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Initial Report on Public Health
Adult Heavy Drinking
Narrative

The adult heavy drinking episode indicator estimates the age-standardized proportion of people age 20 years and older who reported consuming five or more drinks on at least one occasion during the previous 12 months.

Alcohol use is a significant risk factor for both injury and chronic disease. Heavy drinking puts a person at much higher risk of death or injuries from motor vehicle collisions; alcohol associated illness, falls, drowning and other hazards of poor judgement and reduced coordination. 52, 53 Longer term, heavy drinking can result in high blood pressure, stroke, liver disease, and neurological damage. 54

It is estimated that 10% of all deaths in Ontario directly or indirectly result from alcohol misuse. 55 Alcohol misuse is involved in about 40% of all traffic collisions, 56 which result in a large number of potential years of life lost because of the relatively young age of those killed in traffic collisions. 57

Alcohol misuse is associated with significant economic impacts including:

  • lost productivity due to morbidity
  • premature mortality
  • social services costs
  • law enforcement costs
  • direct health care costs 58

Heavy drinking also increases the risk of violence, 59 vandalism, 60 sexual assault, and unprotected sexual encounters with the potential for unplanned pregnancy or infection from sexually transmitted diseases. 61

Public health programs and services aim to increase public awareness of the dangers of substance misuse and promote healthy public policy to reduce the risks. Programs and services include:

  • promoting the Low-Risk Drinking Guidelines designed to minimize the health risks of alcohol use
  • promoting responsible driving including not driving under the influence of alcohol
  • advising women who know they are pregnant or are planning on becoming pregnant of the harmful effects of alcohol on their unborn child
  • promoting adoption of municipal alcohol policies
  • providing Server Intervention Training and Safe Bar Policy
  • promoting responsible hosting

In addition, there are provincially funded initiatives such as the FOCUS Community Project which operates in 21 communities with the aim of reducing the abuse of alcohol and other drugs and preventing their associated problems, injuries, and chronic diseases.

In 2007, 37% of people in Ontario age 20 years and older reported consuming at least five or more drinks on at least one occasion in the last 12 months. Based on 36 public health units in Ontario, the highest proportion of heavy drinkers, that is those who reported consuming five or more drinks on at least one occasion in the last 12 months, was 54% and the lowest was 24% of adults age 20 years and older.

Indicator Definition

Definition:

The adult heavy drinking episode indicator estimates the age-standardized proportion of people age 20 years and older who reported consuming five or more drinks on at least one occasion during the previous 12 months.

Data Source(s):

Numerator: Canadian Community Health Survey 2007, Statistics Canada, Ontario Share File distributed by the Ministry of Health and Long-Term Care
Denominator: Canadian Community Health Survey 2007, Statistics Canada, Ontario Share File distributed by the Ministry of Health and Long-Term Care

Formula:

Weighted number of respondents who are age 20+ years who reported consuming 5 or more drinks, on at least one occasion during the previous 12 months

Weighted number of respondents age 20+ years who did or did not drink
 
x 100

Notes:

  • Numerator ALC_3=Less than once per month(2), Once per month(3), 2-3 times per month(4), Once per week(5), More than once per week (6)
  • Denominator: ALC_1= Yes (1), No (2)
  • Don't Know (97), Refusal (98), Not Stated (99) responses were excluded
  • Age groups in years used for direct age-standardization: 20-34, 35-49, 50-64, 65-74, 75+
  • Direct age-standardization to the 1991 Canadian population

52 Roerecke M, Haydon E, Giesbrecht N. Alcohol and chronic disease: an Ontario perspective. Toronto, ON: Alcohol Policy Network, Ontario Public Health Association; 2007. Retrieved April 17, 2009 from: http://www.apolnet.ca/resources/pubs/rpt_ChronicDisease.pdf.
53 APOLNET. Statistical overview of alcohol use. Toronto, ON: Alcohol Policy Network; 2008. Retrieved April 20, 2009 from: http://www.apolnet.ca/AboutUsHome.html.
54 Mukamal KJ. Patient information: risks and benefits of alcohol. Waltham, MA: UpToDate; 2007. Retrieved April 20, 2009 from: http://www.uptodate.com/patients/content/topic.do?topicKey=~6WTzKjHnjBtd1.
55 Ministry of Health and Long-Term Care. Alcohol and substance abuse prevention [Internet]. Toronto, ON: Queen’s Printer for Ontario; 2006. Retrieved April 15, 2009 from: http://www.health.gov.on.ca/english/public/pub/hpromo/hpromo.html#1.
56 Mercer GW (Applied Research and Evaluation Services, University of British Columbia). Estimating the presence of alcohol and drug impairment in traffic crashes and their costs to Canadians: 1999 to 2006. Oakville, ON: Mothers Against Drunk Driving Canada; 2009. Retrieved April 20, 2009 from: http://www.madd.ca/english/research/estimating_presence.pdf.
57 Core Health Indicators Work Group. Heavy drinking episodes. In: Core indicators for public health in Ontario. Toronto, ON: Association of Public Health Epidemiologists in Ontario; 2009. Retrieved April 15, 2009 from: http://www.apheo.ca/index.php?pid=123.
58 SMARTRISK. The economic burden of injury in Ontario. Toronto, ON: Queen’s Printer for Ontario; 2006. Retrieved April 17, 2009 from: http://www.mhp.gov.on.ca/english/injury_prevention/Smartrisk-EBI-Ont-2006.pdf.
59 Brewer RD, Swahn MH. Binge drinking and violence. JAMA. 2005;294(5):616-8.
60 Kuo M, Adlaf EM, Lee H, Gliksman L, Demers A, Wechsler H. More Canadian students drink but American students drink more: comparing college alcohol use in two countries. Addiction. 2002 Dec;97(12):1583-92. Retrieved April 20, 2009 from: http://www.hsph.harvard.edu/cas/Documents/Canadian1/CanadaPaper.pdf.
61 Centers for Disease Control and Prevention Women and alcohol. Atlanta, GA: Centers for Disease Control and Prevention; 2007. Retrieved April 20, 2009 from: http://www.cdc.gov/Features/WomenAndAlcohol/.

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