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Alcohol screening and brief intervention among military service members and veterans: rural–urban disparities
  1. Justin T McDaniel1,
  2. D L Albright2,
  3. K Laha-Walsh2,
  4. H Henson3 and
  5. S McIntosh2
  1. 1School of Human Sciences, Southern Illinois University Carbondale, Carbondale, Illinois, USA
  2. 2School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
  3. 3School of Education, Southern Illinois University Carbondale, Carbondale, Illinois, USA
  1. Correspondence to Dr Justin T McDaniel, School of Human Sciences, Southern Illinois University Carbondale, Carbondale, IL 62901, USA; jtmcd{at}


Background Access to screening, brief intervention and referral to treatment programmes for alcohol use have been shown to be effective; however, little is known about access to these services among service members and veterans. We examined the association of service member or veteran rural-dwelling area and the following outcomes: recent general health check-up, alcohol screening and alcohol brief intervention.

Methods Data on 5080 military service members and veterans were obtained from the 2017 Behavioural Risk Factor Surveillance System of the USA. We estimated rural–urban disparities in the receipt of a recent voluntary general health check-up, as well as the receipt of alcohol screening and brief intervention, using a mixed logit model.

Results Of the 5080 participants in the study, a total of 4666 (90.49%, 95% CI 89.39% to 91.48%) reported a general health check-up in the last 2 years. Results showed 7.48% of the sample (95% CI 6.64% to 8.41%) exhibited heavy alcohol consumption patterns. Of the 414 participants who did not undergo a general health check-up, 13.80% (95% CI 9.63% to 19.41%) exhibited a pattern of heavy alcohol consumption. Rural individuals were less likely to report a recent health check-up (adjusted OR=0.82, 95% CI 0.79 to 0.87). Rurality was also independently associated with decreased likelihood of receiving an alcohol screening and brief intervention.

Conclusion Greater access to telehealth or other geographically flexible screening and brief intervention programmes is needed in rural areas for service members and veterans.

  • substance misuse
  • public health
  • health informatics

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  • Contributors All authors contributed equally to this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. Data used in this study are available from the Centers for Disease Control and Prevention (

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