American
Indians with alcohol problems have more medical conditions
Alcohol abuse and dependence are known to be major health
problems among American Indians, yet little research has examined
alcohol's detrimental effect on organ systems among these
populations. Looking at two American Indian tribes, a study in the
April issue of Alcoholism: Clinical & Experimental Research
has confirmed that a significant relationship exists between alcohol
disorders and medical conditions, specifically: sprains and strains,
hearing and vision problems, kidney and bladder problems, head
injuries, pneumonia/tuberculosis, dental problems, and liver
problems/pancreatitis.
"Among American Indians, five of the top 10 causes of death
are strongly associated with alcohol use: accidents,
alcoholism, suicides, homicides, and cirrhosis," said Jay
Shore, assistant professor of psychiatry at the University
of Colorado at Denver, the Health Sciences Center's American
Indian and Alaska Native Programs, and corresponding author
for the study. "These causes of death occur at rates at
least three to four times the national average."
Shore added that although previous studies conducted among
American Indians have described alcohol use as one of several risk
factors associated with specific health problems – such as
cardiovascular, respiratory, renal, neurological, or metabolic
conditions – none have focused on the association with formally
defined alcohol abuse or dependence.
"Furthermore," he said, "the majority of these studies drew
their sample from a patient population rather than a community
sample. Ours is the first study to directly examine the relationship
of alcohol abuse and dependence with medical conditions in a large
population-based American Indian sample."
Researchers analyzed data that had been previously collected
from members of two culturally distinct American Indian tribes – the
Southwest (n=1446) and the Northern Plains (n=1638) – living on or
near their reservations. (Tribal names are not disclosed in order to
protect community confidentiality.) Study authors used logistic
regression to examine associations between self-reported alcohol
abuse/dependence and 19 medical conditions.
"Medical conditions that had significant relationships with
alcohol abuse/dependence were sprains and strains, hearing and
vision problems, kidney and bladder problems, head injuries,
pneumonia/tuberculosis, dental problems, and liver problems/pancreatitis,"
said Shore. "The total count of medical conditions was also
significantly related to alcohol abuse/dependence, with a higher
count being associated with the outcome."
Shore said that future research needs to better quantify the
relationship of the degree of alcohol use with medical conditions,
use physician-diagnosed or more objective measures of medical
conditions, conduct prospective studies, and determine if and why
certain populations are at greater risk for alcohol-related medical
problems.