Search

Objective. We investigated whether limiting the hours of alcoholic beverage sales in bars had an effect on homicides and violence against women in the Brazilian city of Diadema. The policy to restrict alcohol sales was introduced in July 2002 and prohibited on-premises alcohol sales after 11 PM. Methods. We analyzed data on homicides (1995 to 2005) and violence against women (2000 to 2005) from the Diadema (population 360 000) police archives using log-linear regression analyses. Results. The new restriction on drinking hours led to a decrease of almost 9 murders a month. Assaults against women also decreased, but this effect was not significant in models in which we controlled for underlying trends. Conclusions. Introducing restrictions on opening hours resulted in a significant decrease in murders, which confirmed what we know from the literature: restricting access to alcohol can reduce alcohol-related problems. Our results give no support to the converse view, that increasing availability will somehow reduce problems.

Objective: The objective of this study is to investigate the impact of distilled spirits, wine, and beer taxes on cirrhosis mortality using a large-panel data set and statistical models that control for various other factors that may affect that mortality. Method: The analyses were performed on a panel of 30 U.S. license states during the period 1971-1998 (N = 840 state-by-year observations). Exogenous measures included current and lagged versions of beverage taxes and income, as well as controls for states' age distribution, religion, race, health care availability, urbanity, tourism, and local bans on alcohol sales. Regression analyses were performed using random-effects models with corrections for serial autocorrelation and heteroscedasticity among states. Results: Cirrhosis rates were found to be significantly related to taxes on distilled spirits but not to taxation of wine and beer. Consistent results were found using different statistical models and model specifications. Conclusions: Consistent with prior research, cirrhosis mortality in the United States appears more closely linked to consumption of distilled spirits than to that of other alcoholic beverages., THIS ARTICLE PRESENTS EVIDENCE concerning the role of alcohol taxation in the determination of aggregate mortality rates due to cirrhosis of the liver. Numerous studies have demonstrated that alcohol taxes [...]

Objective: This article reports the results of an analysis of the relationships between demographic and alcohol consumption variables and the likelihood of injury occurring during the 6-month period prior to survey administration. Method: The data examined are from a general population survey administered to 22,626 respondents (56.9% female) as part of a community trial project to reduce alcohol-involved injury currently being conducted in six communities in California and South Carolina. Three models that relate consumption patterns and exogenous background variables to injury are evaluated. The first considers only demographic background variables. The second model adds three consumption measures (i.e., frequency, average drinks per occasion and variance) to the first. The third adds a control for community of residence. A fourth model is estimated using frequency and average drinks per occasion, by omitting variance. Results: Findings indicate that likelihood of injury is affected by demographic, alcohol consumption and community of residence variables. Specifically, likelihood of injury is significantly related to being young, white, male and single, and having a high variance drinking pattern. Community level effects were found, with California respondents being more likely to experience injuries, controlling for other model variables. Although measures for education and income were included in our analysis, no effects for these variables could be found. Also, other drinking measures (i.e., drinking frequency and average drinks per occasion) were not found to be significantly related to injury, although estimated coefficients were in the predicted direction. Conclusions: Complementary to studies that have noted that a large portion of injuries involve persons who have been drinking prior to injury, our findings suggest a link between likelihood of injury and general drinking patterns., Persons who report variable drinking patterns may be more susceptible to injury. Telephone survey results of 22,626 participants in California and South Carolina were analyzed for injury risk as a function of alcohol consumption variables and demographics. Young, white, unmarried men with irregular drinking habits were more likely to be injured. Participants living in California were at greater risk for injury than South Carolina residents., (J. Stud. Alcohol 58: 372-381,1997) During the past decade there has been a growing recognitions that alcohol consumption increases the likelihood of injury among individuals in the general population. However, [...]

A positive correlation exists between cirrhosis mortality rates and the sales of alcoholic drinks. The study establishes a relationship between chronic heavy consumptions and preferences for strong drinks such as spirits. The consumption of alcoholic drinks causes both long and short term physiological effects. The study uses the data on cirrhosis mortality rates and beverage specific sales rates of 50 states in US over 12 year period to evaluate the relationship.

