The proposed project is a retrospective cohort study of three groups of Navajo Indians first interviewed in 1966-7. One group was comprised of the first 35 patients self-referred to the Indian Health Service hospital in Tuba City, Arizona for Antabuse treatment of alcohol abuse. The other two groups were community controls chosen to represent both traditional and wage work populations.
The aims of the study are to assess the associations between on the one hand alcohol consumption patterns and problems as measured in 1966-7, and on the other outcomes such as mortality, health status, health care utilization, and level of psycho-social functioning. In other words, these aims have more to do with understanding the prognosis of alcohol abuse in this population than with explaining the etiology of alcoholism. The over-arching goal is to determine whether the course of alcohol abuse is similar to what has been observed in other populations. The hypothesis based upon previous observations is that alcohol abuse is not a unitary phenomenon which is the same across cultures, but that there are major differences in course among populations which are best explained by socio- cultural differences. If the hypothesis is not rejected, the consequences could be significant, for that may mean that prevention and treatment programs are not readily transferable but must be adapted to particular client groups, and alcoholism workers serving this population will be able to make more accurate prognoses than has heretofore been possible.