The Vulnerable Population of Alcohol Abusers
I chose the vulnerable population of people who abuse alcohol because of the history of this type of abuse in my family and my own personal drive of wanting to learn more about it. The main subject I was looking forward to learn more about was comparing the findings on researched family dynamics to my own childhood family dynamics involved with alcoholism. I have learned time and time again about all the genetic factors and the specific science of alcoholism but I thought it might be nice change of pace to research the bigger picture of the effects of this disease and not so much the disease itself.
In this paper, alcohol abuse and alcoholism are similar terms but with different definitions. Alcohol abuse will be defined as “pattern of drinking that results in harm to one’s health, interpersonal relationships or ability to work” (“What is the Difference”, 2006). This includes involving oneself in risky behavior such as drinking and driving, being irresponsible such as missing school and work, and has the potential to eventually lead to alcoholism (“What is the Difference”, 2006).
Alcoholism will be defined as a disease that can be diagnosed by looking at a variety of components including “a strong craving for alcohol, continued use despite harm or personal injury, the inability to limit drinking, physical illness when drinking stops, and the need to increase the amount drunk in order to feel the effects” (“What is the Difference”, 2006). I make the assumption based on my own experiences that many people can still be functional in everyday life and still be classified as an alcoholic.
In my family, men on both sides do not consider themselves alcoholics or alcohol abusers solely on the fact that they can perform in everyday life and accomplish their tasks. The denial of alcohol abuse amongst the people I have had closest contact with have been very high and if ever confronted about it they get very defensive. To go along with the extensive research that goes with this paper, I would like to see how the data can be generalized to my own life and my own personal experiences with which I have experienced. Description of the Population
For expressing the important aspects of the vulnerable populations Aday’s model of predictors will be used from Stanhope and Lancaster (2004). Aday’s model consists of an interrelated triangle like set-up consisting of three categories titled social status, social capital and human capital. Social status includes age, sex, race and ethnicity while social capital includes family structure, marital status, voluntary organizations and social networks. Finally, the human capital category includes schooling, jobs, financial income and housing.
To be considered a vulnerable population the group must have negative aspects from all three categories to put them at greatest risk (Stanhope & Lancaster, 2004). Social status. In 2004, there were over 12,000 people in Arizona treated in emergency rooms with alcohol abuse being their first-listed diagnosis. Of this 12,000, the majority age group consisted of young adults aged from 20-44 years old who attributed for 55. 2% of the total treated patients. Other major age groups included the middle-age group (45-64) comprising of 30. 5% and the adolescent age group (15-19) following with 8. %. The smaller percentage age groups fell on opposite sides of the age continuum with the percentages of the elderly (65+) being 3. 3% and children (<15) following with 2. 0%. Overall, of this 12,000 reported cases, 71. 8% were documented as being male and only 28. 1% as female (“Emergency Department”, 2005). The statistics are comparatively different when contrasted with the 2004 inpatient results for discharges in Arizona.. In total, there were over 4,500 discharges from inpatient settings of people who had alcohol abuse as their first-listed diagnosis.
Of this 4,500, the age group that had the highest percentage involved was the middle-aged group (45-64) with 49. 8%. Following the middle-aged group was the young adults (20-44) with 38. 6% and then results drastically declined to the elderly (65+) population which contributed to 9. 9% of the total. The two smaller percentage age groups consisted of adolescents (15-19) with 1. 3% and children (<15) with a mere 0. 48%. However, as compared to the emergency room statistics the male/female percentages were considerably similar with 71. % being male and 28. 5% being female (“Inpatient Discharges”, 2005). Race/ethnicity results can be found for the inpatient Arizona statistics for alcohol abuse but not for the emergency room statistics. Decisively, white non-Hispanics held the highest percentage of patients treated in the inpatient setting with 65. 0% of the 4,500 total patients. Next, after a considerable drop off was the Hispanic or Latino group which attributed for 15. 9% of the total followed by American Indian or Alaskan Natives with 10. 7%.
