Urban and rural Indian drinking patterns: implications for intervention policy development.

Alcohol misuse has taken on epidemic proportions among some (but not all) American Indian populations. Cultural, psychological, socioeconomic and genetic etiologies have been offered to explain this social phenomenon. This study identifies the relative strengths of these causal models to differentiate among both current and lifelong drinking career patterns. Further, antecedent and drinking level differences between urban and rural Indian populations in California are described. Age, sex, level of stress as measured by the Cornell Medical Index, percent of Indian ancestry and level of drinking in the family of origin are less powerful predictors of drinking level. Policy implications of these findings include: the development of intervention programs which involve members of the patient's support network, accelerated interventions in rural Indian communities and mid-level interventions among younger and less debilitated, but identifiably "at risk", populations.