MARQUETTE COUNTY REPORT CARD
ON ALCOHOL USE 1998

INTRODUCTION: Since 1986 the Marquette County Health Department has been working towards improving the health of Marquette County residents using the Healthy People 2000 objectives. The document set the stage for planning long term strategies and health priorities for the community.

The goals for 2000 set the stage for the development of a series of report cards which help increase awareness concerning the health objectives and measure the community's progress in meeting them.

Each report highlights issues related to the community. The report card reflects our mission to monitor health issues in the community, our interest in providing information about current health problems, and our commitment to work together with all sectors of the community to improve the health of Marquette County residents.

We are pleased to publish a two part series of report cards focusing on Alcohol and Tobacco. We will continue to prepare and distribute health report cards and other assessments as a way to keep our community informed.

It is our hope that you find this document useful. We encourage you to share them with your colleagues. If you have suggestions or if you are in need of additional copies, please contact Jim Harrington at (906-475-7848. Thank you for your interest and continued support.

Dr. Randall Johnson, Director
Marquette County Health Department

KEY FINDINGS
Alcohol Use in Marquette County and the Upper Peninsula
1. Alcohol use among Marquette County youth is decreasing.
2. Upper Peninsula binge drinking and heavy drinking rates for adults are the highest in Michigan.
3. Drinking and driving is more likely to occur in the Upper Peninsula than anywhere else in Michigan.
4. Marquette County's alcohol induced death rate is near the highest in the state.
5. Marquette and Alger County youth asset development is identical to national averages.
6. Alcohol products have become more difficult for minors to purchase.
7. Underage youth are exposed to a large amount of alcohol advertising throughout Marquette County.

About the Report Card
The following key provides a quick reference as to how the health status of the community has changed. The rating is based on change between the baseline year and the most current year data available. If Marquette County data is not available, we will rate the Upper Peninsula as a region.

    +        Improvement
   -         Worse
   O        No Change
   NA     Data Not Available

ALCOHOL USE REPORT CARD
Background:  Alcohol is the most widely used drug in Marquette County as it is in Michigan and nationally. In 1995, more than 2,000 deaths in Michigan were alcohol related. Alcohol use is related to a variety of serious and fatal injuries including motor vehicle crashes, homicides, suicides, family violence, spinal cord injuries, and drowning. Alcohol consumption has been associated with increased risk of chronic disease including certain cancers, cardiovascular disease, and digestive disease. The use of alcohol in pregnancy can result in developmental problems, decreased birth weights, and Fatal Alcohol Syndrome.

Nationally, progress has been made in reducing alcohol use and related problems in the past 10 years. Per capita alcohol consumption in the United States had declined from 2.54 gallons in 1987 to 2.31 gallons in 1992. Cirrhosis deaths declined from 9.2 per 100,000 in 1987 to 7.8 in 1993. Alcohol related traffic fatalities decreased 31% from 25,165 in 1982 to 17, 780 in 1993.

In Michigan, prevalence of heavy drinking is 4.6% which is higher than the U.S. median of 3.4% among adults. Eleven of the twelve regions monitored in the state are above the U.S. rate. In the Upper Peninsula, the rate of heavy drinking is 6.7%, making it the highest in the state. High school seniors reporting daily drinking was 2%. The binge drinking rate for Michigan high school students was 32% in 1997. This is higher than the U.S. median of 14.3% in 1992. Binge drinking among Marquette County high school seniors was 44% in 1994.

The rates of alcohol abuse in the Upper Peninsula are the highest in the state. Leading researchers believe there are cultural-wide forces leading to these higher numbers despite strong substance abuse educational efforts in schools and communities. Advertising and the prevalence of alcohol at many community and family oriented events may be reasons for the higher prevalence of alcohol abuse.

The cost of alcohol abuse is extensive. The estimated annual cost of alcohol abuse in Marquette County is $25,805,000 or $397 per Marquette County resident based on 1991 data. This includes costs related to alcohol-related crime, direct health care costs, lost productivity, and Fetal Alcohol Syndrome.

