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Druffner N, Egan D, Ramamurthy S, O'Brien J, Davis AF, Jack J, Symester D, Thomas K, Palka JM, Thakkar VJ, Brown ES. IQ in high school as a predictor of midlife alcohol drinking patterns. Alcohol Alcohol 2024; 59:agae035. [PMID: 38804536 DOI: 10.1093/alcalc/agae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 04/27/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
AIMS The aim of the present study was to assess the relationship between adolescent IQ and midlife alcohol use and to explore possible mediators of this relationship. METHODS Study data were from 6300 men and women who participated in the Wisconsin Longitudinal Study of high-school students graduating in 1957. IQ scores were collected during the participants' junior year of high school. In 2004, participants reported the number of alcoholic beverages consumed (past 30 days) and the number of binge-drinking episodes. A multinomial logistic regression was conducted to determine the relationship between adolescent IQ and future drinking pattern (abstainer, moderate drinker, or heavy drinker), and Poisson regression was used to examine the number of binge-drinking episodes. Two mediators-income and education-were also explored. RESULTS Every one-point increase in IQ score was associated with a 1.6% increase in the likelihood of reporting moderate or heavy drinking as compared to abstinence. Those with higher IQ scores also had significantly fewer binge-drinking episodes. Household income, but not education, partially mediated the relationship between IQ and drinking pattern. CONCLUSIONS The present study suggests that higher adolescent IQ may predict a higher likelihood of moderate or heavy drinking in midlife, but fewer binge-drinking episodes. The study also suggests that this relationship is mediated by other psychosocial factors, specifically income, prompting future exploration of mediators in subsequent studies.
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Affiliation(s)
- Natalie Druffner
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Donald Egan
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Swetha Ramamurthy
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Justin O'Brien
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Allyson Folsom Davis
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Jasmine Jack
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Diona Symester
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Kelston Thomas
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Jayme M Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Vishal J Thakkar
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Edson Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
- The Altshuler Center for Education & Research, Metrocare Services, 1345 River Bend Dr, Suite 200, Dallas, Texas, 75247, United States
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Edwards AC, Ohlsson H, Lannoy S, Stephenson M, Crump C, Sundquist J, Kendler KS, Sundquist K. Exposure to alcohol outlets and risk of suicidal behavior in a Swedish cohort of young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:930-939. [PMID: 37526582 PMCID: PMC10916709 DOI: 10.1111/acer.15051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Greater alcohol accessibility, for example in the form of a high density of alcohol outlets or low alcohol taxation rates, may be associated with increased risk of suicidal behavior. However, most studies have been conducted at the aggregate level, and some have not accounted for potential confounders such as socioeconomic position or neighborhood quality. METHODS In a Swedish cohort of young adults aged 18 to 25, we used logistic regressions to evaluate whether living in a neighborhood that included bars, nightclubs, and/or government alcohol outlets was associated with risk of suicide attempt (SA) or suicide death (SD) during four separate 2-year observation periods. Neighborhoods were defined using pre-established nationwide designations. We conducted combined-sex and sex-stratified analyses, and included as covariates indicators of socioeconomic position, neighborhood deprivation, and aggregate genetic liability to suicidal behavior. RESULTS Risk of SA was increased in some subsamples of individuals living in a neighborhood with a bar or government alcohol outlet (odds ratios [ORs] = 1.05 to 1.15). Risk of SD was also higher among certain subsamples living in a neighborhood with a government outlet (ORs = 1.47 to 1.56), but lower for those living near a bar (ORs = 0.89 to 0.91). Significant results were driven by, but not exclusive to, the male subsample. Individuals with higher aggregate genetic risk for SA were more sensitive to the effects of a neighborhood government alcohol outlet, pooled across observation periods, in analyses of the sexes combined (relative excess risk due to interaction [RERI] = 0.05; 95% confidence intervals [CI] 0.01; 0.09) and in the male subsample (RERI = 0.06; 95% CI 0.001; 0.12). CONCLUSIONS Although effect sizes are small, living in a neighborhood with bars and/or government alcohol outlets may increase suicidal behavior among young adults. Individuals with higher genetic liability for SA are slightly more susceptible to these exposures.
