1. Helen Akhondi, MHA Candidate The university of Scranton Scranton, PA
The Impact of Alcoholism in the Slovak Republic, Czech Republic, Austria & Hungary
Helen Akhondi, MHA Candidate
The university of Scranton
Scranton, PA

2. Overview Background Alcohol Use Disorder Consumption Levels & Patterns
Health Consequences
Policies & Interventions
Concluding Lessons for Slovakia

3. Background
End of Soviet Union democratization of EE
More market-driven economy
Improved the economic status of these countries
Slovakia, the Czech Republic, Austria & Hungary are labeled high income
High social acceptance for drinking
Thus, an examination of the alcohol-related health status of these countries would be beneficial
Generally, ↑ economic status of a country = ↑ per capita alcohol consumption & heavy episodic drinking

4. Alcohol Use Disorder Alcohol use disorder (aka. Alcoholism):
“Is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking”
– Mayo Clinic
Pure alcohol per day

5. Causes 4% of all deaths worldwide
“The hazardous and harmful use of alcohol is a major global contributing factor to death, disease and injury” – WHO
3rd largest risk factor for disease & disability globally.
More than HIV/AIDS or Tuberculosis
Causes 4% of all deaths worldwide

6. Causal factor for 60 types of diseases
Risk factors for many health conditions including:
Hypertension
Liver damage
Heart disease
Cancers
Self harm
Injury
etc.

7. Slovakia, the Czech Republic, Austria & Hungary
Country Profiles
Slovakia, the Czech Republic, Austria & Hungary

8. Alcohol Consumption Levels & Patterns

9. Alcohol Consumption
(WHO, 2014)

10. Abstainers (past 12 mo.)
(WHO, 2014)

11. Prevalence of Heavy Episodic Drinking
Slovakia
Females 16.8%
Males 41.3%
Czech Republic
Females 24.9%
Males 38.9%
Austria
Females 28.9%
Males 53%
Hungary
Females 10.3.%
Males 44.5%
(WHO, 2014)

12. Recorded Alcohol Consumption by Type of Beverage
Slovakia
Austria
Czech
Republic
Hungary

13. Health Consequences

14. Prevalence of Alcohol Use Disorders

15. Liver Cirrhosis
Scarring of the liver due to liver diseases or alcoholism.
Formed when liver tries to repair itself over & over.
Scar tissue (fibrosis) is formed
Hinders liver function
Non-reversible
Liver functions by detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.
A normal liver (left) shows no signs of scarring. In cirrhosis (right), scar tissue replaces normal liver tissue.

16. Mortality from Liver Cirrhosis
Slovakia
23.9 deaths from 100,000
Austria
21.4 deaths from 100,000
Czech Republic
15 deaths from 100,000
Hungary
13.7 deaths from 100,000

17. Alcohol-Attributed Liver Cirrhosis
(WHO, 2010)

18.
Journal of Hepatology, Volume 58, Issue 3, 2013, 593–608
Age-standardized death rates per 100,000 population from liver cirrhosis in European countries, males and females aged 20–64

19. Alcohol-Attributable Road Traffic Accidents
(WHO, 2010)

20. Policies & Interventions

21. National legal drinking age
Slovakia  18 yrs.
Czech Republic  18 yrs.
Austria  16 yrs.
Hungary  18 yrs.
National max. BAC when driving a vehicle
Slovakia  Zero tolerance
Czech Republic  Zero tolerance
Austria  0.05%
Hungary  Zero tolerance
(WHO, 2014)

22. Alcohol Excise Tax Slovakia Czech Republic Austria Hungary Beer X Wine
Spirits
(WHO, 2014)

23. Five Priorities in the EU Strategy on Alcohol:
Protect young people
Reduce injuries/deaths from alcohol‐related road accidents
Prevent alcohol‐related harm among adults
Raise awareness on the impact of harmful alcohol consumption & appropriate consumption patterns
Inform & educate
Develop, support and maintain a common evidence base
EU Strategy on Alcohol
Established by the European commission 2006

24. How EU Policies Will be Implemented:
Education and public awareness
Drinking‐driving countermeasures
Restrictions on the availability of alcohol
Advertising controls
Pricing and taxation

25. Slovakia - National Action Plan on the Problems with Alcohol Use 2013 – 2020
1) Measures to reduce demand for alcohol
Taxation
Regulation of sales age, selling location
2) Regulation on advertising
No underage drinking
No portraying as social success
3) Education of communities in the area of alcohol control
Prevention sessions in schools & jobs
4) Primary healthcare intervention
Short term intervention related to alcohol drinking habits by a GP
Lead by the ministry of health
Government endorsed
Advertising regulations Strictly should not display underage drinking, portray alcohol as a sign of social success, show abstinence as a shortcoming, etc.
studies carried out in the UK demonstrated that short-term intervention has led to a 20% reduction in immoderate consumption of alcohol

26. Concluding Lessons for Slovakia
Potential in decreasing cirrhosis and overall death by decreasing alcoholism.
Large opportunity to decrease vehicle accidents
By enforcing and stressing the law
Physicians have a front-line opportunity to educate and evaluate their patient’s alcohol usage.
EU strategy on Alcoholism is a great resource that has examples of how to defeat alcoholism in your community.
- Slovakia is the only country analyzed with no national monitoring system or govt. support for community action
Decrease medical spending for alcoholism from current ~$97 million

27. Thank you!
Any Questions?