Excessive Drinking - Women in Hawaii

Hawaii

Excessive alcohol consumption is a leading cause of preventable mortality in the United States. Nearly 59,000 women lose their lives to excessive alcohol use every year — 1 in 6 deaths among women ages 20-49 are attributable to excessive alcohol use. 

Although the prevalence of alcohol use remains higher among men than women, the gender gap is narrowing. Women absorb alcohol quicker and metabolize it more slowly than men, which can lead to accelerated development of adverse health outcomes even at lower levels of alcohol consumption.

Among women, alcohol consumption is associated with an increased risk of liver disease, heart disease, breast cancer and hypertension. Binge drinking is associated with an increased prevalence of prescription drug misuse and use of other substances such as marijuana, stimulants and cocaine. Alcohol use during pregnancy is associated with preterm birth, stillbirth and miscarriage and can cause fetal alcohol spectrum disorder. Combined use of alcohol and cigarettes during pregnancy may also increase the risk of sudden infant death syndrome (SIDS). Very heavy alcohol consumption, defined as 14 or more drinks per week, may make conception difficult.

Excessive drinking is associated with losses in workplace productivity and increases in health care expenses, criminal justice expenses and expenses related to motor vehicle crashes and property damage. In 2010, excessive drinking cost the U.S. an estimated $249 billion or about $2.05 per alcoholic drink consumed.

According to America’s Health Rankings analysis, the prevalence of excessive drinking is highest among:

• Women ages 18-34 compared with older women ages 35-44.
• Non-Hispanic white women compared with Hispanic and Asian women. Hawaiian/Pacific Islander women also had a high prevalence.
• Women who are college graduates or have some post-high school education compared with women with less than a high school education.
• Women with an annual household income of $50,000 or more compared with those who have lower incomes. 
• Women living in metropolitan areas compared with those in non-metropolitan areas.

Using moderation when consuming alcohol can reduce the risk of adverse short- and long-term health outcomes. However, drinking alcohol while pregnant can be harmful. Alcohol passes to the baby through the umbilical cord and can cause lifelong disabilities. To help prevent unplanned or alcohol-exposed pregnancies, health care providers should engage in discussions with sexually active women who consume alcohol and recommend effective contraceptive methods when suitable.

The Centers for Disease Control and Prevention (CDC) has a tool that allows adults to evaluate their drinking behaviors anonymously and identify barriers and motivators to reducing alcohol consumption. 

The Community Preventive Services Task Force has published findings on several evidence-based interventions to prevent excessive drinking, including:

• Dram shop liability laws, which hold venue owners accountable if a customer buys a drink, leaves and causes harm to either themselves or someone else. 
• Electronic screening and brief interventions (e-SBI).
• Increasing alcohol taxes.

Healthy People 2030 has multiple goals related to excessive drinking, including:

• Increasing abstinence from alcohol among pregnant women. 
• Reducing the proportion of adults who engage in binge drinking.
• Reducing the proportion of people who had alcohol use disorder in the past year.

Elliott, Amy J., Hannah C. Kinney, Robin L. Haynes, Johan D. Dempers, Colleen Wright, William P. Fifer, Jyoti Angal, et al. “Concurrent Prenatal Drinking and Smoking Increases Risk for SIDS: Safe Passage Study Report.” EClinicalMedicine 19 (January 20, 2020): 100247. https://doi.org/10.1016/j.eclinm.2019.100247.

Esser, Marissa B., Gregory Leung, Adam Sherk, Michele K. Bohm, Yong Liu, Hua Lu, and Timothy S. Naimi. “Estimated Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 64 Years, 2015 to 2019.” JAMA Network Open 5, no. 11 (November 1, 2022): e2239485. https://doi.org/10.1001/jamanetworkopen.2022.39485.

Esser, Marissa B., Cassandra M. Pickens, Gary P. Jr. Guy, and Mary E. Evans. “Binge Drinking, Other Substance Use, and Concurrent Use in the U.S., 2016–2018.” American Journal of Preventive Medicine 60, no. 2 (February 1, 2021): 169–78. https://doi.org/10.1016/j.amepre.2020.08.025.

Fan, Dazhi, Li Liu, Qing Xia, Wen Wang, Shuzhen Wu, Guo Tian, Ying Liu, et al. “Female Alcohol Consumption and Fecundability: A Systematic Review and Dose-Response Meta-Analysis.” Scientific Reports 7, no. 1 (October 23, 2017): 13815. https://doi.org/10.1038/s41598-017-14261-8.

Green, Patricia P., Lela R. McKnight-Eily, Cheryl H. Tan, Roberto Mejia, and Clark H. Denny. “Vital Signs: Alcohol-Exposed Pregnancies — United States, 2011–2013.” MMWR. Morbidity and Mortality Weekly Report 65, no. 4 (February 5, 2016): 91–97. https://doi.org/10.15585/mmwr.mm6504a6.

Sacks, Jeffrey J., Katherine R. Gonzales, Ellen E. Bouchery, Laura E. Tomedi, and Robert D. Brewer. “2010 National and State Costs of Excessive Alcohol Consumption.” American Journal of Preventive Medicine 49, no. 5 (November 1, 2015): e73–79. https://doi.org/10.1016/j.amepre.2015.05.031.

White, Aaron M. “Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States.” Alcohol Research: Current Reviews 40, no. 2 (2020): 01. https://doi.org/10.35946/arcr.v40.2.01.

Wilsnack, Sharon C., Richard W. Wilsnack, and Lori Wolfgang Kantor. “Focus on: Women and the Costs of Alcohol Use.” Alcohol Research: Current Reviews 35, no. 2 (2013): 219–28.