Public Health Project

There are countless public health issues plaguing the United States and other developed countries, but one that stands out as one of the major crises in the US is alcoholism. While ideally, its consumption would consist of adults drinking a glass of wine with dinner, it is known to all that this is sadly not the case. Both the intake and excessive intake, also known as binge drinking, of alcohol has become commonplace amongst all genders, ages and demographics, discriminating against no one. In order to understand the scope of this public health issue and subsequently, possible solutions it is necessary to know exactly what alcoholism is; a physical and emotional dependency on the intake of alcoholic beverages. According to the CDC, excessive alcohol use or binge drinking is defined as drinking 5 or more drinks for men and 4 or more drinks for women on a single occasion.[1] Additionally, it reports that six people die every single day due to alcohol poisoning and that among this category of deaths, 30% of them contain alcoholism as a factor.[2] While alcoholism can have detrimental effects on any individual of any age, a subset of this widespread public health issue is specifically underage binge drinking. While technically it is illegal for adolescents under 21, also known as minors, to buy or consume alcohol, underage binge drinking perseveres as a rising phenomenon. 

To fully present the problem of alcoholism, specifically in the underage population, associated factors along with its physical, mental effects and its motivations must be enumerated. Although underage drinking is prevalent and could be found amongst teenagers of all backgrounds, socioeconomic status and education are factors which heavily affect alcohol consumption. In addition to factors which influence its consumption, alcohol is linked to negative health outcomes and various diseases such as liver failure and cancer along with mental cognitive impairments with higher susceptibility amongst teenagers. Lastly, motivations driving adolescents to binge drink include social norms and influences. 

First, alcoholism is associated with low socioeconomic and education status. An environment can have a great effect on an individual’s decisions and perspectives, leading them to various behaviors and lifestyles. Studies show that individuals with a lower socioeconomic status are found to experience greater negative consequences from alcohol. Regarding youth specifically, studies have examined childhood socioeconomic status and subsequent alcohol use and found that children who come from families with a low socioeconomic status tend to have a poorer or lack of education which is associated with the development of alcohol use disorders.[3] Additionally, studies on dramatic changes in socioeconomic status such as the economic recession in the early 2000s has found that individuals who experience a drastic change in socioeconomic status such as losing a job or a home is associated with developing a dependency on alcohol and other negative-alcohol related effects. 

Next, alcoholism is associated with both negative physical and mental effects. An excessive intake of alcohol is associated with diseases such as liver failure, cancer and cardiovascular disease. Studies were done in general hospital settings to assess diseases which were alcohol-related in inpatients. The most frequently found diseases which had a definite relationship to alcohol use were delirium tremens, epilepsy, head injuries and cirrhosis of the liver.[4] In addition, alcoholism also leads to severe cognitive defects as well. It is well known that alcohol impairs judgement, normal perceptions, ability to speak and understand language, reaction time and decision-making mostly temporarily. However, the more severe the alcohol intake is, the more severe cognitive impairment. For example, Alcoholic Korsakoff’s syndrome is characterized as cognitive impairments in memory, specifically short term. Even if this syndrome isn’t present, it has been proved that alcoholics experience changes in brain structure and thus cognitive impairments, especially dangerous amongst teenagers who are likely to drive under the influence or involve themselves in regretful sexual behavior.[5] Compared to adults, the brains of younger individuals are still developing throughout adolescence both structurally and functionally. Due to the brain’s plasticity during this time, research shows that alcohol did not only have immediate effects such as loss of memory from hippocampal dysfunction but it has long term effects due to developmental interferences such as impaired motor coordination as adults.[6]

