risky drinking behavior – alcohol use and injury in la crosse county
DESCRIPTION
Risky Drinking Behavior – Alcohol use and Injury in La Crosse County. Stephen Hargarten, MD, MPH Injury Research Center, Medical College of Wisconsin Brenda Rooney, PhD, MPH Gundersen Lutheran Medical Center Keri Briel Frisch, MS Injury Research Center, Medical College of Wisconsin. - PowerPoint PPT PresentationTRANSCRIPT
Risky Drinking Behavior – Alcohol use and Injury in La Crosse CountyStephen Hargarten, MD, MPHInjury Research Center, Medical College of Wisconsin
Brenda Rooney, PhD, MPHGundersen Lutheran Medical Center
Keri Briel Frisch, MSInjury Research Center, Medical College of Wisconsin
Public Health Approach
Source: Suicide Prevention Resource Center
Translated into a Program Planning Model
Where are we now?
- Data - Assessment - Problem
Identification
How do we get there?
- Activities, interventions
- What does the evidence say?
How do we know it worked?What indicators will we
measure?What will we compare them
to?How will we measure them?What will we do with results?
Where do we want to be? Outcomes (short
and long term)
(Source: Barbara Hill, MSSW, Ann Christiansen, MPH, Clare Guse, MS, Peter Layde, MD,MSc as part of the Wisconsin Injury Prevention Coalition project.)
Define the problem with dataBurden of alcohol-related injury in La Crosse
County data from: WISH (Wisconsin Interactive Health
Statistics) Medical examiner Emergency department and inpatient data Wisconsin CODES (Crash Outcome and
Evaluation System) WVDRS (Wisconsin Violent Death Reporting
System) Police Departments Universities
AcknowledgementsThe partners would like to acknowledge the special efforts of the following individuals in
contributing to the development of this report:
Al Bliss, Health Educator, La Crosse County Health Department Mary Czinner, Program Coordinator, Injury Research Center at the Medical College of
Wisconsin Keri Briel Frisch, MS, Program Manger, Injury Research Center at the Medical College
of Wisconsin Clare Guse, MS, Senior Biostatistian, Injury Research Center at the Medical College of
Wisconsin Robert Hanrahan, medical student, Medical College of Wisconsin Stephen Hargarten, MD, MPH, Director, Injury Research Center at the Medical College
of Wisconsin Michelle Hirsch, Programmer, Gundersen Lutheran Brianna Kopp, MPH, Injury Prevention and Surveillance Coordinator, Wisconsin Injury
Prevention Program Brenda Rooney, PhD, MPH, Clinical Epidemiologist and Medical Director, Department
of Community and Preventive Care Services, Gundersen Lutheran Medical Center John Steers, Medical Examiner, La Crosse County Julie Berg, Programmer, Franciscan Skemp Police departments of City of La Crosse, City of Campbell, City of Holmen, City of
West Salem and the La Crosse County Sheriff’s Department Viterbo University, University of Wisconsin-La Crosse, Western Technical College
Preliminary results
Deaths due to injury 2002-2006
Deaths of La Crosse county residents aged 15-24; population size 22,056
Cause of Death Number of deaths
Rate (per 100,000)
YPLL (total years lost to age 75)
Unintentional Injuries
11 9.94 601
Suicide 10 9.03 554
Homicide 4 3.61 219
All cancer 4 3.61 228
Diabetes mellitus
2 1.81 110
Source: WISH, Wisconsin Interactive Health Statistics
Alcohol-related injury deaths 2003-2007Deaths in La Crosse county aged 15-24
Number of
deaths
Sex Cause of death Manner of death
Blood alcohol range
2003-2007
14 13 Male1
Female
6 Motor Veh. Crash4 drowning
1 fall1 pedestrian
2 suicide
9 Unintentional2 Intentional
2 Undetermined
.15-.32
Source: Office of the Medical Examiner
Hospital data Discharge data from Gundersen
Lutheran and Franciscan Skemp ECodes for emergency department
visits and inpatient stays “La Crosse” residents vs. “Other”
nonresidents treated in facilities 2004-2006 combined Comparison to state from Wisconsin
Inpatient Hospital Discharge Data
Alcohol-related injury emergency department visits 2004-2006: Homicide-Assault
11
19
12
19
5
9
0
5
10
15
20
La Crosse Non-resident State average
12-24 y25+
44/393
75/400
13/108
24/126
Alcohol-related injury inpatient stays 2004-2006: Homicide-Assault
4750
22
48
17
31
0
10
20
30
40
50
60
La Crosse Non-resident State average
12-24 y25+
9/19
17/34
4/18
22/46
Alcohol-related injury emergency department visits 2004-2006: Suicide-Self harm
5
18
7
0
7
18
0
5
10
15
20
La Crosse Non-resident State average
12-24 y25+
7/141
15/82
3/410/17
Alcohol-related injury inpatient stays 2004-2006: Suicide-Self harm
