1 Manitoba Centre for Health Policy

Social Outcomes Associated

with Alcohol Use Disorders

in ManitobaNathan C. Nickel, PhDSeptember 26, 2017

2 Manitoba Centre for Health Policy

PLEASE NOTE…

Material in this presentation is

PRELIMINARY and CONFIDENTIAL

and is not for distribution or discussion

until the final report is released.

3 Manitoba Centre for Health Policy

Study Objectives

1. Calculate trends in alcohol dependence over the observation

period, 1990-2014;

2. Identify whether alcohol dependence is associated with

increased use of health and social services.

3. Identify when someone with alcohol dependence uses the

most services

4 Manitoba Centre for Health Policy

Today’s Presentation

Outcomes associated with alcohol dependence:

1. Health services use

2. Social services use

5 Manitoba Centre for Health Policy

MCHP Houses the De-IdentifiedManitoba Population Research Data Repository

HospitalHospitalPhysician Services

Physician Services

Nursing HomeNursing Home

Home CareHome Care

ImmunizationImmunization

Vital StatisticsVital Statistics

Emergency DepartmentEmergency Department

ClinicalClinical

Health SurveysHealth

SurveysMedical

LaboratoryMedical

Laboratory

CancerCareCancerCare

EducationEducation

Family ServicesFamily

Services

Income Assistance

Income Assistance

Healthy Child MB

Healthy Child MB

Social HousingSocial

Housing

JusticeJustice• Families First

• Healthy Baby

• EDI

• Families First

• Healthy Baby

• EDI

• ICU

• FASD

• Pediatric

Diabetes

• Cardiac

Surgery

• ICU

• FASD

• Pediatric

Diabetes

• Cardiac

Surgery

• K to Grade 12

• Post-Secondary

(UofM)

• K to Grade 12

• Post-Secondary

(UofM)

Census Data

at Area Level

Census Data

at Area Level

Pharmaceuticals

Manitoba

Population-Based

Registry

6 Manitoba Centre for Health Policy

Identifying Alcohol Use

Disorder in Administrative Data

Our cohort is defined by anyone meeting the following

conditions in the period 1990/91-2014/15:

1. Diagnosis of a mental health issue associated with harmful

alcohol consumption;

2. Diagnosis of a physical health issue associated with harmful

alcohol consumption; or

3. Filled prescription for drug associated with harmful alcohol

consumption.

7 Manitoba Centre for Health Policy

Question:

We looked at whether the incident rate (the number of

new cases of Alcohol Use Disorder) has changed over

time. What do you think?

Between 1990 and 2014, the incident rate for Alcohol

Use Disorder has …

A) Increased

B) Decreased

C) Remained the Same

8 Manitoba Centre for Health Policy

Matching Criteria

At time of diagnosis, cases and matches are the same age,

same sex, living in same area, at the same time.

Analyses

Followed people in the data from 5 years before diagnosis

to 20 years after diagnosis

Identifying Matches

9 Manitoba Centre for Health Policy

Social Services Use Indicators

1. Justice System (charges)

• Driving While Impaired (DWI)

• Domestic/Family Trouble

• Any Justice Charge

2. Social Housing

3. Children in Care (Time Permitting)

10 Manitoba Centre for Health Policy

Question:

The relationship between having an alcohol use

disorder and being charged with a crime was ….

A) Greater among males than among females

B) Greater among females than among males

C) About the same for both

11 Manitoba Centre for Health Policy

Any Justice Charge

1. Female and male cases: spike in the rate of any justice charge in

year prior to diagnosis

2. Female and male cases: rate of any justice charge decreased after

spike and continued to fall over time

3. Females and males: cases had statistically higher rates of any

justice charge than matches

12 Manitoba Centre for Health Policy

Question:

The relationship between having an alcohol use

disorder and being charged with a crime was ….

A) Greater among males than among females

B) Greater among females than among males

C) About the same for both

13 Manitoba Centre for Health Policy

• Observe a spike year before diagnosis

– Serve as catalyst for connecting with system

– May offer opportunity to connect more

individuals with services

• Continued elevation following diagnosis

• Identify interventions which can mitigate

difference

Conclusions

14 Manitoba Centre for Health Policy

PLEASE NOTE…

Material in this presentation is

PRELIMINARY and CONFIDENTIAL

and is not for distribution or discussion

until the final report is released.

15 Manitoba Centre for Health Policy

DISCUSSION

16 Manitoba Centre for Health Policy

• Do these results correspond with your

experience?

– If so … how?

– If not, how do your experiences differ?

• What do these results mean for policy and

practice?

– What solutions might these results suggest?

– How can we better serve Manitobans?

Table Discussion

17 Manitoba Centre for Health Policy

Thank You / Questions

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