March 1991
page 7
Health Information
Smoke Signals
Interested in a Health Career?
Once again the University of Oklahoma is offering the
Headlands Indian Health Careers Summer Prop-am to
American Indian students interested in a health career.
Students need to be either in their senior year of high
school or freshman year of college to attend.
The program is designed to increase the science and
mathematics backgrounds and communication skills of
students. Courses are offered b mathematics, chemis
try, physics, biology and communication.
All expenses are paid including room, board, tuition,
round trip airfare, plus a $300 stipend. Classes at the 8
week session are held at Mackinaw City, Michigan.
What a great opportunity! Call the office for more
details.
Health Professions
Pre-graduate
Scholarship Program
This program provides financial support for Indian
students only to enroll in courses leading to a baccalau
reate degree in specific pre-professional areas.
For the 1991-1992 scholarship cycle, an applicant must
be accepted by andor enrolled in a program beginning
in Fall 1991 for one of the priority career categories of:
Pre-medicinePre-dentistry - The applicant must be
enrolled in a bachelor degree program which will, upon
it's completion, prepare himher for entry into an
accredited medical, osteopathic, or dental school.
Within this category, priority is given to students in their
junior and senior year, with freshman and sophomores
funded only if there are remaining funds available.
Community Health
Representative Program
The CHR program was started in June, 1990 as a
component of the Tribal Health Program. Three
positions are funded by Indian Health Service through a
contract with the Tribe.
The CHR's are Darlene Aaron, who works with Tribal
members in Marion and Polk County, Joe Brisbois, who
works in Multnomah and Washington County and
Bonnie Martin, covering Tillamook and Yamhill
County.
These are some of the kinds of duties a CHR may
perform:
DIRECT PATIENT CARE
Home visits - monitoring patient health status.
Assist in Tribal Health Clinic
PATIENT ADVOCACY
Interpretation
Health liaison for continuity of care
Community liaison (community resource)
PATIENT EDUCATION
Provide information to patients, families, and other
community groups.
Monitoring patient sclf-care
Listening, advising, counseling
HEALTH PROMOTIONDISEASE PREVENTION
Assessing community health needs and environmental
health conditions
TRANSPORT
Transportation to medical providers for eligible mem
bers who do not have transportation available
If you have questions please call the Tribal
Office at 879-5211.
Experts Link Price to Alcohol Abuse
The Washington Post
For as long as people have missed work because of a
hangover, died prematurely of liver disease or crashed
their cars while drunk, health-policy experts have argued
about how best to control the drinkers who regularly
and dangerously abuse alcohol.
Now, as a result of congressional passage last year of
the largest increase in federal beer, wine and liquor
taxes since 1951, one of the more controversial of those
theories will be put to the test: Does raising the price of
alcohol reduce alcohol abuse?
Clearly, experts say, higher prices will cut the total
amount of alcohol consumed. As with many products,
the demand for beer, wine and spirits is said by econo
mists to be elastic, meaning that on average people will
buy more of it when it is cheap and less of it when the
price rises.
But is the behavior of the small percentage of problem
drinkers as elastic as that of the average consumer? Is a
teen-ager less likely to get drunk on a Saturday night, or
an alcoholic less likely to drink a fifth of Scotch because
each of their drinks costs them a few pennies more?
What has made this issue controversial is the fact that
in recent years the taxes placed on alcohol by federal,
state and local governments have never kept up with
inflation (not even after the recent federal-tax hike).
For example, if the federal taxes on liquor had been
adjusted for inflation from 1951 on, a standard-size
bottle of scotch would today cost an extra $5.50.
For those who see no correlation between alcohol
prices and alcohol abuse, this steady decline in the
relative price of beer, wine and liquor is of little more
than anecdotal interest.
But for the handful of economists, social-policy experts
and consumer groups, such as the Center for Science in
the Public Interest, who contend that prices matter even
to hard-core drinkers, this phenomenon has been little
short of a social catastrophe, resulting in far more
deaths, economic damage and social disruption than
would have been the case otherwise.
"The irony is that at a time when concern over the
damage done by alcohol abuse is peaking, (we) have
nonetheless failed to act on the single most effective
measure for actually doing something about it," Duke
University economist Philip Cook said.
At the heart of the idea that prices matter is the notion
that drinkers, even those addicted, aren't entirely
immune to outside influences on their behavior.
"People start with an image of what it means to be
alcohol dependent, that an alcoholic is beyond choice,"
Cook said. "But the other side is that the career of a
heavy drinker is a day-to-day thing...and attaching
immediate consequences to the decision of whether or
not to drink appears to have considerable influence even
on chronic alcoholics."
According to data derived from measuring the change
in consumption patterns in states that raise their alcohol
taxes, for example, heavy-drinking young people are very
susceptible to outside factors such as price.
Michael Grossman, City University of New York
economist, used that data to calculate what would have
happened had federal beer taxes been adjusted for
inflation and raised to match liquor taxes (two steps that
combined would raise the federal tax on a six-pack from
32 cents to $2.52).
He estimated that about 32 percent of heavy-drinking
16 to 21 year-olds (those who drink four to seven times a
week) would have cut their drinking dramatically, to one
to three times a week.
Grossman ran the same kind of analysis for auto
accidents. Here he calculated that simple indexing of
the beer excise tax from 1951 onward (equal to raising
the federal tax on a six-pack to 76 cents) would have so
reduced heavy-drinking episodes among young people
that it would have saved roughly 1,000 18 to 20 year-olds
a year in reduced car accidents.
Young people generally don't have much money and
haven't necessarily established a permanent drinking
habit, so their sensitivity to price makes sense. But
evidence exists that hardened adult drinkers also change.
Cook, for example, has looked at how mortality rates
from cirrhosis of the liver - a chronic disease commonly
but not exclusively related to alcohol abuse - change
when states raise alcohol taxes.
Cirrhosis is a good measure, he said, because it is a
disease that only the heaviest drinkers get. It is also a
degenerative disorder, the progress of which can be
interrupted is alcohol consumption is slowed. In other
words, if hardcore drinkers cut back their drinking
because of higher prices, that would be reflected almost
immediately in lower death rates.
When Cook looked at states that raised their liquor
taxes, that is exactly what he found.
Cook's research is controversial. First, cirrhosis rates
have been falling steadily during the past 20 years, which
makes it difficult to figure how much of a state's de
crease is due to higher taxes, and how much due to
overall improvement in the national health.
Second, even though only heavy drinkers tend to get
cirrhosis of the liver, the disease only strikes about 10
percent of the heavy-drinking population.
The data of Grossman and Cook also measure the
effects of very small hikes in alcohol prices. What is not
clear is whether the same favorable trends would
continue with more tax increases.
The experience of some European countries, for
example, is that boosting prices too high encourages the
production of cheaper, bootleg alcohol, undermining the
aim of a price increase.
Some analysts worry, too, that greatly increased alcohol
prices would encourage the "forbidden-fruit" syndrome,
inadvertently increasing the social perception of
alcohol's value.
The most serious objection to the work of Grossman
and Cook, however, concerns the definition of a hard
ened drinker.
"Anyone who has studied and understood people with
these problems as I have knows this (idea) is a mythol
ogy," said Morris Chafetz, founding director of the
National Institute on Alcoholism and Alcohol Abuse
and President of the Health Education Foundation.
"People come up with mathematical formulas and
forget that (alcoholics) don't follow mathematical
formulas. ...Kitty Dukakis said that when she couldn't
get alcohol, she drank rubbing alcohol. Even people on
skid row manage to get alcohol. Their need is so great
that they are simply not price sensitive."