Mark Pabst, MPH Division of Gastroenterology and Hepatology University of California, San Francisco
Dec 17, 2015
Who am I? A clinical researcher A behavioral epidemiologist
Why am I here? Nepotism To provide an introduction to some public
health approaches to problem drinking in colleges and universities
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals. “
Public health is concerned with threats to the overall health of a community based on population health analysis.
Death: 1,700 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries, including motor vehicle crashes (Hingson et al., 2005).
Injury: 599,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol (Hingson et al., 2005).
Assault: More than 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking (Hingson et al., 2005).
Unsafe Sex: 400,000 students between the ages of 18 and 24 had unprotected sex and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex (Hingson et al., 2002).
Suicide: Between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking (Presley et al., 1998).
Males Whites Members of fraternities and
sororities Athletes First-year students who have
engaged in binge drinking in high-school.
(Johnston et al., 2001b; Meilman et al., 1994, 1999; Presley et al., 1996a, 1996b; Wechsler et al., 1996, 1997a, 1998, 2000b).
Students at 2-year institutions Those who attend religious schools Students enrolled at commuter schools Students attending historically Black
colleges and universities.
(Meilman et al., 1995; Presley et al., 1996a, 1996b; Wechsler et al., 2000b).
Access to low-cost alcohol Attending a college with a high rate
of binge drinking Feeling a need to “fit in” A belief that most friends binge
drink
Identify problem behaviors Use available statistics to identify specific
behaviors that affect a population’s health The principal of “Harm Reduction”
Educate target audiences about how behaviors are harmful Develop materials aimed at those at-risk that
emphasize potential downsides of the behavior
Harm to health is often secondary
SNM uses commercial advertising techniques to correct misperceptions of social norms, thereby decreasing the perceived pressure to engage in a behavior
Instead of identifying problems, SNM messages contain statistics about the non-problem behavior of a majority of people in order to encourage that behavior in others.
Uses nonjudgmental messages about the behaviors of a majority of a well-identified target audience.
Source: http://www.higheredcenter.org/environmental-management/change/normative/social-norms
Must collect or obtain data showing students overestimate their peers’ binge drinking. If there is no misperception of the norm, then
strategy likely to be unsuccessful. Strategy has been employed widely “Participants should be aware that this
case study is not a request to develop a social norms campaign.”
“Rather than blame students for their behavior or try to persuade them to stop drinking, participants in A Matter of Degree are identifying the environmental factors such as alcohol advertising and marketing, institutional policies and practices, local ordinances—even social and cultural beliefs and behaviors—that converge to encourage alcohol abuse, and work together to create positive changes. “
Source: www.alcoholpolicymd.com/programs/amod.htm
AMOD targets the easy accessibility, low price, and heavy marketing of alcohol in college communities
Creates mandatory responsible beverage-service training
Results in increased monitoring of outlets selling alcohol near campus
Encourages adoption of strict parental notification policies
Implements more stringent accreditation requirements for fraternities/sororities
Sponsors alcohol-free activities Increases substance free space in dorms
Source: (Weitzman et al., 2003c).
What is Social Capital? “The collective value of all social networks and the
inclinations that arise from these networks to do things for each other” -Robert Putnam
The social resources, trust, reciprocity, and mutual aid in a social group.
How is it Measured? Networks Trust Collective action Social inclusion Information and communication
“Social capital may play an important role in preventing binge drinking in the college setting” (Weitzman and Kawachi , 2005)
Campuses with higher-than-average levels of social capital had a 26% lower individual risk for binge drinking High social capital at HBC cause of low rates
of binge drinking? Anti-drinking programs aimed at
increasing social capital have yet to be comprehensively evaluated