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People who drink heavily are worse at taking care of their overall health than other categories of drinkers, according to a new Kaiser Permanente study that included some Clark County residents.

Heavy drinkers compound their health problems through other risky practices as well as unhealthy attitudes, said lead author Carla Green. They are less likely to see a doctor for routine care, and more likely to view good health as a matter of luck.

They are less likely to use seat belts and more likely to smoke. They are more likely to report unhealthy diets and poor sleep patterns.

The study involved 7,884 members of the regional Kaiser Permanent health program, which includes Southwest Washington. The study used a mail-in survey, followed by two years of electronic health records. About 15 percent fit the study’s population definition of risky drinkers.

Researchers also found that women who are heavy daily drinkers report worse health then men who drink at the same level.

On the flip side, the study echoed previous findings that moderate drinkers reported slightly better health than all other categories, including lifelong abstainers.

The study appeared online this week in the journal Addiction Research & Theory.

The report didn’t inventory the bad health outcomes linked to heavy drinking.

“We didn’t measure diseases or injuries,” said Green, a senior investigator at the Kaiser Permanente Center for Health Research in north Portland.

“We pulled out key public health messages we thought were important,” Green said. “We have been concerned that people who drink a lot avoid the doctor, and they have a constellation of other practices that put them at risk.”

Survey topics included attitudes as well as behaviors, which helped answer one particular question for Green.

“People who drink heavily use fewer health services. I always thought it doesn’t make sense: If you drink heavily, you’re more likely to be sick,” she said. “Is something preventing heavy drinkers from seeking health care?

“We included a series of questions about taking care of themselves. Are they sceptical about medical care? If they’re sick, is there any hope of making themselves better? Most frequent heavy drinkers felt health was a matter of good fortune. If you feel that good health is a matter of good fortune, you don’t feel there is much you can do to affect it.”

Another pattern, Green said, indicates that “People who drink moderately report better health.”

That group — people who have from one to three drinks a day — also reports better health-related practices and attitudes, and is more likely to seek routine medical care.

“Previous research has linked moderate alcohol drinking with cardiovascular benefits, so that might be the underlying reason moderate drinkers report better health,” Michael Polen, study co-investigator, said in a news release.

“It’s also possible that there are additional factors we didn’t measure that account for this positive relationship,” he said.

Now Kaiser researchers want to get this information on heavy drinkers into the hands of clinical practitioners.

“We’ve identified a group of people really at risk, who don’t come in for medical care. We won’t catch them at the doctor’s office unless it’s some kind of emergency visit. That really means that outreach is the word of the day,” Green said. “We have to think carefully how reach them.

“Conversely, when they do come in, it’s an opportunity to intervene and try to talk to people about health related practices. If the physician finds someone is drinking heavily, they have to think that other things are likely to be problems.”

The health system might have an ally in that outreach, since men constitute almost 80 percent of the at-risk drinking population.

“Women are good at getting their husbands in to see the doctor,” Green said.

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