Surveillance 101: Excessive Alcohol Consumption:Michigan Perspective

Katherine Gonzales, MPHAlcohol Epidemiologist

Michigan Department of Community Health

CSTE Substance Abuse Preconference WorkshopJune 9, 2013

MDCH Alcohol Epidemiology Program

• Frame excessive alcohol use as a health issue– Binge drinking

• Conduct surveillance – Analyze & provide statewide & local data– Evaluate new data sources for surveillance

• Provide scientific foundation for informing discussion

• Act as department liaison & representative

• Contribute to national work

Working with Partners• Responding to immediate data needs

– Discussing missed opportunities– Providing data for county & regional comparisons– Placing excessive alcohol consumption burden

within scientific and local context

• Data-driven planning– Identifying high-risk sub-populations & behaviors

• Lessons learned – Identifying allies: media, public & political support– Using personal stories and data

Michigan Core Data SourcesAnnual: – Behavioral Risk Factor Surveillance System– Youth Risk Behavior Surveillance System

(biennial)– Inpatient Discharge Data– Death Certificates– Traffic Crash Data – Fatal Analysis Reporting System

2011 Michigan Behavioral Risk Factor Survey Data

Local MiBRFS Data

2009 Binge Drinking MiBRFS & MiYRBS

MiBRFS Data Considerations• Timely, most reliable data available

• Limited to non-institutionalized persons > 18 years

• Underestimate– Improving data collection

• Self-report– Account for 20-30% of sales

www.michigan.gov/brfs

2011 Michigan Youth Risk Behavior Survey Data

MiYRBS Data Considerations• Most reliable data available

• Self-report

• Difficult to add new questions

• Local data are limited

• Only representative of public high school students

www.michigan.gov/yrbs

Inpatient Discharge Data

Inpatient Data Considerations• Alcohol information can vary by

hospital & provider

• Only hospital charges are available

• Not a good measure of acute events

• Counts are events, not individuals

Michigan Alcohol- Attributable Death Data

Mortality Data

Mortality Data Considerations• Documents most severe cases of

alcohol use

• Can be linked to YPLLs

• Underestimate– Reporting may vary by individual

completing death certificate

www.michigan.gov/vitalrecords

Fatality Analysis Reporting System Data

Alcohol-Involved Fatal Crashes, 2011

Alcohol-Involved Fatal Crashes, 2011, cont.

Alcohol-Involved Fatal Crashes, 2011, cont.

FARS Data Variables• Atmospheric Condition• City• County• Crash Date (mmddyyyy),

Day, Hour, Month• Drowsy Driver• Holiday Related• Latitude (Degrees)• Longitude (Degrees)• Number of Fatalities In

Crash

• Number of Vehicle Forms Submitted

• Age• Injury Severity• Police Reported Drug

Involvement• Police-Reported Alcohol

Involvement• Race• Sex• BAC

FARS Data Considerations• Most extreme cases of impaired driving

• Data from all fatal crashes are collected

• Strong political, advocacy & industry support

• Website is easy to use

www-fars.nhtsa.dot.gov/

Michigan Traffic Crash Facts

County Traffic Crash Data

Traffic Crash Data Considerations

• Released annually

• Standardized reporting

• Strong political & public support for collection

Annual– Treatment Episode Data System (TEDS)– Liquor license data– Crime reports– Pregnancy Risk Assessment Monitoring

System

Supplemental Data Sources

Treatment Episode Data Set Data

TEDS Data, cont. • Reported annually

• Only public treatment services data included

• Counts are events, not individuals

• Can be linked to other data sources

http://wwwdasis.samhsa.gov/dasis2/teds.htm

Liquor License Data

Active Wayne County Liquor Licenses

Active Wayne County Liquor Licenses

Liquor License Considerations• Potential for geospatial analysis

• Updated frequently

• Types of licenses– Incomplete

• Bars vs. restaurants• Special or temporary

• Establish partnerships with retailers

• Violation history available

www.michigan.gov/lcc

Uniform Crime Reports

Crime Data

Crime Data Considerations• Data available only for crimes identified and reported

– Data collection on alcohol use very limited

• Sensitive to enforcement & available resources

• Tailor data to fit your needs

• Potential for geospatial analysis

http://www.michigan.gov/msp/0,4643,7-123-1645_3501_4621-281784--,00.html

Other “Data” • Monitoring new policy & legislation

• Informing agencies & coalitions– BAC – Farmer’s markets

• Providing requested data when possible

“New” Data Sources• Youth Tobacco Survey

• National EMS Information System (NEMSIS)

• Syndromic Surveillance

• Future Data Sources?– Violent Death Reporting System– Maternal Mortality Review– Great Lakes Health Information Exchange

Acknowledgements• Michigan Department of Community

Health– Sarah Lyon-Callo– Corinne Miller

• Centers for Disease Control and Prevention – Alcohol Program

Contact Information

Katy Gonzales, MPH517-373-8352gonzalesk2@michigan.gov

www.michigan.gov/substanceabuseepi