|
|
|
The alcohol factor:
Health educators weigh in on loaded issue
Too many times, we have read the headlines and heard the news
reports of tragedy where alcohol was a factor. A life has been ended
by a traffic accident. There are additional tragic stories that don’t
make headlines. A friend dies prematurely due to alcohol related disease;
a marriage or relationship ends; a child or spouse experiences abuse
or neglect; a job is lost: alcohol was a factor.
Alcohol is omnipresent in our culture and has been since our very beginnings.
Looking back more than 350 years ago, it seems that alcohol has been
a part of the American lifestyle since the colonists arrived. It has
been written that when the Puritans set sail to Massachusetts, they
had taken care to bring with them forty-two tons of beer and 10,000
gallons of wine in contrast to fourteen tons of water.
What has challenged me in my health education mission of promoting healthy
lifestyles is the “personal values” component. The topic can
vary from tobacco use, safety belt and helmet use to diet choices. But
the common denominator always is there—personal choice, opinion
or even attitude.
A model standard of practice in health education includes measuring
three components—knowledge, attitude and behavior. We measure the
success of our health education methodologies in positive changes in
each of these areas.
Did we educate? Did we provide enough information to impact a person’s
attitude to the level that motivated them to change from a negative
behavior to a positive behavior? And better yet, did we provide them
with enough environmental support to sustain that behavior change?
From that first step, that “educational get-go,” from that
beginning knowledge component, we experience the presence of personal
values, opinion and attitude. That presence can create a very complicated
and delicate setting.
For example, health professionals often use various screening and assessment
tools to determine an individual’s level of wellness. Inherent
in such tools are questions related to the alcohol factor.
Such questions pertain to the frequency and amount of alcohol consumed
or a self assessment using a rating scale as to whether alcohol has
caused problems.
The screening or assessment may offer six drinks in one setting or one
to three drinks, two to three times a week as a response.
In other words, in your opinion, is your use of alcohol a factor in
your health status? How does your use of alcohol compare to a standard?
A standard that may be interpreted as representing the values of a health
professional.
A health promotion message often asks a person to “use alcohol
in moderation” or to “drink responsibly.” But again,
by whose measure and by whose values is a level of moderation determined?
These queries cause a person to reflect on their personal practices
and perhaps on the culture within their family. A person’s life
experiences contribute to the manner in which values are formed.
Families celebrate with alcohol; glasses are raised to toast the bride
and groom; a fine dinner is accompanied by a fine bottle of wine; a
cool mug of beer is a natural after a softball game; a barrel of beer
with friends at camp; or a stop for one drink with friends on the way
home from work.
Who’s to say how much is too much? When does alcohol become a factor?
Health professionals have educated, data-driven responses; individuals
have personal opinions.
And so the challenge in health education begins when knowledge conflicts
with attitudes and opinions.
A health educator is aware of the importance of “environmental
support” in sustaining personal health behavior choices. The environment
is represented by the community in which we live—and it can offer
a positive or negative influence on the alcohol factor.
What about the norms and values of the community? And what role does
the community have in shaping or supporting personal values or vice
versa? And further still, what role does our government have with regard
to the alcohol factor?
Even the colonists soon realized the consequences associated with the
alcohol factor. For example, the Plymouth Colony in 1633 prohibited
the sale of spirits “more than two pence worth to anyone but strangers
just arrived.” In 1637, Massachusetts ordered that no person shall
remain in any tavern “longer than necessary occasions.”
Yes, alcohol remains a significant factor from a community and governance
perspective. It is taxed, licenses must be obtained to sell it, there
are restrictions when and were alcohol can be sold and at what age it
can be purchased.
A person’s definition of community and attitudes about community
and government’s role in personal choices is another example of
a very value-laden arena.
I remember two things very clearly about Marquette when I moved here
in the early 1980s. The first was as I watched the Fourth of July parade
curbside on Third Street; I noticed numerous personal coolers containing
alcohol.
