Binge drinkers report sub-optimal health status more often than non-binge drinkers

Results will be published in the August 2010 issue of Alcoholism: Clinical & Experimental Research.

"Self-rated health (SRH) is a single question that has been used by many national and international health surveys to measure participants' perception of their overall health status," explained James Tsai, an epidemiologist at the CDC and corresponding author for the study. "Several decades of research has accumulated substantial and consistent evidence that SRH is strong predictor of future morbidity and mortality, as well as functional decline and health care utilization."

"Binge drinking − defined as four or more drinks per occasion for a woman, and five or more drinks per occasion for a man − is a dangerous pattern of alcohol consumption that is associated with a wide range of health and social problems in the U.S., including car crashes, violence, STDs, and unintended pregnancies," added Robert D. Brewer, alcohol program leader at the CDC. "What's more, adult binge drinkers typically … consume an average of about eight drinks per binge episode, well in excess of the cut-points used to define this behavior. Even so, most binge drinkers are not alcohol dependent."

Researchers examined a total of 200,587 adult, current drinkers (89,919 men, 110,668 women) who participated in the 2008 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS asked participants to rate their health by answering the question: "Would you say that, in general, your health is excellent, very good, good, fair, or poor?" Study authors then estimated the prevalence of binge drinking and heavy drinking (defined as an average of 14 drinks per week for men, and seven or more drinks per week for women), as well as the frequency of binge drinking (defined as the number of binge episodes reported by drinkers during a 30-day period). SRH was then divided into the categories of optimal (excellent, very good, or good) and suboptimal (fair or poor).

"The results indicate that binge drinking continues to be a serious public health concern across the lifespan," said Tsai. "Almost 35 million adults reported binge drinking in 2008, and more than 40 percent of these binge drinkers reported four or more episodes of binge drinking during the previous 30 days. Furthermore, frequent binge drinkers and binge drinkers who report high average daily alcohol consumption heavy drinking, are significantly more likely to report suboptimal self-rated health. In addition, these levels of binge drinking were associated with a 13 to 23 percent increased likelihood of reporting suboptimal SRH, when compared to non-binge drinkers."

"These results are significant because persons who report lower self-rated health are at greater risk of hospitalization and death than persons who report higher self-reported health," said Brewer. "Consequently, this study adds to the growing body of scientific evidence showing that binge drinking is associated with a with many serious public health outcomes, including hospitalizations and deaths."

"These results support broad-based implementation of screening and brief interventions for excessive drinking in health-care settings," said Tsai. "The magnitude of the prevalence of binge drinking and the estimated population size also underscores the need to identify and implement effective population-based prevention and intervention strategies."

Brewer concurs. "Although not specifically discussed in this paper, most binge drinkers who report high average daily alcohol consumption tend to binge drink frequently, and may consume more drinks per binge drinking episode as well," he said. "This emphasizes the need to implement effective population-based strategies for preventing binge drinking, including increasing alcohol-excise taxes, limiting alcohol outlet density, and restricting the days and hours when alcohol is sold."