Perspectives in Disease Prevention and Health Promotion Drinking and Driving and Binge Drinking in Selected States, 1982 and 1985 -- The Behavioral Risk Factor Surveys

During the period 1981-1983, behavioral risk factor surveys were conducted in 28 states and the District of Columbia (1). The surveys were designed to gather data on the prevalence of specific behavioral risk factors in the adult population ( 18 years of age) in each state. Since 1984, several states have been collecting risk factor data on a monthly basis as part of the Behavioral Risk Factor Surveillance System. The following analysis was based on the 12 states ("states" includes the District of Columbia) that collected data on drinking and driving and/or binge drinking for 1982 and 1985.

For the purposes of this analysis, the prevalences of drinking and driving and of binge drinking were based on the percentage of persons selecting the answer "One or more times" when asked the following questions:

! For drinking and driving: "During the past month, how many

times have you driven when you've had perhaps too much to drink?" ! For binge drinking: "Considering all types of alcoholic

beverages, that is beer, wine, liquor, as drinks, how many times during the past month did you have five or more drinks on an occasion?" Ten of the 12 states that gathered data on binge drinking in 1982 and 1985 also gathered data on drinking and driving. Table 2 shows the prevalence of drinking and driving, by age and sex, in 1982 and 1985 for these 10 states. Table 3 shows the prevalence of binge drinking by age and sex in 1982 and 1985 for all 12 states. The Wilcoxon Signed Rank Test for paired measurements* (2) was used to evaluate observed changes in the prevalence of drinking and driving and binge drinking in this group of states.

All states reporting drinking and driving data showed a decrease in that behavior among males 35 to 54 years of age between 1982 and 1985 (decrease = 10/10). However, the decrease was not consistent among either males 18 to 34 years of age (5/10) or males greater than or equal to 55 years of age (5/10). For both years, women had lower prevalences than men, but the proportion of states showing a decrease in drinking and driving among women was not statistically significant for any of the three age groups.

Between 1982 and 1985, a significant proportion (p = .05) of the 12 states reporting binge drinking data showed a decrease in the prevalence of binge drinking among men 18 to 34 years of age (10/12) and men 35 to 54 years of age (10/12). A majority of states showed a decrease in binge drinking among men greater than or equal to 55 years of age (8/12), but this change was not statistically significant. A majority of states also showed a decrease in binge drinking for women in each age group, but this decrease was statistically significant (p = .01) only among women 18 to 34 years of age. Reported by T Hughes, Office of Health Education, Arizona Dept of Health Svcs; F Capell, Health Education-Risk Reduction Program, California Dept of Health Svcs; R Conn, EdD, Preventive Health Svcs Administration, District of Columbia Dept of Human Svcs; WW Mahoney, Health Promotion Program, Florida Dept of Health and Rehabilitative Svcs; JD Smith, Div of Public Health, Georgia Dept of Human Resources; S Jain, Div of Health Education, Indiana State Board of Health; K Bramblett, Dept of Health Svcs, Kentucky Cabinet for Human Resources; R Moon, Health Education and Promotion Program, Montana Dept of Health and Environmental Sciences; C Washington, Health Promotion Br, Div of Health Svcs, North Carolina Dept of Human Resources; E Capwell, Bur of Preventive Medicine, Ohio Dept of Health; J Fortune, Div of Health Promotion, Tennessee Dept of Health and Environment; R Anderson, Health Education Dept, West Virginia Dept of Health; Field Svcs Br, Epidemiology Br, Statistics Br, Div of Nutrition, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: No comparison data are available to indicate whether the downward changes in self-reported drinking and driving and binge drinking prevalences for these selected states reflect similar changes at the national level. More of the reporting states showed a decrease in the prevalence of binge drinking than in the prevalence of drinking and driving. For men and women of all ages, the prevalence of binge drinking decreased in a majority of the states. By contrast, only for men 35 to 54 years of age and women 18 to 34 years of age did a majority of states show a decrease in the prevalence of drinking and driving.

Caution must be exercised in interpreting changes based on the self-reported behaviors from these states. The apparent decreases in binge drinking and in drinking and driving may reflect real decreases in the prevalence of these behaviors in the populations surveyed. However, these changes could also be artifactual, due either to seasonal bias in the surveys done in 1982 or to differences between the 1982 and 1985 surveys caused by non-response or under-reporting.

The 1982 surveys were conducted during a 1- to 6-week interviewing period. In contrast, the 1985 data were gathered during a 7-day period each month and then aggregated at year's end to eliminate the potential effect of seasonality on health risk behaviors. However, because the 1982 surveys were conducted across all seasons of the year, seasonality is an unlikely explanation for the changes observed between these two sets of surveys.

Non-response and under-reporting could have affected these results. Analysis reveals lower response rates for the 1985 surveys than for the 1982 surveys in these states. It is possible that non-responders are more likely than responders to engage in these behaviors. In addition, the apparent decrease in self-reported drinking and driving or binge drinking may have resulted from greater under-reporting of these socially undesirable behaviors in the 1985 surveys. If this were the case, however, one might expect to see relatively greater decreases in drinking and driving, which is more socially undesirable than binge drinking and has been the focus of universal public interest.

If an actual decrease in these behaviors has occurred, it could be due, in part, to legislative efforts within the states to raise the drinking age as well as to increased enforcement of laws against driving while under the influence of alcohol. It could also be a result of limiting the number of free drinks establishments can provide to customers during "happy hour" or of changes in the social desirability of these behaviors brought on by the activities of groups such as Mothers Against Drunk Driving. The fact that a greater proportion of states has shown a decrease in the prevalence of binge drinking compared with drinking and driving suggests that persons still reporting the latter behavior may be more resistant to change.

Young males (18 to 34 years of age) continue to show the highest prevalence of both drinking and driving and binge drinking. Therefore, to prevent alcohol-related injuries and death, young males should remain a priority target group for public health intervention.

References

1. Marks JS, Hogelin GC, Gentry EM, et al. The behavioral risk factor surveys: I. state-specific prevalence estimates of behavioral risk factors. Am J Prev Med 1985;1(6):1-8.

2. Snedecor GW, Cochran WG. Statistical methods. 6th ed. Ames, Iowa: The Iowa State University Press, 1967:128-30. *This non-parametric test was used to assess the likelihood that the observed proportion of states showing a decrease in the prevalence of self-reported drinking and driving and of binge drinking between 1982 and 1985 could have happened by chance alone.

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