The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65235

Carla A. Green, PhD, MPH¹, Michael R. Polen, MA¹, Nancy A. Perrin, PhD¹, and Constance Weisner, DrPH, MSW². (1) Center for Health Research, Kaiser Permanente, 3800 North Interstate Avenue, Portland, OR 97227-1110, 503-335-2479, carla.a.green@kpchr.org, (2) Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143

Background: Given the health consequences of excessive drinking, risky drinkers appear to have unexpectedly lower short-term health care use/costs than other groups. Hypotheses that heavy drinkers avoid health care until illness triggers cessation and greater service use have not been directly tested. Methods: 7,767 randomly selected HMO members, age 21-64, completed a survey concerning health, drinking patterns, health-related practices and attitudes. We examined gender and (1) frequency of heavy drinking (4+ drinks/occasion for women, 5+/occasion for men), (2) drinking status (lifelong abstainers, former drinkers, and current drinkers [4 categories]) and (3) attitudes and behaviors. Results: Preliminary two-way MANCOVAs, adjusted for age, mental and physical health, demonstrate that heavier drinkers were more likely than others to be concerned doctors might disapprove of their health-related practices, to dislike visiting the doctor, to feel that good health is a matter of good fortune, and were less likely to use seatbelts or exercise. Weekly heavy drinkers made the fewest prior-year outpatient visits, former drinkers the most. Gender by heavy drinking interactions were present for seat belt use and smoking. Of health-related reasons for abstaining or quitting, lifelong abstainers and former drinkers cited the following (respectively): health problems (11%, 24%), health concerns (21%, 28%), prescription medications (10%, 13%). 19% of former drinkers cited drinking-related problems. Discussion: Results support hypotheses that people abstain from or quit drinking because of health, that heavier drinkers avoid health care, creating missed opportunities for prevention and intervention, and that health care avoidance cannot be sustained by the heaviest daily drinkers.

Learning Objectives:

• Discuss relationships between patterns of alcohol consumption and health care use/avoidance.
• Understand reasons for lifelong abstention from alcohol and drinking cessation.
• Identify attitudes related to drinking patterns that may affect willingness to use health services.

Keywords: Alcohol Use, Care Seeking

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.