Introduction and Aims: Previous research on alcohol‐related motor vehicle crashes (AMVC) share a substantial limitation: sources of geographic variations in background crash risks may confound estimated spatial relationships between alcohol outlets and AMVCs. The aim of this study was to address this concern by examining, spatial–temporally, relationships between alcohol outlets and AMVCs adjusting for a set of six roadway characteristics that may be, independently, related to crash risks. While most similar studies focus on one metropolitan area, we use a unique sample of 50 cities. Design and Methods: The spatial sample for this study consisted of 8726 Census 2000 block groups representing 50 mid‐sized California cities. Dependent measures were counts of crashes located within Census block groups. Independent measures included socio‐demographics, social disadvantage, alcohol outlets and roadway characteristics. We assessed relationships of crashes to independent measures using hierarchical generalised linear models. Results: Greater roadway length, greater percentage of highways, greater average speeds, fewer T‐intersections, greater curviness and less fragmentation were related to greater numbers of crashes as was alcohol outlet density. Discussion Above and beyond alcohol outlet type and density, we found that roadway characteristics were related to AMVC risks across a sample of 50 mid‐sized cities. Measures of roadway characteristics are an essential component of any model of motor vehicle crashes that attempts to assess impacts of alcohol outlets on motor vehicle crashes risks. [ABSTRACT FROM AUTHOR]

Background: The rapid growth of opioid abuse and the related mortality across the United States has spurred the development of predictive models for the allocation of public health resources. These models should characterize heterogeneous growth across states using a drug epidemic framework that enables assessments of epidemic onset, rates of growth, and limited capacities for epidemic growth.Methods: We used opioid overdose mortality data for 146 North and South Carolina counties from 2001 through 2014 to compare the retrodictive and predictive performance of a logistic growth model that parameterizes onsets, growth, and carrying capacity within a traditional Bayesian Poisson space-time model.Results: In fitting the models to past data, the performance of the logistic growth model was superior to the standard Bayesian Poisson space-time model (deviance information criterion: 8,088 vs. 8,256), with reduced spatial and independent errors. Predictively, the logistic model more accurately estimated fatality rates 1, 2, and 3 years in the future (root mean squared error medians were lower for 95.7% of counties from 2012 to 2014). Capacity limits were higher in counties with greater population size, percent population age 45-64, and percent white population. Epidemic onset was associated with greater same-year and past-year incidence of overdose hospitalizations.Conclusion: Growth in annual rates of opioid fatalities was capacity limited, heterogeneous across counties, and spatially correlated, requiring spatial epidemic models for the accurate and reliable prediction of future outcomes related to opioid abuse. Indicators of risk are identifiable and can be used to predict future mortality outcomes. [ABSTRACT FROM AUTHOR]

Population analyses of the correlates of neighborhood crime implicitly assume that a single spatial unit can be used to assess neighborhood effects. However, no single spatial unit may be suitable for analyses of the many social determinants of crime. Instead, effects may appear at multiple spatial resolutions, with some determinants acting broadly, others locally, and still others as some function of both global and local conditions. We provide a multiresolution spatial analysis that simultaneously examines US Census block, block group, and tract effects of alcohol outlets and drug markets on violent crimes in Oakland, California, incorporating spatial lag effects at the 2 smaller spatial resolutions. Using call data from the Oakland Police Department from 2010–2015, we examine associations of assaults, burglaries, and robberies with multiple resolutions of alcohol outlet types and compare the performance of single (block-level) models with that of multiresolution models. Multiresolution models performed better than the block models, reflected in improved deviance and Watanabe-Akaike information criteria and well-supported multiresolution associations. By considering multiple spatial scales and spatial lags in a Bayesian framework, researchers can explore multiresolution processes, providing more detailed tests of expectations from theoretical models and leading the way to more effective intervention efforts. [ABSTRACT FROM AUTHOR]

