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APHA Scientific Session and Event Listing

Timothy S. Naimi, MD, MPH, Zuni Public Health Service Hospital, P.O. Box 465, Zuni, NM 87327, 505 782 7566, tbn7@cdc.gov, Machell Town, MS, Behavioral Surveillance Branch, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Atlanta, GA 30341, Robert D. Brewer, MD, MSPH, CDC, 4770 Buford Hwy, MS K-67, Atlanta, GA 30341, and Ali H. Mokdad, PhD, Division of Adult and Community Health, Behavioral Surveillance Branch, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, M/S K66, Atlanta, GA 30341.

Excessive alcohol consumption kills approximately 75,000 persons in the U.S. annually. Although screening for alcohol ‘misuse' (i.e., consuming alcohol in excess of national guidelines) in primary care settings is recommended by the U.S. Preventive Services Task Force, it is rarely performed, even among those who drink excessively. However, it is unclear whether failure to screen results from limited health care access, missed screening opportunities, or both. We analyzed data from the 2002 Behavioral Risk Factor Surveillance System, a population-based telephone survey of U.S. adults. Current health insurance status and a history of a recent medical check-up (within 2 years) were assessed in relation to alcohol consumption. Excessive drinkers were those who reported past-30 day binge drinking (consuming 5+ drinks on >=1 occasions), heavy drinking (consuming >60 drinks for men or >30 for women), or both. The prevalence of excessive drinking among the general population (17%) was only slightly higher than that observed among those with current health insurance (15%) or a recent checkup (14%). Among excessive drinkers, 79% had current health insurance and 78% had a recent checkup. Excessive drinkers with the lowest rates of health insurance were young, Hispanic, less educated, and unemployed. However, most excessive drinkers who lacked health insurance (70%) or a checkup (85%) were employed. Low rates of alcohol screening among excessive drinkers are mostly due to missed screening opportunities rather than a lack of screening opportunities. Systems approaches to address these missed opportunities (e.g., reminder systems) should be routinely implemented in primary care settings.

Learning Objectives:

• Assess health access among those who drink alcohol in excess of national guidelines.
• Understand the implications for efforts to prevent the health and social effects of excessive drinking, including the development of alcohol abuse or dependence.

Keywords: Access to Health Care, Alcohol Problems

Presenting author's disclosure statement:

Not Answered