SARASOTA COUNTY BINGE DRINKING 1

Sarasota County Evidence Based Practices

Jordan Dillmore
University of South Florida
College of Nursing














SARASOTA COUNTY BINGE DRINKING 2

Introduction
Sarasota County, Florida is urban but it has its relaxed, yet not rural areas as well.
Sarasota is on the West Coast of Florida and flows directly up the coast line. It covers 572 square
miles with 153.6 square miles of water (City-Data, 2012). According to the Economic
Development Corporation of Sarasota County (EDC), the top three major government employers
for Sarasota County are the School Board of Sarasota County, Sarasota Memorial Healthcare
System, and Sarasota County (EDC, 2013). The major private employers are Publix, Venice
Regional Medical Center, and PGT Industries (EDC, 2013). There are many large health care
facilities that serve Sarasota County including All Childrens Specialty Care of Sarasota, Doctors
Hospital of Sarasota, Englewood Community Hospital, Venice Regional Medical Center,
Sarasota Memorial Health Care System, and HealthSouth (EDC, 2013). Sarasota happens to
have a massive art industry and according to Southern Living Magazine, it is the nations per
capita arts capital. It houses the original Ringling Brothers Museum with many world-
renowned circus schools, the Van Wezel Performing Arts Hall, and many festivals such as the
Sarasota Jazz Festival and the Sarasota Film and Comedy Festivals. Sarasota is also home to the
Sarasota Orchestra, the Sarasota Ballet of Florida, and the Sarasota Opera (EDC, 2013). It is safe
to say that Sarasota has an artistic culture which draws so much of the countys tourism.
Population and Socioeconomic Factors
Sarasotas residents are mainly in the 35-64 years of age group, making the population
fairly young (DOH, 2013). According to the United States Census, Sarasota is 75.4% White,
15.1% Black, and 16.6% Hispanic (City-Data, 2012). When compared to the people in the entire
state of Florida, the US Department of Commerce (USDOC) says that 75% are White, 16% are
Black, and 22.5% are Hispanic (USDOC, 2013). Sarasota is mainly an English-speaking county
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with only 12.4% of the people over five years of age not speaking English (Index mundi, 2013).
Meanwhile, Florida is linguistically diverse with 26.6% of people over five that do not speak
English (Index mundi, 2013). According to the US Department of Commerce, Sarasota County is
ahead of the game in the realm of socioeconomic status as they have a higher percentage (90.6%)
than the state of Florida (85.3%) when measuring the percentage of people over 25 years of age
with a high school diploma. Sarasota (12.9%) is slightly advanced compared to the State of
Florida (14.9%) in its poverty level (USDOC, 2012). According to this information, Sarasotas
lead could stem from the language nearly being unanimous and the elevated high school
graduation rate.
Analysis of Strengths and Needs
According to the Health Planning Council of Southwest Florida (HPCOSF, Sarasota
County is ranked number five out of sixty-seven counties in the state of Florida for general
health, which is a remarkable achievement (HPCOSF, 2013). Three concerns of health in
Sarasota County are particularly strong in heart disease, hepatitis B, and syphilis. Heart Disease
is a broad term that includes any of the following: high blood pressure, high cholesterol, chest
pain, abnormal heart rhythms, or even heart failure (WebMD, 2013). Heart disease is a leading
cause of death in Sarasota County, Florida, and the entire Unites States but Sarasota Countys
rates of occurrence are lower than Floridas and that of the United States as well. In Sarasota, it
only affects 112.8 per 100,000 people compared to Floridas 150.8 per 100,000 people (HPCOS,
2013). According to the Center for Disease Control, hepatitis B is an infection that attacks the
liver, which is spread by excretions of bodily fluids (CDC, 2012). The liver disease can be acute
or chronic, chronic meaning that it has remained in the persons system for more than six months
and can lead to serious illness and even death (CDC, 2012). Sarasota is currently ahead of the
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state of Florida in terms of the rate per 100,000 people with Hepatitis B. In 2006, Sarasota was at
.77 and Florida was at 2.46, which is a considerable difference (DOH, 2009). Although,
prevention of hepatitis B has become a priority in that last few years and currently, Sarasota
County has zero cases while Florida has five (DOH, 2013). Syphilis is the next significant
strength that Sarasota County values. Syphilis is a sexually transmitted disease which is easy to
cure in the early stages of its development. Syphilis presents as a small, firm, and round sore on
the anus, genitals, or mouth or as a rash on the palms of the hands or the soles of the feet (DOH,
2013). Syphilis in Sarasota County is present in 2.8 per 100,000 people and in Florida in 6.7 per
100,000 people (DOH, 2013). Sarasota is ranked highly in terms of the health conditions of the
people in the county for many reasons but the most dramatic instances according to percentages
and rates are heart disease, hepatitis B, and syphilis.
