Changing Social Norms on Risky Drinking

Oct 31, 2012, 12:47 PM

In observance of the twentieth anniversary of the Centers for Disease Control and Prevention’s Injury Prevention Center, yesterday’s sessions at the American Public Health Association meeting included a panel discussion on injury and violence prevention. The issue is critical, say experts, because despite ongoing efforts to prevent and reduce injuries in the U.S., they remain they remain the leading cause of death for children and adults between the ages of 1 and 44 years.

Yesterday’s panel, convened around the Injury Center’s theme for the year, "Celebrating the Past and Protecting the Future,” and included experts discussing the need to create new policies to reduce injuries, youth concussions and risky drinking among young adults.

NewPublicHealth spoke with Stephen W. Hargarten, MD, MPH, Professor and Chair of the Department of Emergency Medicine and director of the Injury Research Center at the Medical College of Wisconsin, who discussed risky drinking during yesterday’s discussion.

NewPublicHealth: You head a youth alcohol risk reduction project which you spoke about during an APHA panel yesterday. Tell us about its scope.

Dr. Hargarten: Our project in La Crosse County addresses risky alcohol use and abuse in young adults and those under age 20. We started the project in 2007 addressing the challenge of alcohol-related injuries and death among youth and precipitated by the death of a student who was severely intoxicated and who drowned in the Mississippi River. Our goal is to change the social norms of La Crosse County, which requires that we have community involvement. We have collaborations with the universities, the hospitals, with the public health community in the county, and we are changing the social norms by looking at risk factors among youth, at factors that make this a hostile environment for youth to be able to make good decisions when it comes to alcohol.

NPH: What are the specific actions you’ve taken?

Dr. Hargarten: We are looking at helping young adults make better choices about what they do and don’t do but more importantly I think it is an environmental intervention.  The environment for their deciding to drink alcohol is an important consideration for us to make when we are making the changes necessary. The ways that we are doing that include server training, making sure that colleges are creating a positive environment for the students to make good choices about what they do on weekends, as well as during the week. 

NPH: What information do you have so far on how well it’s working?

Dr. Hargarten: Our preliminary data suggests that we have fewer hospitalizations that are alcohol related for our youth, fewer emergency department visits and while we had seven alcohol-related drownings  in our community between 1999 and 2007, we have had only one such drowning since then. So we are hoping that we are making an impact in our community.

NPH: Is this replicable in other communities?

Dr. Hargarten: Yes, I think that the whole issue of the way we have done this has really presented at-risk youth and abuse as a public health issue. It affects youth, it affects families, it affects the communities and it is important that it is framed that way.  And we have partners who are tavern owners, we have partners who are community leaders, we have partners in academics and those partnerships are critical in order to change social norms.

NPH: And, given the preliminary success that you are showing, do you think this can translate into public health interventions for other risky behaviors by young adults?  

Dr. Hargarten I absolutely do, because we see we are beginning to impact the issue. We are seeing fewer motor vehicle crash deaths that are alcohol related in our community. So, yes, I think it impacts the health of the community in broader ways than we initially had anticipated.

This commentary originally appeared on the RWJF New Public Health blog.