Risky Drinking Behavior – Alcohol use and Injury in La Crosse County Stephen Hargarten, MD, MPH Injury Research Center, Medical College of Wisconsin Brenda.

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Presentation transcript:

Risky Drinking Behavior – Alcohol use and Injury in La Crosse County Stephen Hargarten, MD, MPH Injury Research Center, Medical College of Wisconsin Brenda Rooney, PhD, MPH Gundersen Lutheran Medical Center Keri Briel Frisch, MS Injury Research Center, Medical College of Wisconsin

Public Health Approach Source: Suicide Prevention Resource Center

Translated into a Program Planning Model Where are we now? - Data - Assessment - Problem Identification How do we get there? - Activities, interventions - What does the evidence say? How do we know it worked? What indicators will we measure? What will we compare them to? How will we measure them? What will we do with results? Where do we want to be? Outcomes (short and long term) (Source: Barbara Hill, MSSW, Ann Christiansen, MPH, Clare Guse, MS, Peter Layde, MD,MSc as part of the Wisconsin Injury Prevention Coalition project.)

Define the problem with data Burden of alcohol-related injury in La Crosse County data from: WISH (Wisconsin Interactive Health Statistics) Medical examiner Emergency department and inpatient data Wisconsin CODES (Crash Outcome and Evaluation System) WVDRS (Wisconsin Violent Death Reporting System) Police Departments Universities

Acknowledgements The partners would like to acknowledge the special efforts of the following individuals in contributing to the development of this report: Al Bliss, Health Educator, La Crosse County Health Department Mary Czinner, Program Coordinator, Injury Research Center at the Medical College of Wisconsin Keri Briel Frisch, MS, Program Manger, Injury Research Center at the Medical College of Wisconsin Clare Guse, MS, Senior Biostatistian, Injury Research Center at the Medical College of Wisconsin Robert Hanrahan, medical student, Medical College of Wisconsin Stephen Hargarten, MD, MPH, Director, Injury Research Center at the Medical College of Wisconsin Michelle Hirsch, Programmer, Gundersen Lutheran Brianna Kopp, MPH, Injury Prevention and Surveillance Coordinator, Wisconsin Injury Prevention Program Brenda Rooney, PhD, MPH, Clinical Epidemiologist and Medical Director, Department of Community and Preventive Care Services, Gundersen Lutheran Medical Center John Steers, Medical Examiner, La Crosse County Julie Berg, Programmer, Franciscan Skemp Police departments of City of La Crosse, City of Campbell, City of Holmen, City of West Salem and the La Crosse County Sheriff’s Department Viterbo University, University of Wisconsin-La Crosse, Western Technical College

Preliminary results

Deaths due to injury Deaths of La Crosse county residents aged 15-24; population size 22,056 Cause of DeathNumber of deathsRate (per 100,000) YPLL (total years lost to age 75) Unintentional Injuries Suicide Homicide All cancer Diabetes mellitus Source: WISH, Wisconsin Interactive Health Statistics

Alcohol-related injury deaths Deaths in La Crosse county aged Number of deaths SexCause of deathManner of death Blood alcohol range Male 1 Female 6 Motor Veh. Crash 4 drowning 1 fall 1 pedestrian 2 suicide 9 Unintentional 2 Intentional 2 Undetermined Source: Office of the Medical Examiner

Hospital data Discharge data from Gundersen Lutheran and Franciscan Skemp ECodes for emergency department visits and inpatient stays “La Crosse” residents vs. “Other” nonresidents treated in facilities combined Comparison to state from Wisconsin Inpatient Hospital Discharge Data

Alcohol-related injury emergency department visits : Homicide-Assault 44/393 75/400 13/108 24/126

Alcohol-related injury inpatient stays : Homicide-Assault 9/19 17/34 4/18 22/46

Alcohol-related injury emergency department visits : Suicide-Self harm 7/141 15/82 3/41 0/17

Alcohol-related injury inpatient stays : Suicide-Self harm 50/ /388 53/ /373

Alcohol-related injury emergency department visits : Motor Vehicle Crash 35/553 35/834 13/245 14/374

Alcohol-related injury inpatient stays : Motor Vehicle Crash 24/64 36/154 42/142 68/313

Alcohol-related injury emergency department visits : Falls 45/ / /436 45/1167

Alcohol-related injury inpatient stays : Falls 12/64 122/1252 8/83 66/1014

Alcohol-related injury emergency department visits

La Crosse ED visits compared to state

ED highlights ,364 unintentional injury related ED visits (6,321 visits for year olds) 1,308 intentional injury related ED visits (683 visits for year olds) 595 alcohol-related unintentional injury visits (198 visits for year olds) 181 alcohol-related intentional injury visits (67 visits for year olds)

Alcohol-related injury inpatient stays

La Crosse inpatient stays compared to state

Inpatient highlights ,767 unintentional injury related inpatient stays (698 visits for year olds) 1,226 intentional injury related inpatient stays (385 visits for year olds) 566 alcohol-related unintentional injury stays (122 visits for year olds) 457 alcohol-related intentional injury stays (116 visits for year olds)

Limitations of hospital data Relies upon E-codes system in place at hospital Youth probably less likely coded for alcohol use

Alcohol-related studies show Alcohol Is Associated with Up to 70% Domestic Abuse 40-50% Traffic Fatalities Up to 80% Homicides 68% Manslaughters 69% Drownings 38% Child Abuse Up to 60% Rapes 37-40% Assaults 20-36% Suicides Source: Public Health Strategies to Reduce Alcohol-Related Illness, Injury and Death in Milwaukee County, Milwaukee Academy of Medicine, 1998

IOM Report on Underage Drinking In 1999, 40 percent of people under 21 who were victims of drownings, burns and falls tested positive for alcohol In 2000, alcohol-related traffic fatalities constituted almost 37 percent of all fatal youth traffic fatalities It is estimated that 50 percent of youth violent crime is alcohol-related

Using data to target interventions: MVC

Burden on law enforcement Alcohol-related police calls August 2007 City of La Crosse4,028 Campbell*67 Holmen*40 West Salem*65 La Crosse County Sheriff*317 *primarily liquor law violations, OWI, underage drinking

City of La Crosse Police Dept Age and sex of those involved in alcohol-related calls

Discussion Does this represent the problem? Other data sources to investigate? Evidence-based strategies to address the problem

Burden of Alcohol-related Injury Report Completion in May 2008 Available in printed copies at final coalition meeting June 2008 Available online through the La Crosse Medical Health Science Consortium (LMHSC) or the Injury Research Center (IRC)