HEALTHY PEOPLE 2020

PRESENTATION
COMMUNITY HEALTH PART I- FALL 2016
SAREENA KHOSLA, BETH LUTHER, ELIZABETH WINELAND, SARAH
RAGAZA, MEREDITH LENOX, ASHLEIGH BRANNON, SELENA PENN,
RYAN MURPHY, ANNA MCLEAN, MIECHA GREEN
INTRO
The objectives of this presentation are to discuss and
identify the substance abuse issues and trends across
the globe, in the United States, in the state of Virginia,
and in the Hampton Roads area. This will be
completed through the focus on, and evaluation of,
the Healthy People 2020 objective Reducing the
Number of Deaths Attributed to Alcohol: Found of The
Drug & Substance Abuse Criteria.
HP 2020 OBJECTIVES

Reduce the number of deaths attributable to

alcohol
2001-2005 79,646 (baseline)
2006-2010 87,798
TARGET: 71,681 (based off 2001-2005 statistics)
10% improvement
GLOBAL STATUS OF THE ISSUE

According to the World Health Organization (WHO) there is a

direct link between economic wealth and the amount of
alcohol consumed (higher wealth = increased amount of
drinking and decreased amount of abstainers)
High-income countries also have the highest rate of binge
drinking
Defined as: 60 or more grams of pure alcohol or more than 6 drinks at
least monthly (12 ounces (355 milliliters) of beer, 5 ounces (148
milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof distilled
spirits)
GLOBAL STATUS OF THE ISSUE

Lower economic status populations are at the most risk for deaths attributable
to alcohol because they are less likely to be able to avoid consequences
Higher economic status populations have the luxury of drinking in safer
environments as well as checking themselves in to higher quality treatment
facilities with better health insurance
Approximately 3.3 million deaths, or 5.9% of all global deaths, are related to
alcohol worldwide
Alcohol leads to dependence and is related to more than 200 diseases
encompassing physical and mental conditions
UNITED STATES STATISTS
Alcohol-induced Death
In 2014, total of (ages)
30,722 people
died of alcohol- 1-4 = 1
induced causes 15-24 = 143
(dependent/non- 25-34 = 1,237
dependent 35-44 = 3,259
usage/accidental 45-54 = 8,880
poisoning) 55-64 = 10,760
65-74 = 4,656
75-84 = 1,434
85+ = 347
Age not stated =5
UNITED STATES
Age-adjusted death rate for alcohol-induced causes for the total population
increased 3.7% from 8.2 (2013) to 8.5(2014)
Males 2.8 times more than females
Compared to white population rates for the black population was 31.9% lower
Death rate increased for white males (3.8%) white females (8.9%), black females
(13.8%), Hispanics (7.2%), non-Hispanic white males (3.2%), non-Hispanic white female
(6.3%), and non-Hispanic black females (13.3%). Non-Hispanic black males stats did not
change significantly
Excessive alcohol consumption costs the U.S $223.5 billion in 2006 (= $1.90 per
drink)
due to binge drinking
Increase in cost results from loss in
Workplace productivity (75%)
Health care (11%)problems cause by drinking
Law enforcement/criminal justice (9%)due to alcohol consumption
Motor vehicle crashes (6%)
VIRGINIA STATISTS
Alcoholism remains a significant public health issue facing Virginia
residents.
When compared with other drugs, alcohol is responsible for more
drug treatment admissions in Virginia than any other drug by a
large margin.
According to Virginia Life Expectancy, alcohol abuse is ranked as
one of the top 50 causes of death.
In 2016 alone, the highest alcohol related deaths occur in ages 55-
64 with 77 deaths recorded.
According to the VLE, there has been 194 alcohol related deaths in
Virginia.
HEALTH STATUS OF HAMPTON ROADS