Lastly, motivations for underage binge drinking lie heavily in social facilitation, norms and personal benefit. Teenagers who are under the influence of alcohol find it easier to be outgoing and socialize confidently than when they are sober and more reserved. Additionally, since underage binge drinking has become commonplace, a norm amongst peers, it has become widely accepted to engage in such behavior and even encouraged. Teenagers view drinking as part of the normal journey to adulthood, something in which everyone engages in. The influence of peers could mean peer pressure, reported in the younger age groups, but can also refer to social encouragement and guidance. Personal benefit of alcohol consumption also served as a motivating factor as a combination of looking to escape reality and enjoying the buzz and excitement of a lack of control.[7]

While the CDC reports that binge drinking has declined in 2015, statistics still show that one in three high school students drank in the past 30 days and one in six students are binge drinkers. Additionally, 4,300 deaths among individuals aged 21 or younger from 2006 to 2010 were reported due to underage drinking.[8] With such staggering statistics, intervention and solution-making is imperative to save our youth. As the correlates of underage binge drinking are multiple and varied such as community, family, friend associations, socioeconomic status and level of education, a solution such as prevention programs would need to encompass the complexity of the issue, addressing all factors and operating at all levels.[9]

A two-fold youth campaign approach against underage drinking could be launched, aimed at spreading awareness of the risks of alcohol along with the provision of preventive programs and measures. Based on Monitoring the Future (MTF) Survey also known as the National High School Senior Survey on illicit drug use among American adolescents, majority of teenagers don’t know the risks of alcohol use which makes convincing them to refrain extremely difficult and unlikely.[10] Therefore social media campaigns, which could easily reach the youth, exposing the dangers of alcohol would address and counter the motivations presented for underage alcoholism. Due to other factors such as socioeconomic status, family and friends, preventive programs would be administered throughout middle and high school, following the children throughout adolescence. As research shows, underage drinking has become prevalent in many school ages and so only one preventive program provided throughout the course of middle and high school will not be sufficient. In addition to yearly preventive measures, parents should be invited to include them in this process and educate parents on how to guide their children. 

            Strengths of this proposal include credibility to mass media campaigns such as the antismoking campaign which greatly contributed to its decline in youth in the early 2000s. Based on the widespread use of technology and social media amongst teenagers and its influence on them, it’s likely that a mass media campaign against underage binge drinking would have a positive effect. Another strength regarding the annual preventive programs lies in its consistency and prevalence. Simply hearing the same message over again will have an effect along with the nature of already established programs which build interpersonal and social skills to help resist peer pressure and integrate the community at large such as including parents as mentioned above.[11] Possible weaknesses of this solution proposal include the lack of evidence which shows that the more aware youth are of the consequences of drinking, the more vigilant they’ll be in refraining. It could very well be that despite the awareness of its risks, the benefits and motivations of drinking will outweigh it. Additionally, a weakness in the preventive programs could lie in their costliness. Running annual programs in schools for every middle and high school aged student can be costly and found unworthy of funding if the programs results are not showing declines in underage drinking. Despite the weaknesses of this solution proposal, with the necessity of intervention along with the multi-pronged youth campaign approach, I’m confident this proposal would have some positive effect on reducing underage binge drinking.

