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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Alcohol and Other Drug Use

Healthiest Wisconsin 2020 Baseline and Health Disparities Report Alcohol and Other Drug Use. Chapter outline. Chapter Outline. Background Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report Healthiest Wisconsin 2020 objectives and indicators Rationale Key points

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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Alcohol and Other Drug Use

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  1. Healthiest Wisconsin 2020 Baseline and Health Disparities ReportAlcohol and Other Drug Use

  2. Chapter outline Chapter Outline Background • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report • Healthiest Wisconsin 2020 objectives and indicators • Rationale • Key points Data • Risk behaviors among youth • Risk behaviors among adults • Alcohol consumption and availability • Adverse health outcomes • Consequences of substance abuse References Links to additional reports and resources Contacts

  3. Report overview Report Overview • This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf • The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. • Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. • Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

  4. Report overview Report Format Sample annotated slide Full Report • Format: PDF • Intended use: reference document Chapters • Format: Annotated PowerPoint slide set • Intended uses: presentations to • Decision-makers • Service providers • Community leaders • The public

  5. Report overview Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes

  6. Report overview Report Outline: Detail Section 3: Health focus areas Section 4: Infrastructure focus areas

  7. Report overview Report Outline: Detail Section 5: Data summaries by population

  8. Report overview Data notes • Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf • The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. • Population estimates that are considered unreliable are excluded. • Misclassification of racial/ethnic groups may affect the accuracy of rates. • Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

  9. Report overview Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

  10. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 1 By 2020, reduce unhealthy and risky alcohol and other drug use by changing attitudes, knowledge, and policies, and by supporting services for prevention, screening, intervention, treatment and recovery. Objective 1 Indicators • State rates and rankings of selected youth and adult behaviors related to unhealthy and risky alcohol and other drug use. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020,Alcohol and Other Drug Use Focus Area Profile.

  11. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 2 By 2020, assure access to culturally appropriate and comprehensive prevention, intervention, treatment, recovery support and ancillary services for underserved and socially disadvantaged populations who are at higher risk for unhealthy and risky alcohol and other drug use. Objective 2 Indicators • Periodic inventory of the proportion of counties with local capacity to provide alcohol and other drug abuse prevention, intervention (including criminal justice diversion), treatment, recovery support and ancillary services across all revenue streams for underserved and socially disadvantaged populations. • Periodic inventory of the proportion of counties with services specific to racial and ethnic minorities; women; and lesbian, gay, bisexual and transgender populations. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020,Alcohol and Other Drug Use Focus Area Profile.

  12. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 3 By 2020, reduce the disparities in unhealthy and risky alcohol and other drug use among populations of differing races, ethnicities, sexual identities and orientations, gender identities, and educational or economic status. Objective 3 Indicators • Unhealthy and risky alcohol and other drug use by race, ethnicity, sexual identity and orientation, gender identity, and educational or economic status. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020,Alcohol and Other Drug Use Focus Area Profile.

  13. Alcohol and other drug abuse is any use of one or more mood-altering, habit-forming substances that results in negative consequences. Adverse health outcomes associated with excessive alcohol consumption include cirrhosis of the liver and other chronic diseases, alcohol dependence, and fetal alcohol spectrum disorder. Individuals who abuse alcohol and other drugs are more likely to engage in risky behaviors that may result in motor vehicle accidents and fatalities, employment problems, relationship problems, unplanned pregnancies and sexually transmitted diseases, birth abnormalities, child abuse, and crime. The abuse of illicit drugs, like heroin, cocaine, marijuana, and including the non-medical use of mood-altering prescribed drugs, inflicts harm upon individuals, families, and communities. Rationale Rationale Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020,Alcohol and Other Drug Use Focus Area Profile.

  14. Adult risk behaviors In 2011, Wisconsin ranked first in the nation for both heavy drinking and binge drinking among adults. Significant disparities exist in the prevalence of adult risk behaviors. For example: Binge drinking rates were significantly higher among males and younger age groups. Binge drinking rates were significantly lower for Black adults compared to Whites; people in the lowest income and education levels; and in Milwaukee County compared to smaller metropolitan and non-metropolitan counties. Key points Key points

  15. Adult health outcomes and consequences of substance abuse In 2011, the estimated annual costs associated with excessive alcohol use in Wisconsin totaled $6.8 billion. From 2002 to 2010, both alcohol- and drug-related hospitalization rates increased in Wisconsin. Significant disparities exist in the prevalence of adverse consequences associated with substance abuse. For example: The death rate from alcoholic liver disease among American Indians in Wisconsin was much greater than the rate for Whites, similar to national differences. Drug-related deaths involving heroin or other opioids increased nearly four-fold during 2000-2011 Key points Key findings