In 2010 for every 100,000 people in Hampton Roads, 39 have

died with an alcohol related death.
Based on that ratio in Norfolk alone, there were 78 alcohol
related deaths.
Since 2010, Norfolk had 20 related deaths in a population of
233,371.
Alcohol was the third leading cause of death, with opioids
ranked number one.
NATIONAL AND LOCAL TRENDS FOR A
DECADE
88,000 Americans die alcohol related deaths annually
Alcohol contributes to over 200 diseases and injury-related
conditions
5.1 percent of all injury and hospital treated harm was
caused to related to alcohol consumption
In the age range of 15-49, alcohol misuse is the first leading
cause of premature death or disability
NATIONAL AND LOCAL TRENDS FOR A
DECADE
More than one tenth of all children in America live with a
parent who has active health issues related to alcohol
While a 2013 census revealed that our locality of Virginia
reported half of its population as consumers of alcohol, a
2015 census showed that the entirety of the United States
was not far to catch up to the 50 percent population mark
In the category of beige drinking, Virginia reported an
approximate 16% of the population as positive for beige
drinking. Between 2006 and 2010, more than half of all
alcohol related deaths were due to binge drinking
 SUCCESSFUL US DRUG & ALCOHOL
PROGRAMS
D.A.R.E. CINCH AA meetings
Elementary, middle, Consortium for Free support
and high-school the Immunization Local churches
curriculum of Norfolks and
Self- awareness and Children community
management Institutes centers
Responsible decision assessment, Meetings are
making planning, and structured and
Understanding others action for at risk based around
Relationship and families mutual support
communication skills Addresses child
Handling health needs and
responsibilities and provides family
challenges support
SUCCESSFUL PROGRAMS
Hazelden Betty Ford (Nationwide)
Ranked one of the most successful and well-recognized
addiction recovery organizations in the nation.
Evidence based treatment in conjunction with a 12 step
program
Individual therapy
Educational lectures
Group therapy
Special-focus groups
Inpatient substance abuse treatment
Individualized drug and alcohol treatments
Integrated mental health care
Specialized needs of professionals
Outpatient Addiction Treatment
SUCCESSFUL PROGRAMS
Non-12 Step Program
Evidence based treatment in conjunction with holistic
practices.
Treats the whole patient
Does not believe that alcohol addiction is a disease
There is an underlying issue to the addiction
Focus on helping improve choices and educating
Patient does not move at the pace of the program, the
program moves at the pace of the patient
SUCCESSFUL PROGRAMS
Non-12 Step Program: Ripple
Recovery Ranch
Addiction treatment core
services
Cognitive behavior model
Individualized treatment plan
Dual diagnosis
Relapse prevention
12 month after care support
Integrated family therapy
Neuro feedback therapy
Alternative Addiction Treatment
Promoting lasting physical,
mental, emotional, and
spiritual balance
Life Skills Development
Yoga Classes
Mindfulness &
Mediation
Nutrition
Massage Therapy
EMDR
RECOMMENDATIONS FOR GAPS IN
SERVICE
Reasons for gap in U.S.
Addiction is not seen as an actual, chronic disease in society
Relapse is seen as a punishable offense instead of a medical issue
Addiction affects 1 in 10 Americans, yet there is such little funding support
Majority of programs are publicly funded
Many dont know and/or dont accept that they need treatment
Treatment gap
Between Americans who need addiction treatment and the capacity to deliver that
treatment
Other
Lack of health coverage, transportation, treatment programs
Negative opinion from community and jobs
The current gap is due to difficulty financing addiction programs, although
that funding could save money
The economic benefits of treatment outweigh the costs
PROGRAM IMPROVEMENTS

Access:
Improving Overall Access to Care
Only one in 10 Americans who suffer from substance
abuse disorders nationally get the treatment they need
If treatment is not readily accessible, potential patients
may be lost
Better prognosis with earlier initiation of treatment
 PROGRAM IMPROVEMENTS
Quality of care
Continuity of Care and Long Term
Focus
Better outcomes have been seen with
longer durations of treatment
Detoxification process is often a focus
of substance abuse treatment
Recovery and continued abstinence
from drug abuse is a long term
problem
Individualized Treatment
Treatment should be continually
assessed and adjust accordingly
Culture, age, gender, ethnicity
Medical, social, employment, legal, and
psychological problems should be
addressed in treatment
Multifaceted Approach
Address other contributing mental health
problems
drug abuse and addiction are mental
disorders
often co-occur with other mental
illnesses
patients presenting with one
condition should be assessed for the
other
Behavioral Therapy
Develop skills to resist substance
abuse
Problem-solving skills
Alternative hobbies or
constructive activities
Building relationships
PROGRAM IMPROVEMENTS

Funding
Public substance abuse programs are severely underfunded
Private programs are not affordable for most of these individuals
Lack of funding directly impedes accessibility, and ultimately quality,
of care
ADDITIONAL RESEARCH NEEDED

Drug addiction as disease rather than delinquency

Research demonstrating overall effectiveness of substance
abuse programs
Substance abuse programs decreasing economic burden
Disparities in demand for and access to treatment
How to best/most effectively fund programs
NURSES ROLE
Active considerations in the care for a patient with a traumatic
injury related to alcohol misuse would include:
Assess all persons seen for alcohol abuse and alcohol abuse
in the household-Family dynamics related to high prevalence
and the fact that more than 10% of children live with a parent
who misuses alcohol & alcohol is the most commonly abused
drug
Assessment of patients at high risk to substance abuse
Provide education
Providing resources in the community for support to
QUESTIONS?
REFERENCES
Alcohol Facts and Statistics | National Institute on Alcohol Abuse and Alcoholism
(NIAAA). (2016, January 1). Retrieved November 14, 2016, from
https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-
and-statistics
Data and Maps. (2016, September 06). Retrieved November 14, 2016, from
http://www.cdc.gov/alcohol/data-stats.htm
Keepin it REAL Elementary School Curriculum. (2016, September 12). Retrieved
November 17, 2016, from http://www.dare.org/keepin-it-real-elementary-school-
curriculum/
Butterfoss, F., Morrow, A., Rosenthal, J., Dini, E., Crews, R., Webster, J., & Louis, P.
(1998). CINCH: an urban coalition for empowerment and action. Health Education &
Behavior, 25(2), 212-225.
State-Specific Alcohol Consumption Rates for 2013. (2016, September 06). Retrieved
November 14, 2016, from http://www.cdc.gov/alcohol/data-stats.htm
REFERENCES
Office of Disease Prevention and Health Promotion. (2016). Healthy People 2020
Objectives. https://www.healthypeople.gov/node/5225/data_details.
World Health Organization (January, 2015). Media Centre. Retrieved November 16,
2016. http://www.who.int/mediacentre/factsheets/fs349/en/.
THANK YOU