Drinking during pregnancy: American Indians and African Americans

nant," explained Kaskutas, "were more likely to say that these messages made them feel negatively toward themselves. This can, in turn, contribute to a negative self-esteem spiral of drinking and lack of proper care during pregnancy."

"Health campaigns may need to be part of a larger attempt to change social norms," added Ernestine Vanderveen, director of the National Institute on Alcohol Abuse and Alcoholism's Alcohol Research Centers Program, "such as consumption behavior that involves harmful substances like alcohol, nicotine and caffeine." One of the obstacles that researchers and public health officials still face, she noted, is a basic lack of understanding of human behavior. "We still don't fully know how one's behavior relates to one's state of health and well-being, nor do we really understand the difference between 'health-enhancing' and 'health-compromising' behaviors. That's why," she continued, "we really don't know a lot about women's drinking."

Vanderveen said that one of the real strengths of Kaskutas' study was that it was conducted in the field. "This study has relevance because it attempts to get at information that is very difficult to extract," she said. "In general, we probably need more work in terms of finding out from real people what their behaviors are, and how those relate to their health and well-being." Vanderveen wants to see the DEER project's methodology refined, expanded to a larger study group and geographic distribution, and then replicated so that it can address what she called "serious health disparities in the nation."

A large part of the problem, said Kaskutas, is due to misconceptions both about and among the study populations. "I want to address this issue of ethnicity," she said. "When you consider the income of these women, then the higher rate for FAS that we see by ethnicity disappears. So some of this disease is about poverty. And the women in my study were poor very poor, inner-c

Contact: Lee Ann Kaskutas, Dr.P.H.
Alcoholism: Clinical & Experimental Research

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