Preventing Alcohol-Related Problems: Evidence and Community-Based Initiatives

A Q&A with the editors of Preventing Alcohol-Related Problems: Evidence and Community-Based Initiatives, just released by APHA Press.

Norman Giesbrecht, PhD, is an emeritus scientist with the Toronto Centre for Addiction & Mental Health and an adjunct professor at Dalla Lana School of Public Health, University of Toronto. He served as chair of the APHA Publications Board from 2007 to 2011 and received a lifetime achievement award from the APHA Alcohol, Tobacco, and Other Drugs Section in 2008.

Linda M. Bosma, PhD, is president of Bosma Consulting, a Minnesota-based evaluation practice focused on community initiatives. As section and program chair of APHA's Alcohol, Tobacco, and Other Drugs Section, she received the Section Leadership Award in 2009.

Q: Is alcohol a public health problem in the U.S.?

A: According to the World Health Organization, alcohol consumption is linked to more than 200 disease and injury conditions. All of these effects place a substantial burden on population health in terms of death and disability, making alcohol consumption one of the 10 leading factors with the most impact on population health.

Alcohol impacts all sectors of society, drinkers and non-drinkers alike, but thanks to targeted industry marketing and availability, we are seeing evidence of high-risk drinking among young women and high rates of alcohol-related problems for under-educated males and minorities. The alcohol industry continues to develop youth-friendly products such as sweet, fruit-flavored alcopops.

Q: What are the barriers to a public health approach to alcohol consumption in this country?

A: Myths about alcohol that overstate the benefits and under-state the harms — and the stigma associated with alcohol abuse and related problems — work to hinder appropriate action. Governments are challenged to give appropriate priority to alcohol issues in the face of common misperceptions about the role of alcohol in many community problems. And the alcohol industry works to undermine effective policies and strategies.

The more effective interventions, such as higher prices, or restrictions on physical availability [density of outlets] are unpopular. Meanwhile, less effective interventions, such as information dissemination initiatives, are more popular. Individually oriented programs, while necessary, do not have the economy of scale and scope of potential impact as do alcohol policies directed at selling, distribution and marketing.

Q: What can communities do to address alcohol-related problems and reduce the public health harm?

A: Communities can promote evidence-based alcohol policies and establish local coalitions that mobilize community stakeholders to take action. Groups can use local data to identify and address their most pressing local problems. In many cases, resources available locally will be limited, though, so expanding resources will be a major challenge. In addition to examining use rates of alcohol, groups should identify a wide range of potential harms and second-hand effects of alcohol to help mobilize support.

Q: What role can research play in informing policy and practice at the community level?

A: Communities can use research to counter some of the myths associated with alcohol. For example, research shows that higher prices (such as taxation, minimum unit pricing, elimination of store specials and happy hours) are associated with lower consumption and reduced alcohol-related harm. Research, combined with local data, can help coalitions focus attention on the most vulnerable sectors of a population. And findings can provide decision-makers with options for and estimated impacts of different prevention strategies.

Q: How can this book help communities affected by alcohol problems?

A: The book summarizes recent research and combines it with examples of local action that community leaders have successfully applied. Readers can use this book to help identify the range of alcohol-related problems in their community, use research to inform their prevention planning and apply best practices to their own situation. Each community chapter includes a list of resources that its authors found useful in planning community action on alcohol issues.

The book is a timely resource for training at the local level and will be useful for faculty members in public health, political science, public policy and public administration courses. Public health specialists, advocates and administrators, community leaders and policymakers can all benefit.

To order, call toll-free 888-320-APHA; email [email protected]; or visit www.aphabookstore.org. Requests for a review copy should be sent by email to David Hartogs.