32
38
28
41
20
35
0
10
20
30
40
50
60
La Crosse Non-resident State average
12-24 y25+
50/156
149/388
53/192 153/373
Alcohol-related injury emergency department visits 2004-2006: Motor Vehicle Crash
6
4
5
4
3 3
0
2
4
6
8
10
La Crosse Non-resident State average
12-24 y25+
35/553
35/834
13/245
14/374
Alcohol-related injury inpatient stays 2004-2006: Motor Vehicle Crash
38
23
30
22
16 15
0
10
20
30
40
50
La Crosse Non-resident State average
12-24 y25+
24/64
36/154
42/142
68/313
Alcohol-related injury emergency department visits 2004-2006: Falls
5 5
7
4
2
3
0
2
4
6
8
10
La Crosse Non-resident State average
12-24 y25+
45/961
147/3240
30/436
45/1167
Alcohol-related injury inpatient stays 2004-2006: Falls
19
10 10
79
7
0
5
10
15
20
25
La Crosse Non-resident State average
12-24 y25+
12/64
122/1252
8/83
66/1014
Alcohol-related injury emergency department visits
2004-200612 to 24 25+ 12 to 24 25+
Total Intentional 10% 19% 11% 17% Homicide-Assault 11% 19% 12% 19% Suicide-Self Harm 5% 18% 7% 0%
Total Unintentional 3% 3% 4% 2% Fall 5% 5% 7% 4% MVC 6% 4% 5% 4% Other 2% 2% 2% 1%
La Crosse Resident Non-residents
La Crosse ED visits compared to state
2004-200612 to 24 25+ 12 to 24 25+
Total Intentional 10% 19% 6% 12% Homicide-Assault 11% 19% 5% 9% Suicide-Self Harm 5% 18% 7% 18%
Total Unintentional 3% 3% 1% 12% Fall 5% 5% 2% 3% MVC 6% 4% 3% 3%
La Crosse Resident Wisconsin
ED highlights 2004-2006 19,364 unintentional injury related ED
visits (6,321 visits for 12-24 year olds) 1,308 intentional injury related ED
visits (683 visits for 12-24 year olds) 595 alcohol-related unintentional injury
visits (198 visits for 12-24 year olds) 181 alcohol-related intentional injury
visits (67 visits for 12-24 year olds)
Alcohol-related injury inpatient stays
2004-200612 to 24 25+ 12 to 24 25+
Total Intentional 34% 39% 27% 42% Homicide-Assault 47% 50% 22% 48% Suicide-Self Harm 32% 38% 28% 41%
Total Unintentional 21% 12% 16% 10% Fall 19% 10% 10% 7% MVC 38% 23% 30% 22% Other 13% 12% 9% 10%
La Crosse Resident Non-residents
La Crosse inpatient stays compared to state
2004-200612 to 24 25+ 12 to 24 25+
Total Intentional 34% 39% 20% 35% Homicide-Assault 47% 50% 17% 31% Suicide-Self Harm 32% 38% 20% 35%
Total Unintentional 21% 12% 11% 9% Fall 19% 10% 9% 7% MVC 38% 23% 16% 15%
La Crosse Resident Wisconsin
Inpatient highlights 2004-2006 4,767 unintentional injury related
inpatient stays (698 visits for 12-24 year olds)
1,226 intentional injury related inpatient stays (385 visits for 12-24 year olds)
566 alcohol-related unintentional injury stays (122 visits for 12-24 year olds)
457 alcohol-related intentional injury stays (116 visits for 12-24 year olds)
Limitations of hospital data Relies upon E-codes system in
place at hospital Youth probably less likely coded
for alcohol use
Alcohol-related studies show
AlcoholIs Associated
with
Up to 70%Domestic Abuse 40-50%
Traffic Fatalities
Up to 80% Homicides
68%Manslaughters
69%Drownings
38%Child Abuse
Up to 60%Rapes
37-40%Assaults
20-36%Suicides
Source: Public Health Strategies to Reduce Alcohol-Related Illness, Injury and Death in Milwaukee County, Milwaukee Academy of Medicine, 1998
IOM Report on Underage Drinking In 1999, 40 percent of people under 21
who were victims of drownings, burns and falls tested positive for alcohol
In 2000, alcohol-related traffic fatalities constituted almost 37 percent of all fatal youth traffic fatalities
It is estimated that 50 percent of youth violent crime is alcohol-related
Using data to target interventions: MVC
Time of Crash When Alcohol is Indicated, 16-24 Year Olds, La Crosse County, 2002-2004
05
1015202530354045
Time
Num
ber
Burden on law enforcementAlcohol-related police calls 2006- August 2007
City of La Crosse 4,028Campbell* 67Holmen* 40West Salem* 65La Crosse County Sheriff* 317
*primarily liquor law violations, OWI, underage drinking
City of La Crosse Police DeptAge and sex of those involved in alcohol-
related callsAge Female Male Total 17-20 1,004 (40%) 1,529 (60%) 2,533 21-24 135 (23%) 458 (77%) 593 25-64 221 (25%) 674 (75%) 895 65-83 3 (20%) 12 (80%) 15 Total 1,363 (34%) 2,673 (66%) 4,036
Discussion Does this represent the problem? Other data sources to investigate? Evidence-based strategies to
address the problem
Burden of Alcohol-related Injury Report Completion in May 2008 Available in printed copies at final
coalition meeting June 2008 Available online through the La
Crosse Medical Health Science Consortium (LMHSC) or the Injury Research Center (IRC)