Lastly, the final two groups consisted of the Asian or Pacific Islanders contributing 6. 6% and Black or African Americans with a total of 2. 5%. Overall, 1. 4% of the total population was marked as “other” on the results (“Inpatient Discharges”, 2005). Social capital. “It has been estimated that approximately 20 million children in the United States live in homes with at least one alcoholic or drug-addicted parent” (McGaha & Leoni, 1995). Walker (2002) discusses how there are multiple roles that family members may adopt when a parent is an alcoholic.
These roles are identified as the caretaker, hero, scapegoat, mascot/cheerleader and lost child. The caretaker role is usually taken on by the parent not suffering from alcoholism but can be placed taken on be a child in worse type of circumstances. This role consists of meeting the needs of the family while maintaining a normal outlook to anyone looking in. Unfortunately, the caretaker rarely takes the time to care for their own needs because they are constantly taking care of everyone else.
The hero compensates for the alcoholic’s lifestyle by achievements in such things as school or sports and does not receive much attention in other aspects. The only time they get rewarded or recognized is when they excel at their specialty. The scapegoat is usually an unlucky child that is delegated the reason for all that goes wrong with the family. The mascot/cheerleader is usually the comedian of his/her family and their classmates and is usually popular among both.
Occasionally, they do not use the best timing or circumstances for their comedy resulting in adverse reactions from the person or persons it was directed towards. Finally, the lost child is the member of the family who is not normally visible and spends most of their time participating in non-active roles like playing Nintendo, watching television or spending the time in their room away from the family. This child often knows much more than given credit for about the family status and often can have weight problems for their inactive lifestyle.
The article continues to express how members of healthy and functional families do not bunch into these particular roles (Walker, 2002). According to “Group Meetings” (2006) many alcoholics spend “aimless hours” of their time in the bar settings. A bar is a place to socialize and be with other people who share the same interests and lifestyle. Although, once an alcoholic decides that they feel it is time to give up alcohol and actively seek change there is plenty of support around the nation to find help and surround themselves in new social settings.
In Arizona, there are multiple support groups that include Alcoholics Anonymous, chemical dependency groups and many inpatient settings to help get them on their feet (“NI-COR Support Groups”, 2003). For example, at Alcoholics Anonymous there are no fees or payments and are very accessible and the only requirement they have for the people willing to try it out is “the desire to stop drinking” (“Information on Alcoholics Anonymous”, 2006). Human capital.
The “Results from the 2005 National Survey” (2006) studied adult alcohol consumers and the percentage of alcohol use in relation with their education and employment status. With regards to education level the study showed a wide margin between adults who graduated from college and adults with less than a high school education. These findings showed that 69. 4% of college graduates were current drinkers compared with a mere 36. 7% of the adults with less than high school education. Findings for employment included that “rates of current alcohol use were 63. percent for full-time employed adults aged 18 or older in 2005, higher than the rate for unemployed adults (56. 5 percent)” (“Results from the 2005 survey”, 2006). There are many warning signs that an employee can be suffering from alcohol problems which can include an increase in absences (particularly Mondays), consistently showing up late, and a decline in work ethic that correlate with their negative changes in attitude (“Alcohol and the Workplace”, 1999). Interestingly enough, the income varies in favor of the social drinkers when compared to people who do not consume alcohol.
According to “Drinkers Earn More” (2006) male social drinkers earn around 10% more and women social drinkers earn 14% more than their counterpart nondrinkers. This is said be related to the social impacts of the social drinking and the networking and bonding that can take place with the co-workers (“Drinkers Earn More”, 2006). Leading Causes of Illness or Health Risks in the Population Three health risks that are significant to the alcohol abuse or alcoholic populations are motor vehicle accidents (MVA’s), advanced liver disease and peripheral neuropathy.
