Problem drinking: rural and urban trends in America, 1995/1997 to 2003.
OBJECTIVE
Studies examining trends in problem alcohol use for U.S. adults residing in rural locations are lacking. This study examines recent trends in heavy and binge drinking in urban counties and three types of rural counties.


METHODS
Random-digit telephone survey of adults aged 18 years or older residing in states participating in the Behavioral Risk Factor Surveillance System, in the years 1995/1997 (n = 247,255), 1999/2001 (n = 362,077) and 2003 (n = 257,659). Analyses were performed in 2006.


RESULTS
Metropolitan counties experienced higher prevalence of heavy and binge drinking than rural counties in all years, and all geographic areas showed upward trends in both drinking behaviors. Trends in heavy drinking were sharper in rural counties (3.8% to 5.4% compared with 4.9% to 6.0% in metro counties). Metropolitan and rural counties overall saw similar increases in binge drinking, however, the greatest increase occurred in remote micropolitan counties (12.7% to 15.7%).


CONCLUSIONS
Heavy and binge drinking are problems that continue to increase in rural areas nationwide. Because of the difficulties inherent in accessing and administering substance abuse treatment in rural areas, special attention should be given to tailoring alcohol abuse interventions to the needs of rural residents.
Department of Family Medicine, University of Washington, Seattle, WA 98195, USA. bjackson@u.washington.edu
J Elizabeth
JE
Jackson
Mark P
MP
Doescher
L Gary
LG
Hart
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control* / Q000639:trends; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012424:Rural Population; D014481:United States / Q000453:epidemiology; D014505:Urban Population