Janet Collins, PhD Associate Director for Program

Centers for Disease Control and Prevention

Alcohol Policy 15 Plenary LuncheonDecember 6, 2010

Office of the Director

Office of the Associate Director for Program

Translating Research into Practice: Supporting National, State, and Local

Efforts to Reduce Excessive Alcohol Use

Overview of Today’s Presentation

Public Health Surveillance on Excessive

Drinking.

Synthesizing and Disseminating Information on Evidence-Based Prevention Strategies.

Building the Science Base for Preventing Excessive Alcohol Use in States.

New National Initiatives Supporting the Prevention of Excessive Alcohol Use.

Binge & Underage Drinking

Motor Vehicle Crashes

Interpersonal Violence

HIV, STDs

Unintended Pregnancy

Alcohol Dependence

Risk Factor Potential Condition

Fetal Alcohol Spectrum Disorder

Region of the Americas: 10 Leading Risk Factors for

Disease

Murray, PLOS Medicine, 2006

0% 2% 4% 6% 8% 10% 12% 14% 16%

Tobacco

Alcohol

High BMI

High blood pressure

High cholesterol

Low fruit and vegetable intake

Physical inactivity

Illicit drugs

Unsafe sex

Iron deficiency

% total disease burden

Male

Female

Public Health Impact of Excessive Drinking in the

U.S. 79,000 deaths and 2.3 million Years of

Potential Life Lost (YPLL) in the United States each year.

Over half of these deaths and two-thirds of the YPLL are due to binge drinking (≥4 drinks per occasion for women; ≥5 drinks per occasion for men).

Binge drinking is the most common pattern of excessive drinking in the U.S.; over 90% of excessive drinkers binge drink.

Most excessive drinkers are not alcohol dependent.

Binge Drinking Is Common Across the Lifespan

BRFSS, 2009

Binge Drinking Increases with Household Income

12.1

14.616.8

19.3

0

5

10

15

20

25

<$25,000 $25,000-<$50,000 $50,000-$<$75,000 ≥$75,000

Per

cen

t

BRFSS, 2009

Adult and Underage Drinking

Strong tie between adult drinking and youth drinking.

Youth tend to model their behavior after adults.

Adults are often the source of the alcohol consumed by youth.

Many alcohol control policies affect youth and adults.

Guide to Community Preventive Services

Systematic Reviews of Population-Based Interventions across many topic areas

Evaluating Interventions to Prevent and Control Excessive Alcohol Consumption and Related Harms

Recommendations on Intervention Effectiveness by Task Force for Community Preventive Services

For more information, visit: www.thecommunityguide.org/alcohol

Priority Alcohol Interventions for Systematic

Review

•Increasing

alcohol

taxes.

•Regulation of

alcohol

outlet

density.

•Dram shop

liability.

•Maintaining

limits on

days of sale.

•Maintaining

limits on

hours of sale.

•Enhanced

enforcement

of laws

prohibiting

alcohol sales

to minors.

Recommended:

•Alternative strategies for implementing screening and counseling for alcohol misuse.

Under Review:

• Increasing Alcohol Excise Taxes

• Regulating Alcohol Outlet Density

• Dram Shop Liability

Developing action guides to assist state and local

health agencies and coalitions in implementing

Community-guide recommended strategies for:

• Community Anti-Drug Coalitions of America

(CADCA)

• Alcohol Policy Consultants

• Public Health Experts

• CDC’s Alcohol Program

The Center on Alcohol Marketing and Youth

(CAMY) is developing the guides in

collaboration with:

Translation Tools

Building State Capacity in Alcohol Epidemiology

• Public health surveillance.

• Developing partnerships with other

programs and community groups.

• Planning and evaluating effective

population-based interventions.

Funding Alcohol Epidemiologists in New

Mexico, Michigan, and Georgia who

focus on:

Affordable Care Act: Pillars of Prevention

Key preventive services now covered

without cost sharing

Prevention and Public Health Fund

Public health policies and programs

National Prevention Council/National

Prevention Strategy

Grows from $500m to $2b annually

2010 2011 2012 2013 2014 2015-19

$500m

$750m

$1b $1.25b

$1.5b $2b

Prevention and Public Health Fund Provides Sustainable

Funding

Established by the Affordable Care Act.

A unique opportunity to prioritize and align prevention activities.

Chaired by the Surgeon General.

Council members: 17 federal departments.

Advisory Group: 25 non-federal members.

Developing the National Prevention Strategy.

The National Prevention Council

Ground activities in evidence-based practices.

Set specific and measurable actions and timelines.

Align and focus federal prevention and health promotion activities.

Align with existing strategies and initiatives, including: Healthy People 2020. National Quality Strategy. First Lady’s “Let’s Move!” campaign. Surgeon General’s Vision for a Healthy and Fit Nation

2010. National HIV/AIDS Strategy.

http://www.healthcare.gov/nationalpreventioncouncil

National Prevention Strategy

Active Lifestyles

Eliminate Health Disparities

Counter Alcohol/ Substance Misuse

Healthy Eating

Healthy Physical and Social Environment

High Impact Quality Clinical Preventive Services

Injury-Free Living

Mental and Emotional Wellbeing

Strong Public Health Infrastructure

Tobacco-Free Living

Draft Strategic Directions

Community Transformation Grants

Authorized under the Affordable Care Act. Implementation, evaluation, and

dissemination of evidence-based policy, environmental, programmatic, and infrastructure changes to promote healthy living.

Outcomes include reductions in prevalence of chronic disease risk factors, including: Overweight/obesity Poor nutrition and physical inactivity Tobacco use Excessive alcohol use Other factors

Strategies should be prioritized to reduce health disparities.

DHHS Behavioral Health Coordinating Committee

(BHCC) Chaired by Dr. Howard Koh, Assistant

Secretary for Health, and Pam Hyde, SAMHSA Administrator.

Coordinates behavioral health activities across the Department.

CDC, NIAAA, and SAMHSA collaborate on an Alcohol Policy/Underage Drinking Subcommittee.

Subcommittee prepared a vision document on the prevention of excessive drinking among adults and underage drinking that emphasizes the implementation of Community Guide recommendations.

Conclusion Excessive alcohol use, including underage

and binge drinking, continues to be a major public health problem in the U.S.

Effective alcohol control policies are available, but are underused.

New national prevention initiatives offer an excellent opportunity to help bridge this implementation gap, and thereby reduce the many health and social costs of excessive drinking.

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Thank You.

Office of the Director

Office of the Associate Director for Program