Secondly, immediately after the parade I went down to the lakeshore
and it snowed. Both of these memories were in stark contrast to my former
downstate community.
In the past two to three decades, the health education profession has
grown in scope and adopted an additional moniker—“health promotion,
disease prevention.”
We are not only going to educate, we are going to actively promote healthy
behavior and make the connections of behaviors in preventing disease.
Education and prevention are most effective when started as early in
a person’s life as possible. We seek to make an impact on children
early so healthy habits become their values and positive personal health
practices.
Don’t wait until someone has a twenty-year tobacco habit. Prevent
the habit and you are likely to prevent or postpone disease.
And so it is with the alcohol factor.
While a personal health issue may be politically difficult to address
with adults (i.e. I can make my own decisions), that barrier is not
so vocal when it comes to children.
In fact, experience has shown that taking a “protecting children
first” route has proven to be an effective first step. For example,
in the early 1980s, health professionals knew from the data that lack
of adult’s safety belt use and car safety seats for children was
a significant contributing factor to the number of deaths resulting
from traffic accidents.
Yet those same health professionals knew they did not have the political
will or the support of decision makers, to enact legislation requiring
safety belt use. The answer was to first enact a series of Child Passenger
Safety laws...protect children first.
Several years later, with new data that indicated the number of children’s
lives that were being saved, the road was paved for adult legislation
and Michigan’s seat belt law went into effect. The opposition was
there and the opinions of “the seat belt is in my vehicle, I will
use it if I chose” were heard. Yet, the environmental support in
the form of legislation prevailed over individual values, opinions and
attitudes.
And so how is the alcohol factor affecting our youth?
According to the National Academy of Sciences, alcohol use by young
people is extremely dangerous—both to themselves and society at
large.
Underage alcohol use is associated with traffic fatalities, violence,
unsafe sex, suicide, educational failure and other problem behaviors
that diminish the prospects of future success, as well as health risks.
And the earlier teens start drinking, the greater the danger.
“Marquette County Kids & Alcohol: A Town Hall Meeting”
is scheduled for 5:30 p.m. on April 3 at the MARESA office, located
at 321 East Ohio Street in Marquette. It has a colonial ring to it:
town hall meeting. I can almost hear the City Hall bell ringing and
envision a mass of residents converging on town square.
The need still exists in 2006 for a community gathering to discuss an
issue that affects every household and every taxpayer: the alcohol factor.
This event will set the stage with local statistics on youth and alcohol
use. It will be followed by stories illustrating the impacts of alcohol
use on youth from medical and emergency response personnel.
There will be stories told by youth themselves about how alcohol has
affected their lives, and how they have overcome the consequences.
The expectation is that by the end of the gathering, some consensus
can be reached as to what can be done. How can this community come together
and reduce or eliminate the negative impacts of alcohol on youth?
We should congratulate the organizers and all who participate. They
have a great challenge before them.
They are attempting to tackle an important health topic rampant with
values, opinions and attitudes. They are attempting to initiate change
and create a supportive community environment, a collective vision for
the future of the community. They are attempting to assure that youth
of today have an opportunity to grow to their fullest potential. They
recognize that our youth of today are our decision-makers of the future.
I wish them well.
—Leslie Bek
Editor’s Note: For details on the town hall meeting, call 315-2614.
Coping with diabetes
How those with the disease can avoid heart attack or stroke
Carol Grafford, a diabetes educator at Portage Health System in Hancock,
has lived with diabetes for more than thirty years. Simply having diabetes
increases her chances of having a heart attack or stroke by 400 to 600
percent.
Fortunately, Grafford knows she doesn’t have to sit back and wait
for a stroke or heart attack to happen. There are many things she does
that have been shown to maintain heart health. They include:
• Being a non-smoker and avoiding second-hand smoke as much
as possible.
