Alcohol Control Policy and the Blackfeet Reservation: A Study of Attitudes toward Alcohol.

AbstractExcessive consumption of alcohol is a worldwide health and social problem that manifested in the local tribal communities. The purpose of this study was to describe the attitudes of those on the Blackfeet Reservation concerning an alcohol control policy for the Reservation. The survey results from a stratified sample of 400 participants revealed strong support for an alcohol control policy for the Blackfeet Reservation. Factor analysis of the survey instrument demonstrated that clarity and validity can be provided for an instrument that is generated from specific perceived community interests rather than from a general literature search. Discriminant analysis was used to describe the differences between those who supported and those who opposed an alcohol control policy for the reservation. Cluster analysis was used to explore for naturally-occurring groups based on the 400 responses to the 26 items in the survey. Finally, conclusions were drawn based on the survey results for making recommendations to policy makers concerning an alcohol control policy for the reservation.Alcohol Control PolicyExcessive consumption of alcohol is a worldwide health and social problem; "alcohol is a significant contributor to morbidity and mortality in the United States and worldwide" (Nelson et al., 2005, p. 441). Internationally, "alcohol consumption contributes to more than 60 health problems that cause an estimated 4% of the global disease burden" (Brand et al, 2007, p. 752). Many countries have implemented various alcohol control policies in order to address problems caused by alcohol abuse or from drinking beyond moderation. These countries include Latvia which has the highest per capita alcohol consumption rate in the world as a result of the greater availability of alcohol that resulted from the policies that liberalized the alcohol market following its independence in 1989 (Strazdins, 1995). The Netherlands implemented a comprehensive alcohol control policy of increased education, efficient treatment, and new legislation in 1986 after its alcohol consumption rate tripled between 1960 and 1980 (Ginneken & Iwaarden, 1989, p. 109). While the five Nordic Countries of Denmark, Finland, Iceland, Norway, and Sweden have a long history of alcohol control policies (Room, 2002), others like India (The Hindu, October 12, 2008) have recently begun to discuss a policy. In the United States, the primary alcohol control policy since 1984 has been to have a national minimum legal drinking age of 21 years (Wechsler & Nelson, 2010). Nevertheless, alcohol abuse is a significant concern on US college campuses because excessive alcohol consumption has been associated with a wide variety of health, safety, and academic issues (Lavigne et al, 2008, p. 749). This global problem is manifested in the local tribal communities. "Alcohol abuse and alcoholism are the leading health problems among American Indian communities" (May, 1992, p. 5). American Indians and Alaska Natives have a disproportionally high rate of alcohol misuse (Cummins et al., 2003, p. 727), and high rates of morbidity and mortality can be related to this alcohol use (Harris et al., 2003, p. 458). Compared to other ethnic groups, "Native Americans have higher rates of alcohol use, frequency of use, and increased rates of fetal alcohol syndrome" (Szlemko, Wood, & Thurman, 2006, p. 435). The rates of preventable deaths among Native American adults is 133% higher than for European Americans, and the rates for liver disease are 6 times higher (Stone et al., 2006, p. 236). The death rate for Alaska Natives from injuries is nearly five times that of the national rate (Berman, Hull, & May, 2000, p. 311). "Alcohol plays a part in most of these deaths" (p. 311). These dismal statistics are made even worse by the fact that for Native Americans "alcohol is the drug of choice among youth, often with devastating consequences. Alcohol is a leading contributor to injury death, the main cause of death for people under age 2 1 " (Faden & Goldman, 2004/2005, p. …