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Affiliation(s)
- Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Séverine Lannoy
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Integrative Life Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Casey Crump
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
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The role of firearm and alcohol availability in firearm suicide: A population-based weighted case-control study. Health Place 2023; 79:102969. [PMID: 36681063 PMCID: PMC10153632 DOI: 10.1016/j.healthplace.2023.102969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/09/2022] [Accepted: 01/05/2023] [Indexed: 01/21/2023]
Abstract
Firearm availability has been linked to firearm self-harm, but the joint relationship with alcohol availability, while supported by theory, has not been examined. This study sought to quantify the separate and joint relations of community firearm and alcohol availability with individual-level risk of (fatal and nonfatal) firearm self-harm. We conducted a case-control study of California residents, 2005-2015, using statewide mortality, hospital, firearm transfer, and alcohol license data. We estimated monthly marginal risk differences per 100,000 in the overall population and in white men aged 50+ under various hypothetical changes to firearm and alcohol availability and assessed additive interactions using case-control-weighted g-computation. In the overall population, non-pawn shop firearm dealer density was associated with firearm self-harm (RD: 0.02, 95% CI: 0.003, 0.04) but pawn shop firearm dealer and alcohol outlet densities were not. Secondary analyses revealed a relationship between firearm sales density and firearm self-harm (RD: 0.07, 95% CI: 0.04, 0.10). There were no additive interactions between measures of firearm and alcohol availability. Among older white men, generally the same exposures were related to self-harm as in the overall population, but point estimates were substantially larger. Findings suggest community-level approaches to reducing firearm sales may help mitigate suicide risk.
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Allen K, Goldman-Mellor S. Neighborhood Characteristics and Adolescent Suicidal Behavior: Evidence from a Population-based Study. Suicide Life Threat Behav 2018; 48:677-689. [PMID: 28914968 DOI: 10.1111/sltb.12391] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/09/2017] [Indexed: 11/30/2022]
Abstract
Research on the relationship between neighborhood characteristics and adolescents' risk of nonfatal suicidal behavior is scarce. We used California survey data to examine associations between measures of objective neighborhood quality (levels of violent crime, property crime, and socioeconomic disadvantage) and subjective neighborhood quality (perceptions of neighborhood safety and social cohesion) and adolescents' self-reported suicidal ideation and suicide attempt. Objective measures of neighborhood quality were unrelated to adolescents' risk of suicidal behavior. However, adolescents who perceived their neighborhoods to be less safe and less cohesive were 20%-45% more likely than nonsuicidal peers to report suicidal ideation and attempt.
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Goldman-Mellor S, Allen K, Kaplan MS. Rural/Urban Disparities in Adolescent Nonfatal Suicidal Ideation and Suicide Attempt: A Population-Based Study. Suicide Life Threat Behav 2018; 48:709-719. [PMID: 28940747 DOI: 10.1111/sltb.12390] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 06/15/2017] [Indexed: 11/28/2022]
Abstract
Adolescent suicide rates exhibit stark geographic disparities, with rates highest in rural areas. The causes of this disparity remain unclear. We investigated whether adolescent nonfatal suicidal ideation and attempt-leading risk factors for suicide-demonstrate the same rural/urban disparity. Using adolescent data from the 2011-2014 waves of the population-representative California Health Interview Survey (CHIS; N = 4,616), we estimated associations between residence in a rural area and suicidal ideation and suicide attempt, as well as access to psychological care. Survey-weighted logistic regression models controlled for individual- and family-level covariates. Results showed that rural adolescents were, compared to urban adolescents, substantially less likely to report recent suicidal ideation (OR = 0.25, 95% confidence interval [CI] = 0.10, 0.61) and suicide attempt (OR = 0.17, 95% CI = 0.05, 0.66). Suicidal youths in rural and urban areas were equally likely, however, to report receiving psychological care. In this study, rural adolescents in California reported lower rates of nonfatal suicidal behavior compared to urban peers. This pattern contrasts with rates of adolescent suicide fatality, which are higher in rural areas. Results suggest that reducing geographic disparities in youth suicide may require multifaceted public health approaches, in addition to better identification and treatment for high-risk adolescents.