• Keeping cholesterol and blood fats under control—For
many people with diabetes, an LDL (bad cholesterol) level less than
70 mg/dL, HDL (good cholesterol) more than 40 mg/dL (men) or 50 mg/dL
(women), and triglycerides less than 150 mg/dL are desirable. Grafford
keeps her meat portions small and makes certain to include heart-healthy
fats and plenty of vegetables, fruit and whole grains in her diet.
• Controlling blood pressure—Always strive for less than
130/80 mmHg. Eating fruits and vegetables, being active and limiting
salt and alcohol help keep blood pressure under control, too.
• Staying physically active at least thirty minutes a day—Grafford
does this through walking. In addition, she does yoga.
• Losing weight if overweight—Grafford doesn’t have
a weight problem, but this is a concern for many people with diabetes.
Even a ten-pound weight loss can help.
• Keeping blood sugar under control—An A1c level (long-term
measure of blood glucose ) of less than seven percent is recommended.
Since Grafford has Type 1 diabetes, she has to use insulin to control
her blood sugar.
Currently, she uses an insulin pump and checks her blood glucose several
times a day, adjusting the amount of insulin she receives from
her pump based on her blood glucose readings, amount and types of food
she eats and her physical activity level.
• Controlling stress levels—For Grafford, yoga has been
a big factor in managing stress. She also works hard to balance work,
family and fun.
• Avoiding large amounts of alcohol— Grafford chooses
not to drink at all, although cardiologists say one drink per day may
be good for your heart.
• Taking medications as prescribed and getting regular check-ups.
All of these controllable heart attack and stroke risk factors are related
to how we live.
While medications and insulin are important for many with diabetes,
they are not the sole solution. Food, physical activity and staying
tobacco-free are important considerations.
“I think of my body as an incredible gift that lets me do the things
in life that are important to me,” Grafford said. “If I take
good care of my body, I’ll be able to do those things a whole lot
longer.”
To help keep your heart working properly, the Upper Michigan Cardiovascular
Associates and the U.P. Diabetes Outreach Network (UPDON) have teamed
up to provide a free recipe booklet. It includes several tasty yet heart
healthy recipes along with a “Recipe for a Healthy Heart”—the
steps you can take to lower your risk of having a stroke or heart attack.
Various recipes are available at www.diabetesinmichigan.org (click on
Heart Health at the top of the page).
There are more than 19,000 people in the U.P. who have diabetes. An
additional 8,000 U.P. residents are believed to have undiagnosed diabetes.
Also, more than forty percent of adults between the ages of forty and
seventy-four are believed to have pre-diabetes, a condition that can
lead to diabetes if left untreated.
People at risk for developing diabetes are encouraged to visit their
health care provider and get a simple blood test to help diagnose diabetes.
Everyone over the age of forty-five should consider being tested for
diabetes every three years.
If you are under the age of forty-five, overweight and have one or more
of the following risk factors, you should be tested for diabetes. These
risk factors include:
• A family member with diabetes
• Family background of American Indian, African American,
Asian American, pacific Islander or Hispanic American/Latino
• Having gestational diabetes or have given birth to a baby
weighing more than nine pounds
• Blood pressure of 140/90 or higher
• Blood cholesterol levels are not normal
• Physically active less than three times per week.
Additionally, if you have any signs or symptoms of diabetes, you should
see your health care provider right away. They include:
• Increased thirst
• Increased hunger
• Fatigue
• Unexplained weight loss
• Blurred vision
• Sores that do not heal
• Increased urination
Many people with diabetes have no signs or symptoms.
Diabetes can be prevented, but it cannot be cured. People with diabetes
and those at risk for developing diabetes are at higher risk for developing
heart disease. Take action today.
Get tested if you are at risk for developing diabetes. If you have diabetes
or any diabetes risk factors, take action to improve your lifestyle
to keep your heart healthy.
For more information about diabetes and pre-diabetes, call the U.P.
Diabetes Outreach Network at (800)369-9522.
If you are concerned about your heart health, ask your health care provider
if a visit to the Upper Michigan Cardiovascular Associates is needed.
To learn more, visit www.upheart.net
—Ann Constance
|
