Appraising alcohol-related social and health problems in the US: Improvements in data quality and translational strategies promise better policy recommendations

Interventions to reduce alcohol-related damage need to be cognizant of the range, scope and severity of alcohol-related problems and evidence of the most effective and appropriate prevention strategies. The National Alcohol Survey (NAS) series (including 2005) and aggregate statistics (including total alcohol consumption and mortality) over a 25 year period are key resources in identifying and quantifying severity of social and health problems associated with harmful patterns of alcohol consumption. Triangulating from individual and aggregate sources provides a better picture of the distributions of harms (and in a few instances possible benefits) by age, gender and major ethnic minority subgroups, and facilitates future projections. Data on externalities from others' drinking are also considered. The presentation will highlight what national surveillance data may be needed to better establish the burdens represented by the range of identified alcohol-related outcomes. Measures of drinking initiation and heavy drinking in the life course, together with an understanding of relatively enduring drinking styles of birth cohorts, have potential to provide better estimations of subsequent major morbidity and mortality risk factors. We also consider the availability and viability of evidence-based policy levers and interventions, and evaluate their potential to mitigate the important harms in the US context, including measures such as alcohol taxation, state controls and retail monopolies, setting minimum prices by beverage classes, local alcohol availability strategies, and increasing screening, early intervention, and service access. Finally we indicate what data-driven alcohol policy recommendations are feasible and explore what new data and analyses would support such recommendations.