Importance The Patient Protection and Affordable Care Act (ACA) permits states to expand Medicaid coverage for most low-income adults to 138% of the federal poverty level and requires the provision of mental health and substance use disorder services on parity with other medical and surgical services. Uptake of substance use disorder services with medications for opioid use disorder has increased more in Medicaid expansion states than in nonexpansion states, but whether ACArelated Medicaid expansion is associated with county-level opioid overdose mortality has not been examined. Objective To examine whether Medicaid expansion is associated with county × year counts of opioid overdose deaths overall and by class of opioid. Design, Setting, and Participants This serial cross-sectional study used data from 3109 counties within 49 states and the District of Columbia from January 1, 2001, to December 31, 2017 (N = 3109 counties × 17 years = 52 853 county-years). Overdose deaths were modeled using hierarchical Bayesian Poisson models. Analyses were performed from April 1, 2018, to July 31, 2019. Exposures The primary exposure was state adoption of Medicaid expansion under the ACA, measured as the proportion of each calendar year during which a given state had Medicaid expansion in effect. By the end of study observation in 2017, a total of 32 states and the District of Columbia had expanded Medicaid eligibility. Main Outcomes and Measures The outcomes of interest were annual county-level mortality from overdoses involving any opioid, natural and semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone, derived from the National Vital Statistics System multiple-cause-ofdeath files. A secondary analysis examined fatal overdoses involving all drugs. Results There were 383 091 opioid overdose fatalities across observed US counties during the study period, with a mean (SD) of 7.25 (27.45) deaths per county (range, 0-1145 deaths per county). Adoption of Medicaid expansion was associated with a 6% lower rate of total opioid overdose deaths compared with the rate in nonexpansion states (relative rate [RR], 0.94; 95% credible interval [CrI], 0.91-0.98). Counties in expansion states had an 11% lower rate of death involving heroin (RR, 0.89; 95% CrI, 0.84-0.94) and a 10% lower rate of death involving synthetic opioids other than methadone (RR, 0.90; 95% CrI, 0.84-0.96) compared with counties in nonexpansion states. An 11% increase was observed in methadone-related overdose mortality in expansion states (RR, 1.11; 95% CrI, 1.04-1.19). An association between Medicaid expansion and deaths involving natural and semisynthetic opioids was not well supported (RR, 1.03; 95% CrI, 0.98-1.08). Conclusions and Relevance Medicaid expansion was associated with reductions in total opioid overdose deaths, particularly deaths involving heroin and synthetic opioids other than methadone, but increases in methadone-related mortality. As states invest more resources in addressing the opioid overdose epidemic, attention should be paid to the role that Medicaid expansion may play in reducing opioid overdose mortality, in part through greater access to medications for opioid use disorder. [ABSTRACT FROM AUTHOR]

Introduction and Aims: This study examined whether the introduction of a large number of off-premise alcohol outlets into a city over a brief period of time could affect rates of violent crime.Design and Methods: The study analysed annual counts of violent crime across 172 US Census block groups in Lubbock, Texas from 2006 through 2011. Spatial Poisson models related annual violent crime counts within each block group to off-premise and on-premise alcohol outlets active during this time period as well as neighbourhood socio-demographic characteristics. The effects of alcohol outlets were assessed both within block groups and across adjacent block groups.Results: On-premise outlets had a small, significant positive association with violence within a given block group. A similar well-supported local effect for off-premise outlets was not found. However, the spatially lagged effect for off-sale premises was well-supported, indicating that greater densities of these outlets were related to greater rates of violent crime in adjacent areas.Discussion and Conclusions: While these analyses confirmed a previous time-series analysis in finding no city-wide effect of the increase in off-premise outlets, they do suggest that such outlets in a local area may be related to violence in nearby geographic areas. They indicate the importance of examining neighbourhood-specific effects of alcohol outlets on violence in addition to the city-wide effects. They also present further evidence supporting the need to examine the differential effects of on-sale and off-sale premises. [ABSTRACT FROM AUTHOR]