Healthiest Wisconsin 2020 Baseline and Health Disparities Report

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Healthiest Wisconsin 2020 Baseline and Health Disparities Report




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Presentations text content in Healthiest Wisconsin 2020 Baseline and Health Disparities Report

Slide1

Healthiest Wisconsin 2020 Baseline and Health Disparities Report

Alcohol and Other Drug Use

Slide2

Background

Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report Healthiest Wisconsin 2020 objectives and indicatorsRationaleKey pointsDataRisk behaviors among youthRisk behaviors among adultsAlcohol consumption and availabilityAdverse health outcomesConsequences of substance abuseReferencesLinks to additional reports and resourcesContacts

Chapter Outline

2

Chapter outline

Slide3

Report Overview

This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf

The report is designed to address the Health Focus Areas in HW2020

. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.

Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.

Technical notes are available at:

http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

Report overview

3

Slide4

Report

Format

Full Report

Format: PDF

Intended use: reference document

Chapters

Format: Annotated PowerPoint slide set

Intended uses: presentations toDecision-makers

Service providers

Community leaders

The public

Sample annotated slide

Report overview

4

Slide5

Report Outline

Executive Summary

Section

1:

Introduction

Section 2: Demographic

overview

Section 3: Health focus areas

Section 4: Infrastructure focus areas

Section 5: Data summaries by population

Section 6: Technical notes

Report overview

5

Slide6

Report Outline: Detail

Section 3: Health focus areas

Alcohol and other drug use

Chronic disease prevention and management

Communicable diseases

Environmental and occupational health

Healthy growth and development

Injury and violence

Mental health

Nutrition and healthy foods

Oral health

Physical

activity

Reproductive and sexual health

Tobacco use and exposure

Section 4: Infrastructure

focus areas

Access to health care

Report overview

6

Slide7

Report Outline: Detail

Section 5: Data summaries by population

Racial/ethnic

minority populations

American Indians

Asians

Blacks

Hispanics

 

People of lower socioeconomic status

 

People with

disabilities

 

Lesbian

, gay, bisexual,

and transgender

populations

 

Geography

Report overview

7

Slide8

Data notes

Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf The 95% confidence intervals

are denoted by error bars. Where

confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. La

rger confidence

intervals may indicate less reliable estimates that should be

interpreted with caution. Population estimates that are considered unreliable are excluded.Misclassification of racial/ethnic groups may affect the accuracy of rates.Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

Report overview

8

Slide9

Factors that influence health

Social determinants of health

Source:

University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

Report overview

9

Slide10

Healthiest Wisconsin 2020

objectives and indicatorsObjective 1 By 2020, reduce unhealthy and risky alcohol and other drug use by changing attitudes, knowledge, and policies, and by supporting services for prevention, screening, intervention, treatment and recovery.Objective 1 Indicators

State rates and rankings of selected youth and adult behaviors related to

unhealthy and risky alcohol and other drug use.

Source:

Wisconsin Department of Health Services

, Healthiest Wisconsin 2020,

Alcohol and Other Drug Use Focus Area

Profile.

10

HW2020

objectives

Slide11

Healthiest Wisconsin 2020

objectives and indicatorsObjective 2By 2020, assure access to culturally appropriate and comprehensive prevention, intervention, treatment, recovery support and ancillary services for underserved and socially disadvantaged populations who are at higher risk for unhealthy and risky alcohol and other drug use.

Objective 2 Indicators

Periodic inventory of the proportion of counties with local capacity to provide alcohol and other drug abuse prevention, intervention (including criminal justice diversion), treatment, recovery support and ancillary services across all revenue streams

for underserved

and socially disadvantaged populations

.Periodic inventory of the proportion of counties with services specific to racial and ethnic minorities; women; and lesbian, gay, bisexual and transgender populations.

Source:

Wisconsin Department of Health Services

, Healthiest Wisconsin 2020,

Alcohol and Other Drug Use Focus Area

Profile.11HW2020 objectives

Slide12

Healthiest Wisconsin 2020

objectives and indicatorsObjective 3By 2020, reduce the disparities in unhealthy and risky alcohol and other drug use among populations of differing races, ethnicities, sexual identities and orientations, gender identities, and educational or economic status.Objective 3 Indicators

Unhealthy and risky alcohol and other drug use by race, ethnicity, sexual identity

and orientation, gender identity, and educational or economic status.

