Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Xiamei Ma

Second Advisor

Joseph K. Kaholokula

Abstract

Background: Stroke accounts for a much larger percentage of deaths in Hawai`i than in the rest of the United States, and Native Hawaiians experience stroke ten years younger than their Caucasian counterparts. Although the exact reason for this disparity is unclear, the high prevalence of alcohol consumption, along with other factors, has raised concerns.

Methods: The objective of this thesis is to assess the relationship between alcohol consumption and stroke in the Kohala Health Research Project, a multi-ethnic cross-sectional study of Hawai`I residents conducted during 1995-2000. Alcohol consumption was defined as binary (yes vs. no) and categorical (nondrinkers, moderate drinkers, and heavy drinkers), and stroke risk was classified using adaptations of the National Stroke Association's scorecard. Multivariate logistic regression models were used to adjust for a variety of demographic, behavioral, psychosocial, and medical factors, and a backwards function was used to arrive at a final model.

Results: Alcohol consumption was associated with a lower risk of stroke among the 910 subjects [adjusted odds ratio (OR) = 0.6, 95% confidence interval (CI): 0.4-0.8]. Compared with non-drinkers, moderate drinkers had a significantly lower risk of stroke (adjusted OR = 0.5, 95% CI: 0.3-0.7), while heavy drinkers did not appear to have a significantly different risk of stroke (adjusted OR = 0.8, 95% CI: 0.5-1.4). A higher level of education was also associated with a lower risk of stroke, whereas older individuals and ethnic minorities (Native Hawaiians and Japanese) had high risks of stroke.

Conclusion: Alcohol consumption, especially moderate amounts of alcohol consumption, was associated with a lower risk of stroke in this multi-ethnic population. Given the cross-sectional design of the study, a temporal relationship could not be established. Prospective cohort studies are needed to further examine the relationship between alcohol consumption and stroke risk.

Comments

This is an Open Access Thesis.

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