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Pamela J. Trangenstein

Bio: Pamela J. Trangenstein is an academic researcher from University of North Carolina at Chapel Hill. The author has contributed to research in topics: Medicine & Cannabis. The author has an hindex of 8, co-authored 26 publications receiving 145 citations. Previous affiliations of Pamela J. Trangenstein include Boston University & Johns Hopkins University.
Topics: Medicine, Cannabis, Poison control, Odds, Demography

Papers
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Journal ArticleDOI
TL;DR: Examination of adolescents' self-reported exposure to cannabis marketing in states with legalized cannabis and its association with past-year cannabis use suggests States should consider further regulation of cannabis marketing on social media.

40 citations

Journal ArticleDOI
TL;DR: The most robust predictor of alcohol outlet cluster membership was a history of redlining, i.e., racially discriminatory lending policies, and level of economic investment appears to be a key characteristic that separates CBGs in on- and off-premise outlet clusters.
Abstract: Alcohol outlet clusters are an important social determinant of health in cities, but little is known about the populations exposed to them. If outlets cluster in neighborhoods comprised of specific racial/ethnic or economic groups, then they may function as a root cause of urban health disparities. This study used 2016 liquor license data (n = 1204) from Baltimore City, Maryland, and demographic data from the American Community Survey. We defined alcohol outlet clusters by combining SaTScan moving window methods and distances between outlets. We used multiple logistic regression to compare census block groups (CBGs) (n = 537) inside and outside of four types of outlet clusters: total, on-premise, off-premise, and LBD-7 (combined on-/off-premise). The most robust predictor of alcohol outlet cluster membership was a history of redlining, i.e., racially discriminatory lending policies. CBGs that were redlined had 7.32 times the odds of being in an off-premise cluster, 8.07 times the odds of being in an on-premise cluster, and 8.60 times the odds of being in a LBD-7 cluster. In addition, level of economic investment (marked by vacant properties) appears to be a key characteristic that separates CBGs in on- and off-premise outlet clusters. CBGs with racial/ethnic or socioeconomic advantage had higher odds of being in on-premise clusters and CBGs marked by disinvestment had higher odds of being in off-premise clusters. Off-premise clusters deserve closer examination from a policy perspective, to mitigate their potential role in creating and perpetuating social and health disparities. In addition to addressing redlining and disinvestment, the current negative effects of alcohol outlet clusters that have grown up in redlined and disinvested areas must be addressed if inequities in these neighborhoods are to be reversed.

37 citations

Journal ArticleDOI
TL;DR: Access to outlets that allow for off-site consumption had a greater association with violent crime than outlets that only permit on- site consumption and the lack of effective measures to keep order in and around off-premise outlets could attract or multiply violent crime.
Abstract: BACKGROUND While there are overwhelming data supporting the association between alcohol outlet density and violent crime, there remain conflicting findings about whether on- or off-premise outlets have a stronger association. This inconsistency may be in part a result of the methods used to calculate alcohol outlet density and violent crime. This analysis uses routine activity theory and spatial access methods to study the association between access to alcohol outlets and violent crime, including type of outlet and type of crime in Baltimore, MD. METHODS The data in this analysis include alcohol outlets from 2016 (n = 1,204), violent crimes from 2012 to 2016 (n = 51,006), and markers of social disorganization, including owner-occupied housing, median annual household income, drug arrests, and population density. The analysis used linear regression to determine the association between access to alcohol outlets and violent crime exposure. RESULTS Each 10% increase in alcohol outlet access was associated with a 4.2% increase in violent crime exposure (β = 0.43, 95% CI 0.33, 0.52, p < 0.001). A 10% increase in access to off-premise outlets (4.4%, β = 0.45, 95% CI 0.33, 0.57, p < 0.001) and LBD-7 outlets (combined off- and on-premise outlets; 4.2%, β = 0.43, 95% CI 0.33, 0.52, p < 0.001) had a greater association with violent crime than on-premise outlets (3.0%, β = 0.31, 95% CI 0.20, 0.41, p < 0.001). CONCLUSIONS Access to outlets that allow for off-site consumption had a greater association with violent crime than outlets that only permit on-site consumption. The lack of effective measures to keep order in and around off-premise outlets could attract or multiply violent crime.