  16. Key points Key findings: Youth risk behaviors Youth • In Wisconsin, more than one-third of high school students drank alcohol within the past 30 days. • Significant disparities exist in the prevalence of youth risk behaviors. For example: • White students were significantly more likely to binge drink than were Black, Hispanic, and Asian students. • Current marijuana use among Black students was significantly higher than among White, and Asian students. • Early initiation of alcohol use (before age 13) was most prevalent among Latino and Black students; early initiation of marijuana use was most prevalent among Black and American Indian students. • Sexual minority students had much higher rates of marijuana, cocaine, inhalants, and heroin use compared to sexual majority students. • Sexual minority students had higher rates of early initiation of both alcohol and marijuana use than sexual majority students.

  17. Risk behaviorsamong youth

  18. Risk behaviors among youth Rates of current drinking, binge drinking, and marijuana use among Wisconsin high school students, by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  19. Risk behaviors among youth Rates of current drinking, binge drinking, and marijuana use among Wisconsin high school students, by sexual minority status, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

  20. Risk behaviors among youth Rates of lifetime use of cocaine, inhalants, and heroin among Wisconsin high school students, by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  21. Risk behaviors among youth Lifetime use of cocaine, inhalants, and heroin among Wisconsin high school students, by sexual minority status, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

  22. Risk behaviors among youth Rates of early initiation of alcohol and marijuana use among Wisconsin high school students, by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

  23. Risk behaviors among youth Early initiation of alcohol and marijuana use among Wisconsin high school students, by sexual minority status, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

  24. Risk behaviors among adults

  25. Risk behaviors among adults Rates of binge drinking and heavy drinking among Wisconsin adults, by sex, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  26. Risk behaviors among adults Rates of binge drinking and heavy drinking among Wisconsin adults, by age group, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  27. Risk behaviors among adults Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  28. Risk behaviors among adults Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by household income level, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  29. Risk behaviors among adults Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by education level, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  30. Risk behaviors among adults Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by level of urbanization, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  31. Risk behaviors among adults Rates of binge drinking and heavy drinking among Wisconsin adults ages 18-64, by disability status, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  32. Risk behaviors among adults Binge drinking among Wisconsin adults, by sexual orientation, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  33. Alcohol consumption and availability

  34. Alcohol consumption and availability Alcohol consumption by state, gallons per capita, 2009 Wisconsin: 3.0 gallons per capita Gallons per capita U.S. average: 2.3 gallons per capita Source: National Institute on Alcoholism and Alcohol Abuse, Alcohol Epidemiologic Data System.

  35. Alcohol consumption and availability Alcohol outlet density, people per license, Wisconsin, 2011-2012 Source: Wisconsin Department of Health Services, Division of Mental Health and Substance Abuse Services, Bureau of Prevention, Treatment and Recovery; and the University of Wisconsin Law School, Resource Center on Impaired Driving, Wisconsin Alcohol Policy Project.

  36. Adverse health outcomes and costs

  37. Adverse health outcomes Alcoholic liver disease deaths by race/ethnicity, age-adjusted rate per 100,000, Wisconsin, 2008-2010 Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. Note: WISH suppresses small numbers (when cell size is less than 5) to comply with Wisconsin vital records data privacy guidelines; this means a rate may not be presented for every population group.

  38. Adverse health outcomes Alcoholic liver disease deaths by county, age-adjusted rate per 100,000, Wisconsin, 2006-2010 Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. Note: WISH suppresses small numbers (when cell size is less than 5) to comply with Wisconsin vital records data privacy guidelines; this means a rate may not be presented for every population county.

  39. Adverse health outcomes Total motor vehicle crash fatalities and alcohol-related motor vehicle crash fatalities, Wisconsin, 2006-2011 Source: Wisconsin Department of Transportation, final year crash statistics (June 2012). Note: These figures represent final statistics for crashes that occurred on public roads in Wisconsin.

  40. Adverse health outcomes Alcohol- and drug-related hospitalizations, rate per 100,000, Wisconsin 2002-2010 Source: Wisconsin Department of Health Services: Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012.

  41. Adverse health outcomes Alcohol-related hospitalizations by county, rate per 100,000,Wisconsin, 2009-2010 Source: Wisconsin Department of Health Services: Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012.

  42. Adverse health outcomes Opiate-related deaths, rate per 100,000, Wisconsin, 2000-2011 Source: Wisconsin Department of Health Services, Office of Health Informatics, Wisconsin death certificates. Note: Includes all deaths to Wisconsin residents or occurring in Wisconsin.

