1. Community Efforts to Address Alcohol Problems in the United States
Maria G. Carmona
Center for Policy Analysis and Training
Pacific Institute for Research and Evaluation
March 21, 2003

2. Where does policy change occur?
Policy change occurs at
Federal level
State level
Local community level

3. What do communties do when they change alcohol policy?
Identify specific alcohol problem(s)
Identify the causes of problems
Implement interventions to change those causes

4. Community-based Prevention
Strategies to address causes
Problem
Perceived causes
Long-term goal
Intermediate Goal

5. Alcohol-Related Problems
Traffic crashes
Cirrhosis
Suicide
Alcohol dependence
Binge drinking
Interpersonal violence
Fetal Alcohol Syndrome
Work productivity loss
Underage drinking

6. Why do these problems occur?
Four types of community-level causes of alcohol problems:
Alcohol availability
Attitudes or social norms about alcohol use
Poor alcohol regulations or policies
Lack of alcohol enforcement

7. Availability What is the availability of alcohol in the community?
Is alcohol more available for particular segments of the community?
What is needed to obtain alcohol?

8. Attitudes
What are common attitudes about alcohol use in the community?
Do attitudes about alcohol use differ across different ages groups and between genders?
If yes, why do attitudes differ?

9. Regulations or Policies
What regulations control the availability of alcohol?
What regulations control the promotion of alcohol?

10. Enforcement
Are alcohol regulations on promotion and availability enforced?
If not, why?
When someone violates the law, what happens?

11. Example 2: Impaired Driving
Causes
Problem
Strategies
Impaired driving patrols
High-profile sobriety checkpoints targeting minors
Merchant education
Increased compliance checks
Public education campaign to raise awareness of laws and enforcement efforts
Media coverage of sobriety checkpoints, community-based merchant education campaign
Lack of impaired driving enforcement
Easy access to alcohol
Lack of awareness of impaired driving laws
Alcohol-related traffic crashes

12. Example 3: Binge Drinking
Problem
Perceived Causes
Strategies
High density of bars
Abundance of Happy Hours
Failure to check IDS
Older adults providing alcohol for parties attended by underage youth
Low perception of risk and harm from binge drinking
Lack of enforcement of MPA law
New ordinance restricting outlet density
Merchant education
Party Patrols
College policy of parental notification of all alcohol-related offenses
Compliance checks
Keg registration ordinance
Use of media advocacy with all interventions.
Binge Drinking

13. Two Key Points
Efforts to implement policy change depend largely on community support for change.
Media advocacy can be used to generate community support for change.

14. Community Support Community support begins with as little as two
dedicated adults or a few passionate teenagers.
Community support is best harnessed through
formation of a coalition of:
Government officials
Representatives of key community organizations
Respected community leaders or opinion-
makers
Parents
Youth
Other allies (for example, medical professionals)

15. Media Advocacy The strategic use of media to advance a policy goal
Consists of earned media coverage (free!) or use of free media space

16. Media Advocacy
Coverage of problems and causes can be used to generate:
Discussion about policy change
Awareness of policy change
Support for policy change
Changes in community awareness and attitudes (or norms)

17. The Utility of Research to Communities
Baseline data can help communities:
understand the nature of problems
raise awareness about the problem.

18. Alcohol and Young People is a Dangerous Mix
Car crashes are the number one killer of teens, and one-third to one-half of those accidents involve alcohol.
In 1996, 29 % of Maryland 12th graders reported driving after drinking alcohol.
In 1996, 56 % of 12th graders reported having been a passenger with a driver who had been drinking alcohol.
Source: Maryland Adolescent Survey

19. In St. Mary’s County, 120 youth entered the juvenile justice system on alcohol-related offenses in That’s 4 classrooms of students.
Source: Maryland Department of Juvenile Justice

20. Liquor stores in Maryland
213 public high schools2
178 public libraries3
102 movie theatres1
1 U.S. Census, County business patterns for Maryland, 1996
2 U.S. Department of Education, Digest of Education Statistics, 1997; data for school year
3 Maryland Manual On-line, reporting 1997 data

21. The Utility of Research to Communities
Follow-up data:
Documents outcomes
Enables communities to refine efforts
Makes it possible to stories to be told

22. Lessons Learned
The experiences of one community inform other communities.
The experiences of communities inform efforts directed at the state.
Federal-level policy change happens when the documented success of communities and states can no longer be ignored.