Paradigms for Alcohol Use and Co- Occurring Behavioral Health Risk Factors among Women of Childbearing Age

Alcohol use often co-occurs with one or more other behavioral health risk factors that can place women and their offspring at heightened risk for morbidity and mortality. Women with co-occurring alcohol use and behavioral health risk factors, such as tobacco use, illicit drug use, and mental illness are especially vulnerable. These women are not only at increased risk for hazardous reproductive outcomes, but also physical and psychological illness, disability and premature death, interpersonal conflicts, violence and legal problems, unemployment, and poverty. Despite evidence that co-occurring multiple behavioral health risk factors are prevalent and often associated with more severe adverse health outcomes and higher social economic costs, a majority of health promotion and intervention programs are designed to target only one risk factor of concern. Given that * Address all correspondences and reprint requests to: Dr. James Tsai National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention 1600 Clifton Road, Mailstop-E86 Atlanta, GA 30333 USA Tel: 404-498-3951; Fax: 404-498-3940; E-mail address: [email protected] Paradigms for Alcohol Use and Co-Occurring Behavioral Health Risk Factors 2 many of these behavioral health risk factors are interrelated and amenable to interventions, and that many patients frequently present for treatment with two or more behavioral risk factors in various health care settings, establishing paradigms of assessment and intervention for multiple behavioral health risk factors could be more successful in preventing initiation of high-risk behavior, improving targeted health conditions, decreasing the likelihood of co-morbidity, enhancing treatment adherence, preventing relapse, and subsequently maintaining long-term behavioral changes. Prevention of alcohol-related morbidity and mortality among women of childbearing age needs to incorporate the success of evidence-based strategies that address interrelated risk factors across more than one domain.