Bibliography 

  1. CDC – Alcohol and Public Health Home Page – Alcohol. (2017, August 10). Retrieved from https://www.cdc.gov/alcohol/index.htm
  2. Alcoholism Statistics & Information on Group Demographics. (n.d.). Retrieved from https://www.alcohol.org/statistics-information/
  3. Collins, S. E. (2016). Associations Between Socioeconomic Factors and Alcohol Outcomes. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872618/
  4. Gerke, P., Hans-Jurgen, R., & Ulrich, J. (1997). Alcohol & Alcoholism. Alcohol-Related Diseases in General Hospital Patients, 32, 179–184. Retrieved from https://watermark.silverchair.com/32-2-179.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAm8wggJrBgkqhkiG9w0BBwagggJcMIICWAIBADCCAlEGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMLfjBKQyvKZfORVlZAgEQgIICIm9KFkDUXR7xrttOjRnFgq6bzebvG8eDdx7zEhwWSF1PggntSHFKuDUnrZJ2sgN9peMG9gKz3NSMpY2T9kHSVooO2i5X1izcpxx-CZKSDyw24QKWavs_91CtwB1hwVh4wfK93rtT7VhgKSfx1o95k2Q1cn0KoNTbMYk86P3JnDnXRWwaNzywp8cxImfSRm5wLSyi9gbaBCaHj4_3loe_5ZGx2dGTbIgVFMoZdKQZCLtzpgHoNlin7FuiqeaE_-W8FsLoLlB-3N1POVPx_QwIxd36h1rMKw9N05Ok1TtMZer2ComIWLw1anmk5LuTLTV69LSOguxOCJ77pcJlxi78GR5yH0V8ioP_iPy6StMY4rUId4RAJgT5v8JRP6QndR8mODMJ_a-4yE4BwA6sn2X_4VCIFrrXAxoGzob0hz7LZ5VCCGV8jBzq0Xa5iBPI68HEjRxw5m_qkhcI7b_cr5AN87QYQXuKpYz05O7rccK30M6AW6LC3fecxTZVU9B2knbF8SSxTM8jhpT1HMSJ8QtPStBJB2V4qLG6TseBevSv1Cbxh8TmmwhRNJyAdeaDigkXwyPylFvnX5A4Tzr6ShZjANYzcN1Nce4ZG6stDUQR9q-o5283C1teB6vtp3EY2bxixrX-hRJ-ZEwTEmsBIDNiMCXtV7MkfCor8iOHXdkRAXVWBZFWoF7HRoGXPIjLfvLlCvGX7SEMSIZEr0SZ5xEbu086yA
  5. Evert, D. L., & Oscar-Berman, M. (1995). Alcohol-Related Cognitive Impairments: An Overview of How Alcoholism May Affect the Workings of the Brain. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875727/
  6. NIAAA Publications. (n.d.). Retrieved from https://pubs.niaaa.nih.gov/publications/arh284/213-221.htm
  7. Coleman, L., & Cater, S. (n.d.). Drugs: education, prevention and policy. Underage ‘Binge’ Drinking: A Qualitative Study into Motivations and Outcomes, 12, 125–136. Retrieved from https://s3.amazonaws.com/academia.edu.documents/49666477/Underage_binge_drinking_A_qualitative_st20161017-6066-1ld7x2n.pdf?response-content-disposition=inline; filename=Underage_binge_drinking_A_qualitative_st.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A/20200122/us-east-1/s3/aws4_request&X-Amz-Date=20200122T215347Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=bb8d0313d507ee114eaed193467f5d21def432f9bb9d1711620649069c3cf172
  8. Current and Binge Drinking Among High School Students – United States, 1991–2015. (2017, August 1). Retrieved from https://www.cdc.gov/mmwr/volumes/66/wr/mm6618a4.htm
  9. Chung, T., Creswell, K. G., Bachrach, R., Clark, D. B., & Martin, C. S. (2018). Adolescent Binge Drinking. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104966/
  10. Bonnie, R. J. (1970, January 1). Youth-Oriented Interventions. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK37617/
  11. Stigler, M. H., Neusel, E., & Perry, C. L. (2011). School-based programs to prevent and reduce alcohol use among youth. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860568/

[1] https://www.cdc.gov/alcohol/index.htm

[2]  https://www.alcohol.org/statistics-information/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872618/

[4] https://watermark.silverchair.com/32-2-179.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf…

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875727/

[6] https://pubs.niaaa.nih.gov/publications/arh284/213-221.htm

[7] https://s3.amazonaws.com/academia.edu.documents/49666477/Underage_binge_drinking_A_qualitative

[8] https://www.cdc.gov/mmwr/volumes/66/wr/mm6618a4.htm

[9]  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104966/

[10] https://www.ncbi.nlm.nih.gov/books/NBK37617/

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860568/

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