Karen O'Quin

Date of Award


Degree Type

Closed Thesis

Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Sheryl Strasser - Chair

Second Advisor

Monica Swahn


Introduction: Adolescents in the United States use alcohol more than any other substance, including tobacco and marijuana. Continuing alcohol misuse has numerous adverse health effects and is linked to liver disease, cancer, cardiovascular disease and neurological damage. Furthermore, alcohol consumption is a significant risk factor for unsafe sexual behaviors, unintentional injuries, physical and sexual assaults, various types of illegal activities, and suicide (USDHHS, 2007). Aim: The purpose of this study is to compare the individual social indicators from 4 categories that have been identified within the literature as being particularly associated with alcohol consumption in general, and underage alcohol consumption in particular. The categories used were: drinking consequences, urbanicity, poverty, and alcohol outlet density. The social indicators in these categories will be compared in the 10 most-at-risk counties (MAR) and the 10 least-at-risk counties (LAR), and the 20 MAR counties and the 20 LAR counties, as they relate to underage alcohol consumption. Methods: The counties were identified in and data was obtained from Governor’s Cooperative Agreement State Incentive Planning and Development Grant: Social Indicator Study to Assess Substance Use Prevention Needs at the State and County Levels in Georgia. An independent 2-tailed t-test was conducted to compare the means of groups in both the 10 MAR/LAR counties and the 20 MAR/LAR counties. Results: Significant differences were observed in all of the individual indicators in the poverty and alcohol outlet density categories for both the 10 MAR/LAR counties and the 20 MAR/LAR counties. Discussion: There needs to be a more accurate, specific and efficient methods of data surveillance concerning underage drinking behavior. Further research should focus on urbanicity, poverty, and alcohol outlet density as they relate to underage alcohol consumption. There were differences observed between the MAR and LAR counties in all of the poverty alcohol outlet density indicators, and researchers and policy makers should pay special attention to these two areas when designing further research and prevention policies.