Alcohol-involved problems are a serious public health issue. Total annual alcohol-related deaths in the United States are estimated at 88,000 representing roughly 2.5 million years of potential life lost annually, or an average of about 30 years of potential life lost for each death, according to the Center for Disease Control and Prevention. The economic costs of excessive alcohol consumption are staggering, estimated at over 200 billion dollars each year (CDC, 2010).
PRC has always taken a public health perspective in which health and social well-being are seen to be functions of the interactions between individuals and their larger social and physical environments. Individuals are nested within these different environments, with each environment having its own characteristic features that interact with others (see Public Health Model).
At the Individual level are intra-personal factors that characterize drinking behaviors, including genetic predispositions, personality factors, drinking patterns, personal knowledge and values about alcohol, and life skills. Individual drinkers use alcohol in Drinking Contexts, which are local social and physical drinking environments that contribute to patterns of consumption. These contexts include alcohol outlets, drinking groups, and social and lifestyle factors related to drinking. Drinking in these contexts may lead to specific problems like drinking and driving and violent injury (e.g., assaults, homicide).
Two key social environments in which drinkers use alcohol are within Family and Peer groups; studies of which focus on the influences of family and peer groups on drinking; the role of acculturation for ethnic populations; the effects of ethnic, social, and gender group membership; and the role of adolescent access to alcohol at home. Drinking also takes place in association with the Workplace. These studies focus on drinking patterns and habits associated with workplace environments, including drinking with co-workers, the role of workplace alcohol policies and social control on drinking.
These environments are nested within the Community. Research at this level focuses upon studies of the community as a collection of social, cultural, economic and regulatory systems in which alcohol use and misuse occurs; the design, implementation, and evaluation of mutually reinforcing prevention interventions at the community level; and the impacts of local regulations on alcohol access.
The Regulatory Environment concerns studies that examine factors that influence alcohol availability and access, including formal state and federal regulations; the economic and social influence of price, income, and alcohol taxes; and physical availability.
The components of communities that impact alcohol use must be clearly delineated and their dynamic inter-relationships identified in order to represent these dynamic effects. One simple model developed from this perspective is our Community Systems Model. As the figure shows, a variety of community systems influence drinking. These include Social Control and Communication, those social systems which provide information about alcohol use, problems, and constraints; and Retail Sales by Beverage Type, those commercial systems that enable access to alcoholic beverages. These systems directly affect consumption, but a large number of other aspects of community environments are indirectly related to alcohol use. These include Social, Health and Economic Consequences, those systems that respond to drinking problems, like hospital emergency departments; Legal Actions about Drinking, and enforcement and regulatory systems intended to enforce alcohol policy.
Returning to our example, family and peer programs may be seen to affect systems of Social Control and Communication to reduce youth drinking while the Community Economic Sector and Retail Sales act to increase availability and youth access to alcohol. Systems components such as these can work together or in conflict to influence rates of problems related to alcohol in community settings.
Taken together, the Public Model and Systems Model demonstrate that analyses of the environmental determinants of drinking and problems should consider two types of information: (1) the multiple environments in which drinking behaviors take place (the Public Health model) and (2) the behavioral, social, economic and political systems that inter-relate and affect those drinking environments (the Community Systems model). The goals of the Center are to expose this complexity in order to determine those facets of community environments and systems that can best be used to reduce alcohol problems.
The environments in which people drink include work, family, and social groups in informal and commercial settings. Alcohol use is shaped by social and economic factors, and by national, state and local policies. Therefore, environmental approaches to prevention must examine this ecological complexity to find the best environmental strategies to reduce use, abuse, and related problems. The efficacy and effectiveness must then be tested in quasi-experimental and natural settings, and conditions which assure success or failure identified. These reflect the goals of our Center: (1) to undertake innovative basic research that contributes to the development of cost-effective environmental prevention programs and policies at the local, state, and national levels; (2) to undertake research of applied and/or practical importance to policies and programs to prevent alcohol-, tobacco-, and other drug-related problems; (3) to summarize and synthesize new and existing knowledge about prevention theories, policies, and programs, and to disseminate this information to professional, academic, and community audiences; and (4) to provide multidisciplinary training and research opportunities.