  43. Adverse health outcomes Reported hepatitis C virus infections among people ages 15-29, rate per 100,000, Wisconsin, 2003-2012 Source: Wisconsin Department of Health Services, Wisconsin Electronic Disease Surveillance System. Note: Reflects cases reported as of September 2013.

  44. Consequences of substance abuse Estimated annual economic costs of excessive alcohol use in Wisconsin, 2011 Total annual cost: $6.8 billion Source: University of Wisconsin Population Health Institute: The Burden of Excessive Alcohol Use in Wisconsin, March 2013.

  45. References References • University of Wisconsin Population Health Institute. County Health Rankings 2013. http://www.countyhealthrankings.org/our-approach • Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf • LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf • Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/ • Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf • National Institute on Drug Abuse. Drug Facts: Alcohol. http://www.drugabuse.gov/drugs-abuse/alcohol • National Institute on Drug Abuse. Drug Facts: Marijuana. http://www.drugabuse.gov/publications/drugfacts/marijuana • National Institute on Drug Abuse. Drug Facts: Cocaine. http://www.drugabuse.gov/publications/drugfacts/cocaine

  46. References • National Institute on Drug Abuse. Drug Facts: Inhalants. http://www.drugabuse.gov/publications/drugfacts/inhalants • National Institute on Drug Abuse. Drug Facts: Heroin. http://www.drugabuse.gov/publications/drugfacts/heroin • CDC. Fact sheets - Underage drinking. http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm • National Institute on Drug Abuse. Marijuana’s Lasting Effects on the Brain. http://www.drugabuse.gov/about-nida/directors-page/messages-director/2013/01/marijuanas-lasting-effects-brain • CDC. Alcohol Use and Health. http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm • CDC. BRFS Prevalence and Trends Data. http://apps.nccd.cdc.gov/brfss/ • National Institute on Alcoholism and Alcohol Abuse. Surveillance Report #92, Apparent per Capita Alcohol Consumption: National, State, and Regional Trends. http://pubs.niaaa.nih.gov/publications/Surveillance92/CONS09.htm#top • CDC. Preventing Excessive Alcohol Consumption: Regulation of Alcohol Outlet Density. http://www.thecommunityguide.org/alcohol/outletdensity.html • Wisconsin Department of Health Services (DHS). Alcohol License Overview for Wisconsin, 2012. http://www.dhs.wisconsin.gov/substabuse/docs/AlcDensity/AlcoholOutletReport-Wisconsin.pdf

  47. References • National Institutes of Medicine, Medline Plus. Alcoholic Liver Disease. http://www.nlm.nih.gov/medlineplus/ency/article/000281.htm • CDC. CDC WONDER. http://wonder.cdc.gov/ • National Highway Traffic Safety Administration. An Analysis of the Significant Decline in Motor Vehicle Traffic Fatalities in 2008.http://www-nrd.nhtsa.dot.gov/Pubs/811346.pdf • Alcohol-Related Disease Impact (ARDI). http://apps.nccd.cdc.gov/ARDI/HomePage.aspx • DHS. Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012. http://www.dhs.wisconsin.gov/publications/P4/P45718-12.pdf • Wisconsin State Council on Alcohol and Other Drug Abuse: 911 Good Samaritan Recommendations: Analysis and Recommendations for Reducing Drug-related Overdoses in Wisconsin, 2013. http://www.scaoda.state.wi.us/docs/911GSL/GoodSamFINAL081213.pdf • Page, K. et al. Injection Drug Use and Hepatitis C Virus Infection in Young Adult Injectors: Using Evidence to Inform Comprehensive Prevention, Clinical Infectious Diseases, 2013:57 (Suppl 2). • University of Wisconsin Population Health Institute. The Burden of Excessive Alcohol Use in Wisconsin, March 2013. http://uwphi.pophealth.wisc.edu/publications/other/burden-of-excessive-alcohol-use-in-wi.pdf

  48. Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012: http://www.dhs.wisconsin.gov/publications/P4/P45718-12.pdf Alcohol License Overview for Wisconsin, 2012: http://www.dhs.wisconsin.gov/substabuse/docs/AlcDensity/AlcoholOutletReport-Wisconsin.pdf Wisconsin State Council On Alcohol and other Drug Abuse: http://www.scaoda.state.wi.us/ University of Wisconsin Population Health Institute: The Burden of Excessive Alcohol Use in Wisconsin, March 2013. http://uwphi.pophealth.wisc.edu/publications/other/burden-of-excessive-alcohol-use-in-wi.pdf Links to additional reports and resources

  49. Contact Mike Quirke Wisconsin Division of Mental Health and Substance Abuse Services Wisconsin Department of Health Services Email: Michael.Quirke@dhs.wisconsin.gov

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