Although Florida is ranked very highly in health, there is still potential and need to strive
for improvement in particular areas such as first trimester pre-natal care, binge/heavy drinking,
and tuberculosis. First trimester pre-natal care begins with an initial appointment with a
Gynecologist/Obstetrician of ones choice to discuss necessary adjustments for the babys health
(Mayoclinic, 2013). Sarasota County is lacking in this care compared to Florida itself with
77.7% of mothers following this advice versus 79.9% This percentage places Sarasota into the
second quartile for all of Florida counties when comparing first trimester prenatal care (DOH,
2013). Binge/heavy drinking is a serious issue in the United States as a whole and Sarasota is a
contributor to those negative percentages. Binge/heavy drinking is defined as a pattern of
drinking that brings a persons blood alcohol level to 0.08 grams percent or above. According to
the Center for Disease Control and Prevention, this usually occurs at four drinks for females and
five for males (Center for Disease Control, 2013). According to the Department of Health
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(DOH), Sarasota Countys population has 16.4% of their adults that binge/or heavily drink, yet
Florida only has 15.0% (Department of Health, 2013). Overall, Sarasota is behind and has more
people who binge drink. The last weakness in Sarasota County is tuberculosis. According to the
Center for Disease Control, tuberculosis (TB) is caused by a bacteria that usually attacks the
lungs but it can also attack the spine, kidneys, and brain (CDC, 2013). TB is spread through the
air, not by sharing food or drinks or touching the belongings of someone with TB (CDC, 2013).
In 2010, there were 4.6 cases of TB per 100,000 people in Sarasota County and 3.9 per 100,000
people residing anywhere in Florida (HPCOSF, 2013). With a little effort, the Sarasota County
community can intervene and lower the percentages to be consistent with the entire state of
Florida.
Priority Health Issue
Binge/heavy drinking is the priority health issue in Sarasota County. Binge drinking is
the drinking of alcohol to the point where the blood alcohol level is at or beyond 0.08 grams
percent or above (CDC, 2013). It is important to focus on heavy drinking as a priority in health
because this minor act can cause serious illnesses and damage various organs and it is
completely preventable. The preventability of this illness makes it all the more important to
focus on so that the health of Sarasota County residents can be better based on the complications
from heavy alcohol consumption.
The determinant of health model was created by the Department of Health and Human
Services in Healthy People 2020 and it is based on two questions: what makes some people
healthy and others not and how to create a society in which everyone has the ability to live long
lives (US Department of Health and Human Services, 2012)? Healthy People 2020 names
several social, personal, and environmental factors, which interrelate to play a part in health
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status including human biology, environment, and lifestyle (USDHHS 2012). Knowing and
relating these factors helps a community health nurse to address the population of heavy alcohol
consumers in Sarasota County and attempt to conjure interventions for them.
Human biology plays a large role because it has been shown that alcohol is very
addicting and affects mental health (Park, 2013). When alcohol enters the blood stream, there are
many changes that occur in the body- some positive and others negative. Some positive effects
are that the drinker gets the feeling of confidence and their tensions are relieved (Park, 2013).
Negatively, one can get very sick and damage their organs. A positive effect of drinking is the
elimination of stress in some people (Sayette, 1999). Cross-sectional studies have found that
drinking frequency and quantity are associated with positive drinking consequences (Park,
2013).
