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Comorbidity of Alcohol Abuse and Dependence with Medical Conditions in 2 American Indian Reservation Communities

Authors

  • Jay H. Shore,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Aurora, Colorado
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  • Janette Beals,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Aurora, Colorado
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  • Heather Orton,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Aurora, Colorado
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  • Dedra Buchwald,

    1. Department of Medicine, University of Washington, Harborview Medical Center, Seattle, Washington (DB).
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  • the AI-SUPERPFP Team

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Aurora, Colorado
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  • The study was supported by National Institutes of Health Grants 1F32 MH63527-01A1(JHS, PI) R01 MH48174 (SMM, JB, PIs), P01 MH42473 (SMM, PI), AA13800 (DN, PI), and R01 AA13420 (JB, PI).

  • In addition to the above, the AI-SUPERPFP team includes Cecelia K. Big Crow, Buck Chambers, Michelle L. Christensen, Denise A. Dillard, Karen DuBray, Paula A. Espinoza, Candace M. Fleming, Ann Wilson Frederick, Joseph Gone, Diana Gurley, Lori L. Jervis, Shirlene M. Jim, Carol E. Kaufman, Ellen M. Keane, Suzell A. Klein, Denise Lee, Spero M. Manson, Monica C. McNulty, Denise L. Middlebrook, Christina M. Mitchell, Laurie A. Moore, Tilda D. Nez, Ilena M. Norton, Douglas K. Novins, Theresa O'Nell, Heather D. Orton, Carlette J. Randall, Angela Sam, James H. Shore, Sylvia G. Simpson, Paul Spicer, and Lorette L. Yazzie.

Reprint requests: Jay Shore, MD, MPH, American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, P.O. Box 6508 Mail Stop F800, Aurora, CO 80045-0508; Fax: 303-724-1474; E-mail: jay.shore@uchsc.edu

Abstract

Background: The objective was to examine the association of self-reported Diagnostic and Statistical Manual–IV edition alcohol abuse and dependence with medical conditions among American Indians (AIs).

Methods: We analyzed data previously collected in a large epidemiological study of members of 2 culturally distinct AI tribes from the Southwest (SW; n=1,446) and the Northern Plains (NP; n=1,638) living on or near their reservations. Associations of combined self-reported alcohol abuse and alcohol dependence with 19 medical conditions were examined through multinomial logistic regression.

Results: Medical conditions that had significant relationships with alcohol abuse/dependence were sprains and strains [odds ratio (OR) 2.04, p<0.001], hearing and vision problems (OR 2.05, p<0.001), kidney and bladder problems (OR 1.55, p<0.01), head injuries (OR 2.20, p<0.001), pneumonia/tuberculosis (OR 1.49, p<0.01), dental problems (OR 1.89, p<0.001), and liver problems/pancreatitis (OR 2.18, p<0.001). The total count of medical conditions was also significantly related to alcohol abuse/dependence, with a higher count being associated with the outcome (OR 1.17, p<0.001).

Conclusions: In this community-based study of rural AIs, diverse medical conditions were associated with alcohol abuse and dependence. Further research should examine, and confirm, the nature, extent, and tribal variation of the medical consequences of alcohol abuse and dependence in these unique populations.

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