BACKGROUND: Alcohol use and abuse is an important risk factor for a number of chronic diseases and conditions and is common among adults in the United States. Excessive drinking is a significant public health issue in Hawaii. In the America’s Health Rankings 2015 report, Hawaii ranked 43rd out of 50 states in excessive drinking. Alcohol Screening and Brief Intervention (ASBI) is an evidence-based strategy to reduce excessive alcohol consumption. We investigated the likelihood of reporting screening for alcohol use among various demographic and health risk groups.
METHODS: We examined 2014 Hawaii Behavior Risk Factor Surveillance System (BRFSS) data from the ASBI module for 4,789 adults. Survey respondents who reported a health care visit in the past year were asked if during that visit they were asked whether they drink alcohol, how much they drink, and whether they binge drink. We assessed prevalence of these screening questions. Adjusted prevalence ratios (APR) assessed the association between screening and race, education, and insurance status with adjustment for age, smoking, drinking, depression, diabetes, and weight status.
RESULTS: An estimated 65.5% (95% CI=63.7, 67.4) of adults in Hawaii reported being screened for alcohol use. Native Hawaiian (APR=0.91; 95% CI=0.84, 0.99), Other Pacific Islander (APR=0.61; 0.45, 0.82), Chinese (APR=0.74; 0.64, 0.86), Filipino (APR=0.79; 0.72, 0.87), Japanese (APR=0.72; 0.67, 0.79), and Other Asian (APR=0.75; 0.61, 0.92) groups were less likely to be screened than Whites. Those with less than high school education (APR=0.82; 0.70, 0.96) were less likely to be screened compared to college graduates, while insured respondents (APR=1.25; 1.07, 1.47) were more likely to be screened compared to uninsured.
CONCLUSIONS: Screening for alcohol use varies by race, education level, and insurance status even after accounting for high risk behaviors and chronic conditions. Increasing screening rates among these groups and among the entire adult population would help health care providers identify individuals who consume excessive amounts of alcohol and provide brief intervention or referral to services when appropriate. This information will help the public health and health care communities understand the extent to which health care providers are screening patients for alcohol use and support future policy movement to increase ASBI in Hawaii.