The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms.

ContextHigh-risk alcohol consumption patterns, such as binge drinking and drinking
before driving, and underage drinking may be linked to traffic crashes and
violent assaults in community settings.ObjectivesTo determine the effect of community-based environmental interventions
in reducing the rate of high-risk drinking and alcohol-related motor vehicle
injuries and assaults.Design and SettingA longitudinal multiple time series of 3 matched intervention communities
(northern California, southern California, and South Carolina) conducted from
April 1992 to December 1996. Outcomes were assessed by 120 general population
telephone surveys per month of randomly selected individuals in the intervention
and comparison sites, traffic data on motor vehicle crashes, and emergency
department surveys in 1 intervention-comparison pair and 1 additional intervention
site.InterventionsMobilize the community; encourage responsible beverage service; reduce
underage drinking by limiting access to alcohol; increase local enforcement
of drinking and driving laws; and limit access to alcohol by using zoning.Main Outcome MeasuresSelf-reported alcohol consumption and driving after drinking; rates
of alcohol-related crashes and assault injuries observed in emergency departments
and admitted to hospitals.ResultsPopulation surveys revealed that the self-reported amount of alcohol
consumed per drinking occasion declined 6% from 1.37 to 1.29 drinks. Self-reported
rate of "having had too much to drink" declined 49% from 0.43 to 0.22 times
per 6-month period. Self-reported driving when "over the legal limit" was
51% lower (0.77 vs 0.38 times) per 6-month period in the intervention communities
relative to the comparison communities. Traffic data revealed that, in the
intervention vs comparison communities, nighttime injury crashes declined
by 10% and crashes in which the driver had been drinking declined by 6%. Assault
injuries observed in emergency departments declined by 43% in the intervention
communities vs the comparison communities, and all hospitalized assault injuries
declined by 2%.ConclusionA coordinated, comprehensive, community-based intervention can reduce
high-risk alcohol consumption and alcohol-related injuries resulting from
motor vehicle crashes and assaults.

https://jamanetwork.com/journals/jama/articlepdf/193252/JOC90970.pdf

Effect of community-based interventions on high-risk drinking and alcohol-related injuries.

Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.

Human factors in the causation of road traffic crashes

Demographic and environmental correlates of pedestrian injury collisions: a spatial analysis.

Aims Empirical tests of relationships between alcohol outlets and violence are generally conducted with statistical controls for correlates related to characteristics of people and the places in which they live. Crime potentials theory asserts that certain subpopulations are disposed to participate in criminal activities (population potentials) and certain neighborhoods are more likely to be places where crimes occur (place potentials). The current study assesses the degree to which measures of the different geographic distributions of these potentials contribute to violent crime. Design Cross-sectional data on hospital discharges for violent assaults were obtained for residents of 1637 zip code areas in California. Assault rates were related to measures of population and place characteristics using spatial statistical models corrected for spatial autocorrelated error. Findings Rates of assault were related to population and place characteristics within zip code areas, and with characteristics of populations living in adjacent zip code areas. Assault rates were greater in densely populated, poor minority urban areas with greater residential instability. Assault rates were also greater in zip code areas adjacent to densely populated urban areas. Assault rates were related significantly to local densities of off-premise alcohol retail establishments, not bars. However, densities of bars moderated substantially effects related to local population characteristics. Bars were related significantly to violence in unstable poor minority areas and in rural middle-income areas of the state. Conclusion Population and place characteristics are associated with rates of violence across spatial areas. Alcohol outlets directly affect and moderate potentials for violence associated with socio-demographic groups.

Ecological models of alcohol outlets and violent assaults: crime potentials and geospatial analysis

This paper reports on an analysis of geographically based data from four communities conducted to evaluate relationships between measures of the physical availability of alcohol and rates of driving after drinking. From a review of the literature, it was expected that rates of driving after drinking would be directly related to the availability of alcohol at on-premise establishments. Based on theoretical arguments regarding the life activities which underlie drinking and driving it was expected that the effects of availability upon these outcomes would extend significantly beyond the local areas of outlets. Taking into account the geographic variations in environmental characteristics (road network density, traffic flow, population density), and socioeconomic (age, gender, race, marital status, income, employment) and drinking characteristics (rates of abstention, frequency and quantity of use) of resident populations, a spatial analysis of drinking driving and alcohol-related crashes was conducted. The results of the analysis showed that physical availability was unrelated to self-reports of driving after drinking and driving while intoxicated and significantly related to rates of single vehicle night-time crashes. In the latter case, physical availability affected both local and adjacent area rates of crashing.

P. Roeper

Papers

The geography of availability and driving after drinking.