlight Minnesota’s laws prohibiting the sale or service of alcohol to anyone who appears intoxicated could reduce the problems that result when adults are served or sold too much alcohol.

April is alcohol awareness month across the United States. While the CHI works in schools to promote education and awareness about chemical health, and to reduce underage drinking, it also works within Goodhue County communities to help reduce excessive alcohol use among adults. Working together, we can create community environments that produce healthy kids and healthy families.

Let’s set a goal to improve Goodhue County’s Behavioral Health Ranking in 2014. For more information about the national county health rankings or the research conducted by CADA, check out these two websites: www.countyhealthrankings.org and www.cadca.org.

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