Comorbidity of alcohol abuse and dependence with medical conditions in 2 American Indian reservation communities.
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.
American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Aurora, Colorado 80045-0508, USA. jay.shore@uchsc.edu
Jay H
JH
Shore
Janette
J
Beals
Heather
H
Orton
Dedra
D
Buchwald
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006311:Hearing Disorders / Q000150:complications; D006801:Humans; D007198:Indians, North American; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011203:Poverty / Q000706:statistics & numerical data; D013180:Sprains and Strains / Q000150:complications; D014786:Vision Disorders / Q000150:complications