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Affiliation(s)
- Sidra Goldman-Mellor
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA
| | - Kristina Allen
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA
| | - Mark S Kaplan
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
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Cukrowicz KC, Brown SL, Mitchell SM, Roush JF, Hirsch JK. Feasibility of Assessing Suicide Ideation and History of Suicidal Behavior in Rural Communities. Suicide Life Threat Behav 2018; 48:522-530. [PMID: 28940745 DOI: 10.1111/sltb.12378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/07/2017] [Indexed: 01/17/2023]
Abstract
Suicide in rural areas has not received significant attention in the research literature to this point, although suicide rates are higher among adults and older adults in rural areas than in urban areas. The aims of the study were as follows: (1) establish the feasibility of assessing suicide ideation and history of suicidal behavior; (2) determine preliminary estimates of the prevalence of suicide ideation, and history of suicide attempts; and (3) examine the effectiveness and acceptability of safety and referral plans for individuals whose responses indicated elevated suicide risk, in rural communities with limited access to referral care. Participants were 96 adults aged 40 to 85 years old (M = 57.34, SD = 11.47) residing in West Texas. Our results indicate that 26% of participants endorsed a lifetime history of suicide ideation and/or suicide attempt(s) and 12.5% reported suicide ideation in the past year. In addition, 93.4% of participants reported that participation in our suicide-focused study was an excellent or good experience. Results suggest that individuals in rural communities are willing to talk about suicide, found the experience helpful, and were satisfied with the referral process.
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Affiliation(s)
- Kelly C Cukrowicz
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Sarah L Brown
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Sean M Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Jared F Roush
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
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Hoertel N, Faiz H, Airagnes G, Blanco C, Pascal De Raykeer R, Franco S, Ducoutumany G, Lemogne C, Limosin F. A comprehensive model of predictors of suicide attempt in heavy drinkers: Results from a national 3-year longitudinal study. Drug Alcohol Depend 2018; 186:44-52. [PMID: 29547760 DOI: 10.1016/j.drugalcdep.2018.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/04/2017] [Accepted: 01/05/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Heavy drinkers are at high risk for suicide attempt and suicide. Multiple factors, when examined in isolation, have been implicated in the risk of suicide attempt in this population. In this report, we present a comprehensive model of the 3-year risk of suicide attempt in heavy drinkers using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005). METHODS We used structural equation modeling to simultaneously examine effects of four broad groups of clinical factors previously identified as potential predictors of attempted suicides: 1) alcohol use disorder severity, 2) severity of comorbidity, 3) sociodemographic characteristics and 4) help-seeking for alcohol problems. Heavy drinking was defined as drinking 5 or more drinks in a day more than once a week in the month prior to Wave 1. RESULTS About 1.5% of the 1573 heavy drinker participants (i.e., 5.1% of the NESARC sample) attempted suicide during the 3-year follow-up period. After adjusting for all other factors, several factors independently predicted attempted suicides: the alcohol use disorder liability factor measured by DSM-IV-TR criteria for alcohol abuse and dependence and two dimensions of psychopathology, the general psychopathology factor accounting for the shared effects of all comorbid psychiatric disorders and the externalizing dimension accounting for the shared effects of comorbid substance use disorders. No other factor predicted this risk in addition. CONCLUSION This model may help identify individuals with heavy drinking at high risk of suicide and develop more effective suicide prevention strategies.