Source:

Wisconsin Department of Health Services

, Healthiest Wisconsin 2020,

Alcohol and Other Drug Use Focus Area Profile.

12

HW2020

objectives

Slide13

Rationale

Alcohol and other drug abuse is any use of one or more mood-altering, habit-forming substances that results in negative consequences.Adverse health outcomes associated with excessive alcohol consumption include cirrhosis of the liver and other chronic diseases, alcohol dependence, and fetal alcohol spectrum disorder.

Individuals who abuse alcohol and other drugs are more likely to engage in risky behaviors

that may result in motor vehicle accidents and fatalities, employment problems, relationship problems, unplanned pregnancies and sexually transmitted diseases, birth abnormalities, child abuse, and crime.

The abuse of illicit drugs, like heroin, cocaine, marijuana, and including the non-medical use of mood-altering prescribed drugs, inflicts harm upon individuals, families, and communities.

Source:

Wisconsin Department of Health Services

, Healthiest Wisconsin 2020,

Alcohol and Other Drug Use Focus

Area

Profile.

13Rationale

Slide14

Key points

Adult risk behaviorsIn 2011, Wisconsin ranked first in the nation for both heavy drinking and binge drinking among adults.Significant disparities exist in the prevalence of adult risk behaviors. For example:Binge drinking rates were

significantly higher among males and younger age groups.

Binge drinking rates were significantly lower for Black adults compared to Whites; people in the lowest income and education levels; and in Milwaukee County compared to smaller metropolitan and non-metropolitan counties.

14

Key points

Slide15

Key findings

Adult health outcomes and consequences of substance abuse In 2011, the estimated annual costs associated with excessive alcohol use in Wisconsin totaled $6.8 billion.From 2002 to 2010, both alcohol- and drug-related hospitalization rates increased in Wisconsin.Significant disparities exist in the prevalence of adverse consequences associated with substance abuse. For example:

The death rate from

alcoholic liver disease among American Indians in Wisconsin was much greater than the rate for Whites, similar to national differences.

Drug-related

deaths

involving heroin or other opioids increased nearly four-fold during 2000-2011

15

Key points

Slide16

Key findings: Youth risk behaviors

YouthIn Wisconsin, more than one-third of high school students drank alcohol within the past 30 days. Significant disparities exist in the prevalence of youth risk behaviors. For example:White students were significantly more likely to binge drink than were Black, Hispanic, and Asian students.Current marijuana use among Black students was significantly higher than among

White, and Asian students.

Early initiation of alcohol use (before age 13) was most prevalent among Latino and Black students; early initiation of marijuana use was most prevalent among Black and American Indian students.

Sexual minority students had much higher rates of marijuana, cocaine, inhalants, and heroin use compared to sexual majority students

.

Sexual minority students had higher rates of early initiation of both alcohol and marijuana use than sexual majority students.16Key points

Slide17

Risk behaviors

among youth17

Slide18

Rates of

current drinking, binge drinking, and marijuana use among Wisconsin high school students, by race/ethnicity, 2007-2011

Risk behaviors among youth

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Note

: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group

.

18

Slide19

Rates of current

drinking, binge drinking, and marijuana use among Wisconsin high school students, by sexual minority status, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Risk behaviors among youth

19

Slide20

Rates of lifetime

use of cocaine, inhalants, and heroin among Wisconsin high school students, by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Note

: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Risk behaviors among youth

20

Slide21

Lifetime use of cocaine, inhalants, and heroin among Wisconsin high school students, by sexual minority status, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Risk behaviors among youth

21

Slide22

Rates of early initiation of alcohol and marijuana use among

Wisconsin high school students, by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Risk behaviors among youth

22

Slide23

Early initiation of alcohol and marijuana use among

Wisconsin high school students, by sexual minority status, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Risk behaviors among youth

23

Slide24

Risk behaviors among adults

24

Slide25

Rates of binge

drinking and heavy drinking among Wisconsin adults, by sex, 2009-2011

Source

: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

Risk behaviors among adults

25

Slide26

Rates of binge

drinking and heavy drinking among Wisconsin adults, by age group, 2009-2011

Source

: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

Risk behaviors among adults

26

Slide27

Age-adjusted rates of binge

drinking and heavy drinking among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011

landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Risk behaviors among adults

27

Slide28

Age-adjusted rates of binge

drinking and heavy drinking among Wisconsin adults, by household income level, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS

); 2008-2011 landline-only dataset.