36 citations

Journal ArticleDOI
TL;DR: Analysis of Member States’ self-reports of actions to reduce the harmful use of alcohol found that small countries, globally, and countries in Africa and the Americas most likely to have no restrictions were the most common, and alcohol availability policies are becoming less restrictive in low-income countries.
Abstract: Almost 10 years after the World Health Assembly adopted the Global strategy to reduce harmful use of alcohol, and seven years after the inclusion of alcohol as one of the key risk factors in the World Health Organization’s (WHO’s) Global action plan for the prevention and control of noncommunicable diseases 2013–2030, Member States have made little progress in addressing alcohol use as a risk factor for health. We reach this conclusion based on analysis of Member States’ self-reports of actions to reduce the harmful use of alcohol. We used data on alcohol policies from two recent surveys conducted by WHO: a 2015 global questionnaire on the progress on the global alcohol strategy since 2010,1 answered by 138 Member States, and the 2016 Global survey on alcohol and health, answered by 173 Member States. Results were published in WHO’s 2018 Global status report on alcohol and health,2 mostly with data from the 2016 survey, but also including some data from the 2015 survey. Both surveys showed that progress on alcohol policies has been slow. The alcohol strategy outlined 10 areas,3 with three identified as the most effective and cost–effective interventions to reduce alcohol-related harm, costing less than 100 United Sates dollars (US$) per disability-adjusted life year averted. These interventions include strengthening restrictions on alcohol availability, bans or comprehensive restrictions on alcohol advertising across multiple media platforms and increasing alcohol excise taxes. Of these three interventions, countries were most active on taxes, because most depend on tax revenues for national budgets. Member States appear unaware of taxes’ critical public health role in managing the affordability of alcohol. Most countries (155 of the 163 non-Muslim countries responding to the 2016 survey) apply sales tax to beer. The 2015 survey on policy changes revealed that 78 (62%) of the 126 countries that answered this question reported increasing alcohol taxes since 2010; however, only a third of these increases were described by Member States as substantial. In 45 (36%) of these 126 countries, taxes on beer stayed roughly the same. More than two thirds of countries (68%) with excise taxes did not adjust them for inflation, so the likely effect is that alcohol taxes, and by extension prices, have fallen because they are based on beverage volumes, which do not change. Regarding alcohol marketing, the least restrictive policies were the most common, with small countries, globally, and countries in Africa and the Americas most likely to have no restrictions. According to the 2015 survey, since 2010, 8% (11/138) of countries reported a decrease in progress in this area, while 34% (47/138) reported an increase; 58% (80/138) stayed about the same. Smaller countries, overall, lagged behind their larger counterparts. Countries that reported increases in regulation of marketing of alcoholic beverages had on average twice as many residents as countries that reported decreases (average population of 52.9 million versus 22.5 million). Seven countries introduced a new total ban on alcohol marketing since 2010; however, there has been little regulation of new marketing techniques, an area where industry activities are quickly growing. For example, in the United States of America in 2017, according to Advertising Age, a global beer company spent nearly US$ 1 billion on unmeasured marketing including digital, nearly 60% more than it spent on the traditional measured media channels of print, radio and television.4 Results are worst for physical availability, where aside from minimum age purchase laws, most restrictions, such as limits on days and hours of sale, or on licenses to produce, distribute or sell alcohol, declined over time. Underscoring a key disparity, alcohol availability policies are becoming less restrictive in low-income countries. Growing evidence of harm

29 citations

Journal ArticleDOI
TL;DR: Rates of heavy drinking were higher than expected giving impetus to various alcohol policy reforms under consideration in South Africa and better labeling of the alcohol content of different containers is needed together with limiting production, marketing and serving of alcohol in large containers.
Abstract: There is limited information about the potential individual-level and contextual drivers of heavy drinking in South Africa. This study aimed to identify risk factors for heavy drinking in Tshwane, South Africa. A household survey using a multi-stage stratified cluster random sampling design. Complete consumption and income data were available on 713 adults. Heavy drinking was defined as consuming ≥120 ml (96 g) of absolute alcohol (AA) for men and ≥ 90 ml (72 g) AA for women at any location at least monthly. 53% of the sample were heavy drinkers. Bivariate analyses revealed that heavy drinking differed by marital status, primary drinking location, and container size. Using simple logistic regression, only cider consumption was found to lower the odds of heavy drinking. Persons who primarily drank in someone else’s home, nightclubs, and sports clubs had increased odds of heavy drinking. Using multiple logistic regression and adjusting for marital status and primary container size, single persons were found to have substantially higher odds of heavy drinking. Persons who drank their primary beverage from above average-sized containers at their primary location had 7.9 times the odds of heavy drinking as compared to persons who drank from average-sized containers. Some significant associations between heavy drinking and age, race, and income were found for certain beverages. Rates of heavy drinking were higher than expected giving impetus to various alcohol policy reforms under consideration in South Africa. Better labeling of the alcohol content of different containers is needed together with limiting production, marketing and serving of alcohol in large containers.

26 citations


Cited by
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Journal ArticleDOI
TL;DR: Monitoring consumption levels both during and after the CO VID‐19 pandemic will be necessary to better understand the effects of COVID‐19 on different groups, as well as to distinguish them from those arising from existing alcohol control policies.
Abstract: Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios-with opposite predictions regarding the impact of the current COVID-19 pandemic on the level and patterns of alcohol consumption-are introduced. The first scenario predicts an increase in consumption for some populations, particularly men, due to distress experienced as a result of the pandemic. A second scenario predicts the opposite outcome, a lowered level of consumption, based on the decreased physical and financial availability of alcohol. With the current restrictions on alcohol availability, it is postulated that, for the immediate future, the predominant scenario will likely be the second, while the distress experienced in the first may become more relevant in the medium- and longer-term future. Monitoring consumption levels both during and after the COVID-19 pandemic will be necessary to better understand the effects of COVID-19 on different groups, as well as to distinguish them from those arising from existing alcohol control policies.

325 citations

Journal ArticleDOI
05 Mar 2019
TL;DR: A szemle egy rovid attekintest nyujt a WHO altal kozze tett "Global status report on alcohol and health 2018" cimű ertekezesről elsŵn â’n ôl a World Health Organization (WHO) dynes reporton 2018.
Abstract: A szemle egy rovid attekintest nyujt a WHO altal kozze tett "Global status report on alcohol and health 2018" cimű ertekezesről.

238 citations

Journal ArticleDOI
TL;DR: Historical redlining may be a structural determinant of present-day risk of preterm birth and policies for fair housing, economic development, and health equity should consider historical redlining's impacts on present- day residential segregation and health outcomes.
Abstract: Objectives. To assess if historical redlining, the US government’s 1930s racially discriminatory grading of neighborhoods’ mortgage credit-worthiness, implemented via the federally sponsored Home O...

198 citations

Posted Content
TL;DR: For example, this paper estimated that excessive alcohol use cost the U.S. $223.5 billion in 2006, and more current estimates are needed to help inform the planning of prevention strategies.
Abstract: Excessive alcohol use cost the U.S. $223.5 billion in 2006. Given economic shifts in the U.S. since 2006, more-current estimates are needed to help inform the planning of prevention strategies.

171 citations