The environment of the individual goes hand in hand with human biology in terms of the
genes in the body dealing with alcohol and the environment the body is in. The National Institute
on Alcohol Abuse and Alcoholism (NIAAA) has studied the effects of a stressful environment
on the promoter region of the serotonin transporter gene which represents the reactions to alcohol
(Dick & Kendler, 2012). The NIAAA has studied this topic thoroughly and has determined that a
stressful environment enhanced the risk for this allele to react to the alcohol consumed (Dick &
Kendler, 2012). The environment of someone subject to binge drink highly correlates with the
persons lifestyle as well.
When college students were asked what was important, the bulk of them chose that the
availability of beer in the students room and the overall importance of drinking in college is
high (Wechsler, et al, 1995). It was also determined that being a white male and living a single
lifestyle elevated the occurrence of binge drinking (Wechsler et al, 1995). These are just some
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examples of lifestyles that promote heavy drinking, but there are health issues related to alcohol
consumption in many different lifestyles which make this behavior so much more detrimental to
the overall health of Sarasota County.
The environment and lifestyle of a person determines when they will begin drinking and
why, and the human biology determines how the drinking will affect them and if they will want
to continue. Taking a deeper look in the environment and lifestyle, it was determined that college
induces a stressful and pro-binge drinking environment. The incidences of alcohol binging occur
with large variations by age group, for example in Sarasota County the incidence for people 18-
44 is 24.1%, 16.6% for people 45-64, and 9.3% of people aged 65 and older (DOH, 2013).
Comparatively, Floridas rates are 20.9% for 18-44 year olds, 14.4% for 45-64 year olds, and
6.8% for 65 year olds and above (DOH, 2013). In both Sarasota and Florida as a whole, the 18-
44 age group leads in participation of heavy drinking, which just so happens to include the age
that alcohol is permitted and the pressure from friends to begin drinking earlier. The nursing
diagnosis that best applies here is that 18-44 year olds in Sarasota County are most likely to
binge drink related to their new legality and peer influences as evidenced by the raised
percentages of alcohol consumers in the age group.
Interventions
This age group needs to be given priority with interventions to prevent heavy drinking.
The healthcare system and Sarasota County can implement ways to prevent the faulty thinking
that it is important for college students to drink and have beer in their rooms. According to the
same survey, most college students reported binge drinking for the first time during high school
(Wechsler, et al, 1995). This study suggests that interventions should be aimed at high school
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and college students and that fraternity house residents are at the highest risk for lifestyle
induced binge drinking on a college campus (Wechsler, et al, 1995).
The primary prevention for Sarasota County communitys high risk age group is based on
health promotion. The goal of the health promotion intervention will be to prevent the initial
occurrence of heavy or binge drinking in the high school population (Ackley, 2011). It would
include nurses, healthcare staff, or anyone community member interested in helping the cause
whom would be able to travel to high schools and speak with students about drinking. The
explained topics would appeal to the students such as what binge drinking is, why people binge
drink, the risks of binge drinking, alcohol poisoning, and other miscellaneous negative
consequences of heavy drinking. Also, information about blood alcohol concentrations would be
provided for the general knowledge of the population (Nemours, 2013). The information session
would have a strong emphasis on the negative outcomes because the students need to know how
it relates to them. If possible, the health promotion program could instead be held at accessible
teen hangouts such as a YMCA in order to reach out to other high school aged people in case of
drop outs or any other restraint. Once the high school aged population is taught the topic, the
program can be altered and geared towards college aged adults. The program can travel to
college campuses in the County or surrounding areas and present similar information to get the
word out to the rest of the population as well. The role of the community health nurse would be
to organize the information presented, gather people to benefit the cause, and collect resources to
provide to the young people if they desire it or are seeking help.
A secondary intervention is mainly for testing purposes and promoting early
identification (Ackley, 2011). Since most young adults dont attend health fairs while currently
intoxicated, there would be information provided for testing to be done at a riskier time. This
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intervention would require healthcare staff or anyone with minor health knowledge and any
community members who care about the cause. These volunteers would go out to a local health
fair or put on their own to promote early identification for alcohol abuse. This would be available
to anyone who was interested in participating but geared towards parents and young adults.
