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Research Update
Alcohol Use and Pregnancy: An Important Canadian Public Health and Social Issue
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6 Universal Prevention of Prenatal Alcohol Use Problems
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Linking Prenatal Alcohol Use and FASD to Social Policy While individuals and neighbourhoods carry an obvious responsibility in promoting their own health, many of the determinants of health, such as income levels, the distribution of wealth and the degree of disparity in living standards are a function of government policies. It is therefore clear that prevention will not occur without attention being given to policies that affect these factors. No attempt has yet been made in the scientific literature to link changes in problematic prenatal alcohol use and FASD to social policy changes. |
What the Studies Say Universal measures – which address the general public or an entire population group with policies, programs and messages – to prevent women's substance use during pregnancy can range from popular approaches such as public awareness campaigns, to less popular and controversial policy initiatives such as increasing taxation on alcoholic beverages and mandating warning labels on alcoholic beverage containers. Most universal prevention measures for this issue have not been scientifically evaluated and many suffer from weak program design; the most evaluated measure, beverage warning labels, has been shown to affect awareness in the general population in the short term and drinking behaviour among low-risk women only. Nevertheless, well-designed and evaluated universal prevention measures have the potential to create an environment within which a range of more intensive and targeted measures can receive support and effectively operate.
For the purposes of this section, universal prevention measures address the general public or an entire population group (community, school or neighbourhood) with policies, programs and messages aimed at preventing prenatal alcohol use problems. The measures discussed include population health promotion, alcohol control, public awareness activities, measures directed to adolescents and young adults, and multi-component strategies.
6.1 Population Health Promotion
Those serious about having an impact on the prevalence of prenatal alcohol use must take into account broad factors that have been shown to affect the health of individuals and populations – income, education, quality jobs and social support. Research shows that people with higher levels of education and income generally have better states of health than those with low income and less education; this effect is accentuated when there is a large disparity between high- and low-income earners in a population.125 Consistent with this pattern, women living in poverty, for complex reasons, tend to have less healthy birth outcomes.126
This pattern holds true for substance-related pregnancy issues. Although the picture is far from complete, the data presented in the previous sections for Canada and the US suggest that the prevalence of FASD is greater in lower socio-economic families and communities.
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