Access to Health Care and Heavy Drinking in Patients with Diabetes or Hypertension: Implications for Alcohol Interventions

Aims: The aims of this study are: 1) to examine the associations among several different aspects of health care access—health insurance, regular place for care, primary care use, and the frequency of primary care use—and heavy drinking for patients with chronic conditions that can be adversely affected by heavy drinking, and 2) to explore whether increased health access could be used to facilitate alcohol interventions in primary care. Methods: A nationally representative sample of 7,428 U.S. adults diagnosed with hypertension and diabetes was extracted from the 2007 National Health Interview Survey (NHIS) data. Multivariate logistic regression models were performed to examine the associations between health care access and heavy drinking among current drinkers, controlling for demographic variables and self-rated health status. Results: Regular source of care and frequent use of primary care were protective factors from heavy drinking. Health insurance was not significantly associated with heavy drinking. Conclusions: Increased access to health care, as indicated by a regular source of care and frequent use of primary care, may help reduce heavy drinking in patients with hypertension or diabetes. Alcohol interventions may be more effective and better integrated into routine primary care practice if subgroups of patients who have chronic conditions that can be adversely affected by drinking are targeted.