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Affiliation(s)
- Nicolas Hoertel
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, France; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France.
| | - Hadi Faiz
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, France
| | - Guillaume Airagnes
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Rachel Pascal De Raykeer
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, France
| | - Silvia Franco
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Géraldine Ducoutumany
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France
| | - Cédric Lemogne
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, France; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France
| | - Frédéric Limosin
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin-Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, France; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France
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Yuma-Guerrero P, Orsi R, Lee PT, Cubbin C. A systematic review of socioeconomic status measurement in 13 years of U.S. injury research. JOURNAL OF SAFETY RESEARCH 2018; 64:55-72. [PMID: 29636170 PMCID: PMC10372816 DOI: 10.1016/j.jsr.2017.12.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/09/2017] [Accepted: 12/05/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The purpose of this review was to assess the impact of socioeconomic status (SES) on injury and to evaluate how U.S. injury researchers have measured SES over the past 13years in observational research studies. DESIGN & METHODS This systematic review included 119 US injury studies indexed in PubMed between January 1, 2002 and August 31, 2015 that used one or more individual and/or area-level measures of SES as independent variables. Study findings were compared to the results of a previous review published in 2002. RESULTS Findings indicate SES remains an important predictor of injury. SES was inversely related to injury in 78 (66%) of the studies; inverse relationships were more consistently found in studies of fatal injury (77.4%) than in studies of non-fatal injury (58%). Approximately two-thirds of the studies (n=73, 61%) measured SES along a gradient and 59% used more than one measure of SES (n=70). Studies that used a gradient measure of SES and/or more than one measure of SES identified significant relationships more often. These findings were essentially equivalent to those of a similar 2002 review (Cubbin & Smith, 2002). CONCLUSIONS There remains a need to improve measurement of SES in injury research. Public health training programs should include best practices for measurement of SES, which include: measuring SES along a gradient, selecting SES indicators based on the injury mechanism, using the smallest geographic region possible for area-level measures, using multiple indicators when possible, and using both individual and area-level measures as both contribute independently to injury risk. Area-level indicators of SES are not accurate estimates of individual-level SES. PRACTICAL APPLICATIONS Injury researchers should measure SES along a gradient and incorporate individual and area-level SES measures that are appropriate to the injury outcome under study.
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Affiliation(s)
- Paula Yuma-Guerrero
- Colorado State University, College of Health and Human Sciences, School of Social Work, 127 Education, 1586 Campus Delivery, Fort Collins, CO 80523-1586, United States.
| | - Rebecca Orsi
- Colorado State University, College of Health and Human Sciences, School of Social Work, 127 Education, 1586 Campus Delivery, Fort Collins, CO 80523-1586, United States
| | - Ping-Tzu Lee
- Colorado State University, College of Health and Human Sciences, School of Social Work, 127 Education, 1586 Campus Delivery, Fort Collins, CO 80523-1586, United States
| | - Catherine Cubbin
- The University of Texas at Austin, School of Social Work, Austin, TX, United States
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Xuan Z, Naimi TS, Kaplan MS, Bagge CL, Few LR, Maisto S, Saitz R, Freeman R. Alcohol Policies and Suicide: A Review of the Literature. Alcohol Clin Exp Res 2016; 40:2043-2055. [PMID: 27618526 DOI: 10.1111/acer.13203] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/25/2016] [Indexed: 11/28/2022]
Abstract
Both intoxication and chronic heavy alcohol use are associated with suicide. There is extensive population-level evidence linking per capita alcohol consumption with suicide. While alcohol policies can reduce excessive alcohol consumption, the relationship between alcohol policies and suicide warrants a critical review of the literature. This review summarizes the associations between various types of alcohol policies and suicide, both in the United States and internationally, as presented in English-language literature published between 1999 and 2014. Study designs, methodological challenges, and limitations in ascertaining the associations are discussed. Because of the substantial between-states variation in alcohol policies, U.S.-based studies contributed substantially to the literature. Repeated cross-sectional designs at both the ecological level and decedent level were common among U.S.-based studies. Non-U.S. studies often used time series data to evaluate pre-post comparisons of a hybrid set of policy changes. Although inconsistency remained, the published literature in general supported the protective effect of restrictive alcohol policies on reducing suicide as well as the decreased level of alcohol involvement among suicide decedents. Common limitations included measurement and selection bias and a focus on effects of a limited number of alcohol policies without accounting for other alcohol policies. This review summarizes a number of studies that suggest restrictive alcohol policies may contribute to suicide prevention on a general population level and to a reduction of alcohol involvement among suicide deaths.
