Drinking patterns and problems of the "stably insured": A study of the membership of a health maintenance organization

Objective: This article describes drinking patterns and examines the preval ence of heavy drinking and alcohol problems, and their association with oth er behavioral and social problems within the membership of a health mainten ance organization, a setting in which increasing numbers of Americans recei ve services. Method: The sample is representative of the stably insured mem bership of the Northern California Region of Kaiser Permanente Medical Care Program; i.e., those who have been insured continuously under that plan fo r 30 months or longer. A telephone survey of the adult membership (N = 10,2 92) was conducted between June 1994 and February 1996. Results: As in other studies, health and mental health status and smoking were related to drink ing levels, with symptoms higher for those in the heaviest drinking group. However, in contrast to studies of those using medical services, demographi c characteristics (e.g., young age) were not associated with heavy drinking in this population. When controlling for drug use and drinking, however, w omen and those reporting any mental health symptom were more likely to repo rt alcohol problems. Conclusions: Findings suggest that in private managed care populations, particular behavioral indicators may be mon important tha n demographic characteristics in screening for problem drinkers. The identi fication of individuals who report a mental health symptom, who drink a lar ge number of drinks occasionally or who report any drug use may be importan t in a health maintenance approach to prevention and case finding.