These indicators for problems related to alcohol use are binge drinking, heavy drinking, and drinking and driving. Binge drinking is defined as consuming 5 or more alcoholic beverages on one occasion at least once in the past month. Heavy drinking refers to an average consumption of 60 or more alcoholic beverages in the past month, and drinking and driving refers to individuals who report having driven after having too much to drink one or more times in the past month.

Status Report on Marquette County Objectives

- Heavy Drinking
By the year 2000, reduce the number of adults who report they have consumed 60+ drinks in the past month to no more than 5%.

    Michigan(1993): 4.6%
    Upper Peninsula(1993): 6.7%

Michigan's Upper Peninsula has the highest risk for heavy drinking in the entire state according to the statewide Michigan Behavioral Risk Factor Surveillance Survey. The 1992 U.S. Media rate was 3.4%.

O Youth Asset Development
   National 1998: 18 assets
    Marquette and Alger County 1998: 17.4 assets

Marquette and Alger County youth have on average only 17.4 of the 40 developmental assets. 7% of all students surveyed had 31 of the 40 assets. The number of developmental assets local youth possess are almost identical to national averages. Assets help protect youth from risky behaviors such as problem alcohol use. The good news is that everyone can be an asset builder. Marquette and Alger counties have mobilized to increase the number of assets youth have.

+ Alcohol Use by High School Seniors
By the year 2000, reduce to 25% the number of high school seniors who have used alcohol at least once a month for the past twelve months.

    Marquette County(1990): 70%
    Marquette County(1997): 63%

Alcohol use among high school seniors has decreased significantly between 1990 and 1997 yet still remains above the national average. The decrease has also been demonstrated at all lower grade levels. The national average in 1992 was 51%. The most encouraging news is that eighth grade levels have dropped dramatically from 45% in 1990 to 31% in 1994. A reason for this positive trend could be the reduction in the number of illegal sales to minors. In 1993, baseline data was collected indicating 44.5% of retailers sold alcohol to a minor. In 1995, that number was down to 23.5%.

Binge Drinking Has Increased.
Binge Drinking(5 or more drinks in a row) is a serious problem among high school students and young adults. According to the Marquette County Drug Free Schools survey results, four out of ten 12th grade students reported binge drinking in 1994. This is greater than the 29.2% rate of binge drinking reported among adults compared to the national average of 14.4% and the Michigan average of 18.5%.

- Drinking and Driving
By the year 2000, decrease to no more than 2% the number of adults at risk for drinking and driving.

    Baseline Michigan(1990) 3.3%
    Most Current Year Upper Peninsula(1993) 5.7%

Drinking and driving is more likely to occur in the Upper Peninsula than any other region in the state. According to Upper Peninsula data, 5.7% of adults surveyed reported they had possibly too much to drink and drove compared to a Michigan average of 4.1% and U.S. median of 2.5%. Marquette County school data shows a decline from 32% in 1990 to 23% in 1994, among high school seniors who drove after drinking. In 1994, 39% of local high school seniors reported riding in a car whose driver had been drinking.

- Alcohol Induced Deaths
By the year 2000, reduce alcohol related deaths to no more than 6.5 per 100,000 population.

    Michigan(1992) 6.6 deaths per 100,000 population
    Marquette County(1997) 7.8-11.5 per 100,000

The health effects of alcohol abuse are often difficult to measure directly because the problems associated with alcohol are often associated with other diseases. One measure of the impact of alcohol abuse is the extend of the alcohol induced death rate. In 1994, 2,000 Michigan deaths were attributed to alcohol. A high percentage were from cirrhosis. In 1994, Marquette County had 11 deaths due to cirrhosis per 100,000 people. The rate for 1992 in Michigan was 6.6 per 100,000 and compared to the U.S. rate of 6.8 per 100,000. Michigan Critical Health indicators show Marquette County alcohol-induced death rates are the highest in the State.

