The Prevention Paradox and a Public Health Approach to College Student Drinking

Tobin Nelson, University of Minnesota School of Public Health
May 21, 2009

Heavy use of alcohol is the third leading cause of mortality in the United States, accounting for nearly 80,000 deaths on an annual basis.[1] Heavy drinking is a particular problem among young people who attend college.

More than four in five college students drink alcohol and they tend to drink more heavily than older adults and their peers who do not attend college.[2-4] Beyond the risk of death, drinking causes a wide range of serious negative health and social consequences for college students who drink and for those around them.[4] These negative consequences need to be prevented.
While the problems associated with college student drinking are well-documented, effective solutions remain elusive. Despite concerted effort over the past decade, no significant improvements in student alcohol use and negative consequences have been observed.[4-6]. The lack of progress to date in reducing student alcohol use is due, in part, to a failure to consider the problem from a Public Health, or population, perspective. This research brief describes the empirical basis for a fundamental concept supporting a Public Health approach, the Prevention Paradox, as it relates to college student drinking. These data motivate a subsequent discussion of "high-risk" and "population" approaches to addressing the problem of student drinking, with direct implications for prevention practice.

See the full research brief at: http://www.sph.umn.edu/about/pubs/brief/home.html