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Affiliation(s)
- Ziming Xuan
- Department of Community Health Sciences , Boston University School of Public Health, Boston, Massachusetts.
| | - Timothy S Naimi
- Section of General Internal Medicine , Boston Medical Center, Boston, Massachusetts
| | - Mark S Kaplan
- Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California
| | - Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lauren R Few
- Department of Psychiatry , Washington University School of Medicine, Saint Louis, Missouri
| | - Stephen Maisto
- Department of Psychology , Syracuse University, Syracuse, New York
| | - Richard Saitz
- Department of Community Health Sciences , Boston University School of Public Health, Boston, Massachusetts
| | - Robert Freeman
- National Institute on Alcohol Abuse and Alcoholism , NIH, Bethesda, Maryland
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Toudehskchuie GRG, Fereidoon M. What Can Influence Iranian Suicide Attempters to Go Through the Process of Non-Fatal Suicide Act Once Again? A Preliminary Report. Community Ment Health J 2016; 52:597-608. [PMID: 26995684 DOI: 10.1007/s10597-015-9958-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
The thrust of this study was to examine some of the psycho-social risk factors for the recurrence of non-fatal suicide attempt in a sample of 1121 inmates admitted between April 2012 to June 2013 at the toxicology emergency ward, Noor Medical Centre, Isfahan, Iran. Out of the total participants, 240 of them reported history of suicide attempt and assumed the status of case group. The remaining 881 patients were admitted first their attempt and constituted the control group. Cases were compared to the controls with respect to select demographic features (i.e. age, sex, education, occupation, marital status, type of residence, and locale), current suicide attempt method, family history of suicide and drug abuse, history of psychiatric disorder, physical ailment and physical disability, substance abuse and alcohol use, psychiatric diagnosis, and recent life hassles (i.e. interpersonal, occupational, financial, medical, and home affairs). We used a structured interview schedule to interview the participants. Psychiatric diagnosis was based on the DSM-IV criteria. Data were computer analyzed using SPSS.21 and administering statistical analysis including Chi Square, t-student, and logistic regression. Demographic risk factors for recurrence of suicide attempts at the univariate level included occupational status [Crud odds Ratio (COR) = 0.53] and type of residence (COR = 1.40). Medical and psychiatric risk factors at the univariate level included substance abuse (COR = 1.97), physical ailment (COR = 1.76), alcohol use (COR = 1.84), psychiatric disorder (COR = 3.69), and history of suicide in the family of origin (COR = 1.86). Recent life hassles risk factors at the univariate level included financial constraints (COR = 1.46) and medical emergencies (COR = 3.48). A multivariate logistic regression model identified five variables (i.e. substance abuse, alcohol use, psychiatric illness, suicide in family, and medical emergencies) that were statistically associated with an increased risk for recurrence of nonfatal suicide attempt. The model predicted chances of repeating suicide attempt correctly 79 % of the time. These observations indicate that people who report to the toxicology emergency ward for nonfatal suicide not only need immediate relief but also careful psychiatric and social assessments which subsequently may lead to psychiatric admission and comprehensive community interventions.