Risk behaviors among adults

28

Slide29

Age-adjusted rates of binge

drinking and heavy drinking among Wisconsin adults, by education level, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS

); 2008-2011 landline-only dataset.

Risk behaviors among adults

29

Slide30

Age-adjusted rates of binge

drinking and heavy drinking among Wisconsin adults, by level of urbanization, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS

); 2008-2011 landline-only dataset.

Risk behaviors among adults

30

Slide31

Rates of binge

drinking and heavy drinking among Wisconsin adults ages 18-64, by disability status, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS

); 2008-2011 landline-only dataset.

Risk behaviors among adults

31

Slide32

Binge

drinking among Wisconsin adults, by sexual orientation, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS

); 2008-2011 landline-only dataset.

32

Risk behaviors among adults

Slide33

Alcohol consumption and availability

33

Slide34

A

lcohol consumption by state, gallons per capita, 2009

Source: National Institute on Alcoholism and Alcohol

Abuse, Alcohol Epidemiologic Data System.

Gallons per capita

Alcohol consumption and availability

U.S. average:

2.3 gallons per capita

Wisconsin:

3.0 gallons per capita

34

Slide35

Alcohol outlet density, people per license, Wisconsin, 2011-2012

Source:

Wisconsin Department of Health Services, Division of Mental Health and Substance Abuse Services, Bureau of Prevention,

Treatment and Recovery; and the University of Wisconsin Law School, Resource Center on Impaired Driving, Wisconsin Alcohol Policy Project.

Alcohol consumption and availability

35

Slide36

Adverse health outcomes and costs

36

Slide37

Alcoholic liver disease deaths by race/ethnicity

, age-adjusted rate per 100,000, Wisconsin, 2008-2010

Source

: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.Note: WISH suppresses small numbers (when cell size is less than 5) to comply with Wisconsin vital records data privacy guidelines;

this means

a rate may

not be presented for every population group.

Adverse health outcomes

37

Slide38

Alcoholic liver disease deaths by county, age-adjusted

rate per 100,000, Wisconsin, 2006-2010

Source

: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. Note: WISH suppresses small numbers (when cell size is less than 5) to comply with Wisconsin vital records data privacy guidelines; this means a rate may not be presented for every population county.

Adverse health outcomes

38

Slide39

Total motor vehicle crash fatalities and

alcohol-related motor vehicle crash fatalities, Wisconsin, 2006-2011

Source: Wisconsin Department

of Transportation, final year crash statistics (June 2012).Note: These figures represent final statistics for crashes that occurred on public roads in Wisconsin.

Adverse health outcomes

39

Slide40

Alcohol- and drug-related hospitalizations, rate per 100,000, Wisconsin 2002-2010

Source

: Wisconsin Department of Health Services: Wisconsin Epidemiological Profile on Alcohol and Other Drug Use,

2012.

Adverse health outcomes

40

Slide41

Alcohol-related

hospitalizations by county, rate per 100,000,Wisconsin, 2009-2010

Source

: Wisconsin Department of Health Services: Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012.

Adverse health outcomes

41

Slide42

Source

:

Wisconsin Department of Health Services, Office of Health Informatics, Wisconsin death certificates. Note: Includes all deaths to Wisconsin residents or occurring in Wisconsin.

Opiate-related deaths, rate per 100,000, Wisconsin, 2000-2011

Adverse health outcomes

42

Slide43

Source

:

Wisconsin Department of Health Services, Wisconsin Electronic Disease Surveillance System.

Note: Reflects cases reported as of September 2013.

Reported hepatitis C virus infections among people ages 15-29, rate per 100,000, Wisconsin, 2003-2012

Adverse health outcomes

43

Slide44

Estimated annual

economic costs of excessive alcohol use in Wisconsin, 2011

Source

: University of Wisconsin Population Health

Institute: The

Burden of Excessive Alcohol Use in

Wisconsin, March 2013.Total annual cost: $6.8 billion

Consequences of substance abuse

44

Slide45

R

eferencesUniversity of Wisconsin Population Health Institute. County Health Rankings 2013. http://www.countyhealthrankings.org/our-approach Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies.

http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf

Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/

Wisconsin Department of Health Services (DHS).

Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdfNational Institute on Drug Abuse. Drug Facts: Alcohol. http://www.drugabuse.gov/drugs-abuse/alcoholNational Institute on Drug

Abuse. Drug Facts: Marijuana. http://www.drugabuse.gov/publications/drugfacts/marijuana

National Institute on Drug

Abuse.

Drug Facts: Cocaine. http://www.drugabuse.gov/publications/drugfacts/cocaine

45

References

Slide46

National Institute on Drug Abuse. Drug Facts: Inhalants.

http://www.drugabuse.gov/publications/drugfacts/inhalantsNational Institute on Drug Abuse. Drug Facts: Heroin. http://www.drugabuse.gov/publications/drugfacts/heroinCDC. Fact sheets - Underage drinking. http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htmNational Institute on Drug Abuse. Marijuana’s Lasting Effects on the Brain. http://www.drugabuse.gov/about-nida/directors-page/messages-director/2013/01/marijuanas-lasting-effects-brainCDC. Alcohol Use and Health. http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htmCDC. BRFS Prevalence and Trends Data. http://apps.nccd.cdc.gov/brfss/National Institute on Alcoholism and Alcohol Abuse. Surveillance Report #92, Apparent per Capita Alcohol Consumption: National, State, and Regional Trends. http://pubs.niaaa.nih.gov/publications/Surveillance92/CONS09.htm#top

CDC. Preventing Excessive Alcohol Consumption: Regulation of Alcohol Outlet Density.

http://www.thecommunityguide.org/alcohol/outletdensity.htmlWisconsin Department of Health

Services (DHS).

Alcohol License Overview for

Wisconsin, 2012. http://www.dhs.wisconsin.gov/substabuse/docs/AlcDensity/AlcoholOutletReport-Wisconsin.pdf46

References

Slide47

National

Institutes of Medicine, Medline Plus. Alcoholic Liver Disease. http://www.nlm.nih.gov/medlineplus/ency/article/000281.htmCDC. CDC WONDER. http://wonder.cdc.gov/National Highway Traffic Safety Administration. An Analysis of the Significant Decline in Motor Vehicle Traffic Fatalities in 2008. http://www-nrd.nhtsa.dot.gov/Pubs/811346.pdf

Alcohol-Related Disease Impact (ARDI). http://apps.nccd.cdc.gov/ARDI/HomePage.aspx

DHS. Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012.

http://

www.dhs.wisconsin.gov/publications/P4/P45718-12.pdf

Wisconsin State Council on Alcohol and Other Drug Abuse: 911 Good Samaritan Recommendations: Analysis and Recommendations for Reducing Drug-related Overdoses in Wisconsin, 2013. http://www.scaoda.state.wi.us/docs/911GSL/GoodSamFINAL081213.pdfPage, K. et al. Injection Drug Use and Hepatitis C Virus Infection in Young Adult Injectors: Using Evidence to Inform Comprehensive Prevention, Clinical Infectious Diseases, 2013:57 (

Suppl 2). University of Wisconsin Population Health Institute. The Burden of Excessive Alcohol Use in Wisconsin, March 2013.

http://

uwphi.pophealth.wisc.edu/publications/other/burden-of-excessive-alcohol-use-in-wi.pdf

47

References

Slide48

Links to additional reports and resources

Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2012: http://www.dhs.wisconsin.gov/publications/P4/P45718-12.pdfAlcohol License Overview for Wisconsin, 2012: http://www.dhs.wisconsin.gov/substabuse/docs/AlcDensity/AlcoholOutletReport-Wisconsin.pdf

Wisconsin State Council On Alcohol and other Drug Abuse:

http://www.scaoda.state.wi.us/University of Wisconsin Population Health Institute: The Burden of Excessive Alcohol Use in Wisconsin, March 2013.

http://

uwphi.pophealth.wisc.edu/publications/other/burden-of-excessive-alcohol-use-in-wi.pdf

48

Slide49

Contact

Mike QuirkeWisconsin Division of Mental Health and Substance Abuse ServicesWisconsin Department of Health ServicesEmail: Michael.Quirke@dhs.wisconsin.gov49


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