Regarding MVA’s in 2004, there were 1150 traffic fatalities in Arizona in which 38% were alcohol related (“Arizona Drunk Driving”, 2006). This is slightly lower than the 2002 national average of alcohol related traffic accidents which accounted for 41% of national traffic fatalities (“National Driving”, 2006). Another possible health risk to an alcoholic is advanced liver disease, which happens to be of particular concern for alcoholics because “alcohol is absorbed in the small intestine and passes directly into the liver, where it becomes the preferred energy source.
The liver, then, is particularly endangered by alcoholism” (“Alcoholism”, 2001). After large amounts of alcohol are consumed for an extended period of time, the liver inflames and damage to the surrounding tissue occurs which can eventually result in liver cirrhosis. Approximately 10% of alcoholics will eventually progress into advanced liver disease and 10-35% will develop alcoholic hepatitis. Alcoholic hepatitis is viewed as a precursor to liver cirrhosis being that one in five people who suffer from it will eventually develop liver cirrhosis (“Alcoholism”, 2001).
Lastly, “severe alcoholism is associated with osteoporosis (loss of bone density), muscular deterioration, skin sores, and itching” (“Alcoholism”, 2001). This disease process affects the rate of health problems like peripheral neuropathy (limb nerve damage) which happens to have a prevalence of 5-15% amongst people suffering from alcoholism. Signs of peripheral neuropathy include paresthesia, numbness, and pain of the extremities mostly involving the hands and feet (“Alcoholism”, 2001). Environmental Health Threat
Approximately “eighty-90 percent of alcoholics smoke – -a rate three times that of the general population” (Behm, Cramblett, Brauer, Calkins & Lawhon, 2004). Combine that with what was mentioned earlier, with alcoholics that can spend “aimless hours” of their time in the bar settings (“Group Meetings”, 2006). When comparing environmental smoke levels the finding were found that “levels of environmental tobacco smoke in restaurants and bars were found to be 2 to 5 times higher than in residences with smokers and 2 to 6 times higher than in office workplaces” (“Secondhand Smoke Fact Sheet”, 2006).
With this high of prevalence of smoking amongst alcoholics correlated with the time spent in bars, even non-smoking alcoholics are coming in contact with a high quantity of second-hand smoke. “It is estimated that approximately one-third of lung cancers in nonsmokers result from passive exposure to cigarette smoke” (“Environmental Tobacco Smoke”, 2006). According to the “Secondhand Smoke Fact Sheet” (2006) secondhand smoke is identified as a known cause of cancer and causes roughly 3,400 lung cancer deaths and 22,700-69,600 coronary heart disease deaths annually in the United States occur just amongst the nonsmoking population.
A Healthy People 2010 objective related to improving the statistics of this health threat is number 27-5 entitled “Increase smoking cessation attempts by adult smokers” (“Increased Smoking Cessation”, 2000). In summary, this objective has the goal to raise the smoking cessation attempts for active smokers of adults over the age of 18 from 41% to 75% by 2010 (“Increased Smoking Cessation”, 2000). Prevention of Environmental Health Threat
The United States workforce started to take a stance on public smoking in 1999 and never looked back. Ever since 1999, roughly 70% of the jobs in the United States have been under some type of smoke-free environment. As recent as 2005, there have been nine states to ban smoking in almost all public work places including areas such as bars, restaurants and nightclubs (“Secondhand Smoke Fact Sheet”, 2006). In 2006, Arizona will try to join that list of the nine other states with proposition 201 up for vote.
Proposition 201 is known as the “Smoke-Free Arizona Act” which entails that the people of Arizona have “the right to breathe clean indoor air in public places and at work, and that the health of Arizonans will be improved by prohibiting smoking in all enclose public places and places of employment” (“Ballot Propositions”, 2006). There are a few cities and towns of Arizona that have already taken their own steps to restricting smoking in their personal public places but this would be a major stepping stone if it is able to be accepted to the state level (“Ballot Propositions”, 2006).
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