To the parents, there would be alcohol tests available that they can use on their child
whenever the parent feels the child may be under the influence. They would also be presented
with the information on how to get their child help if they suspect a need for it. For all of the
young adults in attendance, resources would be given with contact information for people they
can talk to if they have questions or would like to enroll in a program to receive help with their
addiction. The role of the community nurse would be to explain the possible results of alcohol
tests to the parents so they know how to interpret the information. The community nurse would
be a resource for parents or young adults about any issues that may be occurring. The community
nurse can also reach out for support from doctors, hospitals, or health organizations.
The tertiary intervention is mainly aimed towards maximizing recovery from alcohol
abuse for young adults (Ackley, 2011). The best way to do so would be to join a community
health nurse with individuals of any age that may have personal experience of their own or
amongst loved ones that may be interested in sharing his or her insight. This group of individuals
would sit down with recovering or current alcohol abusers specifically in the 18-44 year old
range where so much attention is needed, although no one would be turned away if they are of
another age. These meetings will be for the benefit of providing someone to talk to about the
troubles they run into but to focus on the successes and the positive difference they have made in
their lives. This provides people with similar difficulties a place to be accepted and treated with
the respect they deserve. These recovering or current alcohol abusers will be provided a safe
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place to make friends in hopes to easily continue on their paths. The difference between this and
an Alcoholics Anonymous meeting is that the age is slightly restricted in order to protect the
individuals whom attend and there will not be a structured program plan to follow. The
discussions at each meeting will be on the topics that the participants care to bring to attention
and they will be based on current events or local activities currently taking place. The topics are
aimed towards preventing and refraining from the drinking lifestyle or stressful environments
shown to promote drinking. The community health nurses duties will be to maintain a safe
environment for the troubled population to express themselves. The community health nurse will
act as a friend and a resource in order to maintain the well-being of these individuals.
Conclusion
Sarasota County needs to host a meeting for recovering and current alcohol abusers in the
18-44 age group located in each of the four towns in the county at least once a week. The events
can be held anywhere including YMCAs, churches, personal houses, etcetera with the help of the
communities in each town. The meeting should be advertised and promoted in public places such
as malls, restaurants, churches, gyms, and even doctors offices or rehabilitation centers
throughout the county. The goal would be the same as the tertiary intervention discussed above,
to aid young adults and adults suffering from alcohol abuse to find friends and discuss their
needs and successes while in a safe environment. The effect of this action on healthcare will
hopefully reduce the knowledge deficit about binge drinking and prevent any unintentional
injuries formulated from intoxication. Some of the stakeholders would include the healthcare
system and the community to promote these special events as well as the support of legislators
and public officials in terms of promotion and endorsement. Most of the work would be in the
hands of volunteer public health workers and volunteer community health nurses to provide this
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service and the community to provide a safe shelter for the meetings to be held in. There is no
funding needed in order to operate this amenity but if the money was offered, then it could be
paid to a construction company to build a low maintenance pavilion on the water or in a park
somewhere safe within Sarasota County. The supporters of this new program would be of great
assistance if they would advertise and tell people about the meetings.
To start the creation of this meeting, public health volunteers would be contacted and
gathered to help in the development of this meeting. Once there are a few people on board,
advertisements would be created and put in public places. Some volunteers would go into
rehabilitation centers, hospitals, doctors offices, and anywhere else that people in need could be
and the general information about the meetings and the first meeting date would be announced.
The new health policy would impact the health of 18-44 year old alcohol abusers residing
in Sarasota County who are currently underserved and without the knowledge to speak out for
themselves in their time of need. This proposal would impact the health of this population by
giving them a way out of their problem and preventing a relapse. This policy would enhance the
population health of Sarasota County by lowering the rates of alcohol abusers in this age group
all the while maintaining the lowered rate without occurrence of relapses. By preventing alcohol
consumption in high amounts, Sarasota County incidence of cirrhosis and liver disease will be
lowered as well raise the well-being of mental health and stress complications. Alcohol is potent
and if consumed, must be done in moderation and the overall health status will rise
exponentially.



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