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Affiliation(s)
| | - Mahsa Fereidoon
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
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Fone D, Morgan J, Fry R, Rodgers S, Orford S, Farewell D, Dunstan F, White J, Sivarajasingam V, Trefan L, Brennan I, Lee S, Shiode N, Weightman A, Webster C, Lyons R. Change in alcohol outlet density and alcohol-related harm to population health (CHALICE): a comprehensive record-linked database study in Wales. PUBLIC HEALTH RESEARCH 2016. [DOI: 10.3310/phr04030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundExcess alcohol consumption has serious adverse effects on health and results in violence-related harm.ObjectiveThis study investigated the impact of change in community alcohol availability on alcohol consumption and alcohol-related harms to health, assessing the effect of population migration and small-area deprivation.DesignA natural experiment of change in alcohol outlet density between 2006 and 2011 measured at census Lower Layer Super Output Area level using observational record-linked data.SettingWales, UK; population of 2.5 million aged ≥ 16 years.Outcome measuresAlcohol consumption, alcohol-related hospital admissions, accident and emergency (A&E) department attendances from midnight to 06.00 and violent crime against the person.Data sourcesLicensing Act 2003 [Great Britain.Licensing Act 2003. London: The Stationery Office; 2003. URL:www.legislation.gov.uk/ukpga/2003/17/contents(accessed 8 June 2015)] data on alcohol outlets held by the 22 local authorities in Wales, alcohol consumption data from annual Welsh Health Surveys 2008–12, hospital admission data 2006–11 from the Patient Episode Database for Wales (PEDW) and A&E attendance data 2009–11 were anonymously record linked to the Welsh Demographic Service age–sex register within the Secure Anonymised Information Linkage Databank. A final data source was recorded crime 2008–11 from the four police forces in Wales.MethodsOutlet density was estimated (1) as the number of outlets per capita for the 2006 static population and the per quarterly updated population to assess the impact of population migration and (2) using new methods of network analysis of distances between each household and alcohol outlets within 10 minutes of walking and driving. Alcohol availability was measured by three variables: (1) the previous quarterly value; (2) positive and negative change over the preceding five quarters; and (3) volatility, a measure of absolute quarterly changes during the preceding five quarters. Longitudinal statistical analysis used multilevel Poisson models of consumption and Geographically Weighted Regression (GWR) spatial models of binge drinking, Cox regression models of hospital admissions and A&E attendance and GWR models of violent crime against the person, each as a function of alcohol availability adjusting for confounding variables. The impact on health inequalities was investigated by stratifying models within quintiles of the Welsh Index of Multiple Deprivation.ResultsThe main finding was that change in walking outlet density was associated with alcohol-related harms: consumption, hospital admissions and violent crime against the person each tracked the quarterly changes in outlet density. Alcohol-related A&E attendances were not clinically coded and the association was less conclusive. In general, social deprivation was strongly associated with the outcome measures but did not substantially modify the associations between the outcomes and alcohol availability. We found no evidence for an important effect of population migration.LimitationsLimitations included the absence of any standardised methods of alcohol outlet data collation, processing and validation, and incomplete data on on-sales and off-sales. We were dependent on the quality of clinical coding and administrative records and could not identify alcohol-related attendances in the A&E data set.ConclusionThis complex interdisciplinary study found that important alcohol-related harms were associated with change in alcohol outlet density. Future work recommendations include defining a research standard for recording outlet data and classification of outlet type, the methodological development of residence-based density measures and a health economic analysis of model-predicted harms.FundingThe National Institute for Health Research Public Health Research programme. Additional technical and computing support was provided by the Farr Institute at Swansea University, made possible by the following grant:Centre for the Improvement of Population Health through E-records Research (CIPHER) and Farr Institute capital enhancement. CIPHER and the Farr Institute are funded by Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Chief Scientist Office (Scottish Government Health Directorates), the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute for Health Research, the National Institute for Social Care and Health Research (Welsh Government) and the Wellcome Trust (grant reference MR/K006525/1).