Summary and Implications for Action
Progress in Marquette County has been made toward achieving Healthy Michigan 2000 objectives for youth recently. The good news is that the rates seem to be decreasing for youth, however, even with the reduction, they are still over 10% higher than the state average. It is still early to tell if a recent downward trend will continue for youth. Adult rates, however, are not showing the same promise. Binge drinking, drinking and driving, and heavy drinking alcohol use are the highest rates in the state.

Children who drink begin experimenting with alcohol at early ages. They are exposed to alcohol use by family members, other adolescents, and the media. A recent Marquette County alcohol advertising survey found an average of 11 alcohol ads in convience stores, gas stations, and grocery stores that sell alcohol. Prevention efforts targeted to children and adolescents need to address multiple risk factors and must be linked to other efforts to reduce violence, teen pregnancy, sexually transmitted disease, HIV/AIDS, injury, and traffic crashes.

Successful prevention efforts include a community-wide approach to change social norms around alcohol use and to develop policies that minimize alcohol abuse problems. Efforts to change community wide norms and policies must involve the whole community including families, schools, work places, health care providers, media, businesses, and government.

Research by the Search Institute indicates that increasing the number of developmental assets our young people possess will decrease the behavior such as drinking and driving and binge drinking. Prevention programs throughout Marquette and Alger Counties are implementing strategies that enhance youth asset development.

A recently completed survey of Marquette County residents by the Marquette County Coalition for Substance Abuse and Violence Prevention pointed to three areas to focus prevention efforts. The ROAD Project(Reduction of Alcohol Impaired Driving), as it is referred to, has targeted enhancing alternative activities for youth, enforcement of alcohol related laws, and parental involvement with youth. In addition, awareness, community education, and policy efforts will be strategies for alcohol prevention.

Public Health Implications
Alcohol use continues to contribute to a wide range of preventable health and social problems locally. These include unintentional injuries(motor vehicle crashes, falls, drownings, burns), chronic diseases(cardiovascular, cancer, digestive diseases), violence(homicide, suicide, assault), unintended pregnancies, sexually transmitted diseases, and children born with alcohol related birth defects. A reduction of alcohol use could potentially result in reducing these health issue as well.

Recommendations
Alcohol prevention activities in Marquette County have not been successful in holding youth rates under the national average despite progressive efforts to reduce access and provide education to youth. It may, however, have been successful in keeping the rate from skyrocketing further. Prevention efforts will continue incorporating educational and awareness programs in the community as well as policy development. Support of local alcohol laws and server training is recommended in addition to lowering the legal blood alcohol level to .08 in Michigan. Community youth asset development will be incorporated in alcohol prevention programming. Increasing the number of youth with 31-40 assets is a community goal. Research indicates reduction of alcohol advertising would reduce demand among youth.

About the Data
There is limited data available about adult alcohol use in Marquette County. Most data is provided by the Behavioral Risk Factor Survey collected by the Michigan Public Health Institute. Marquette County student survey data provided in this report represents combined data from school districts throughout the county. Student survey results may vary by district.

Resources
Many organizations exist in Marquette County that address substance abuse prevention in a variety of ways. These include schools, voluntary health organizations, health care providers, public health agencies, and others. The following organizations have developed collaborative efforts to reduce alcohol use in Marquette County and Michigan:

Marquette County Substance Abuse and Violence Prevention Coalition
184 U.S. Highway 41 East
Negaunee, MI 49866
(906)475-7848

Michigan Resource Center
111 West Edgewood Blvd. Ste. 11
Lansing MI 48911
1-800-626-4636

The Prevention Network
P.O. Box 4458
East Lansing, MI 48826-4458
1-800-4968

References
Western Michigan ATOD survey for Marquette County Schools, 1990-1994.
Michigan Behavioral Risk Factor Surveillance System: Michigan Public Health Institute, 1989-1993.
Michigan Critical Health Indicators, 1997.
Search Institute, MAISD report of the results of the Student Life Survey Profile, 1997.

For More Information
Extra copies of this report and detailed information about alcohol use and alcohol control strategies in Marquette County are available by contacting the Marquette County Health Department, Community Health Division at (906)475-7848.

Last UPdate:  03 April, 2002