Link between alcohol abuse and dependence with medical conditions in two American Indian reservation communities

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.