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Affiliation(s)
- David Fone
- Farr Institute, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Jennifer Morgan
- Farr Institute, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Richard Fry
- Farr Institute, Swansea University Medical School, Swansea, UK
| | - Sarah Rodgers
- Farr Institute, Swansea University Medical School, Swansea, UK
| | - Scott Orford
- School of Geography and Planning, Cardiff University, Cardiff, UK
- Wales Institute of Social and Economic Research, Data and Methods (WISERD), Cardiff University, Cardiff, UK
| | - Daniel Farewell
- Farr Institute, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Frank Dunstan
- Farr Institute, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - James White
- Farr Institute, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Medicine, Cardiff University, Cardiff, UK
| | - Vas Sivarajasingam
- Violence and Society Research Group, School of Dentistry, Cardiff University, Cardiff, UK
| | - Laszlo Trefan
- Farr Institute, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Iain Brennan
- Violence and Society Research Group, School of Dentistry, Cardiff University, Cardiff, UK
| | - Shin Lee
- School of Geography and Planning, Cardiff University, Cardiff, UK
| | - Narushige Shiode
- School of Geography and Planning, Cardiff University, Cardiff, UK
| | - Alison Weightman
- Specialist Unit for Research Evidence, University Library Service, Cardiff University, Cardiff, UK
| | - Chris Webster
- School of Geography and Planning, Cardiff University, Cardiff, UK
| | - Ronan Lyons
- Farr Institute, Swansea University Medical School, Swansea, UK
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Giesbrecht N, Huguet N, Ogden L, Kaplan MS, McFarland BH, Caetano R, Conner KR, Nolte KB. Acute alcohol use among suicide decedents in 14 US states: impacts of off-premise and on-premise alcohol outlet density. Addiction 2015; 110:300-7. [PMID: 25310999 PMCID: PMC4427246 DOI: 10.1111/add.12762] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/21/2014] [Accepted: 10/03/2014] [Indexed: 11/29/2022]
Abstract
AIMS To estimate the association between per capita alcohol retail outlet density and blood alcohol concentration (BAC) from 51 547 suicide decedents and to analyse the relationship between alcohol outlet density and socio-demographic characteristics among alcohol-positive suicide decedents in the United States by racial/ethnic groups and method of suicide. DESIGN Analysis of US data, 2003-11, National Violent Death Reporting System. SETTING Suicide decedents from 14 US states. PARTICIPANTS A total of 51 347 suicide decedents tested for BAC. MEASUREMENTS BAC and levels were derived from coroner/medical examiner reports. Densities of county level on-premises and off-premises alcohol retail outlets were calculated using the 2010 Census. FINDINGS Multi-level logistic regression models suggested that higher off-premises alcohol outlet densities were associated with greater proportions of alcohol-related suicides among men-for suicides with alcohol present [BAC >0; adjusted odds ratio (AOR) = 1.08, 95% confidence interval (CI) = 1.03-1.13]. Interactions between outlet density and decedents' characteristics were also tested. There was an interaction between off-premises alcohol availability and American Indian/Alaska Native race (AOR = 1.36; 95% CI = 1.10-1.69) such that this subgroup had highest BAC positivity. On-premises density was also associated with BAC >0 (AOR = 1.07; 95% CI = 1.03-1.11) and BAC ≥0.08 (AOR = 1.05; 95% CI = 1.02-1.09) among male decedents. CONCLUSIONS In the United States, the density of both on- and off-premises alcohol outlets in a county is associated positively with alcohol-related suicide, especially among American Indians/Alaska Natives.
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Affiliation(s)
- Norman Giesbrecht
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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13
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Conner KR, Huguet N, Caetano R, Giesbrecht N, McFarland BH, Nolte KB, Kaplan MS. Acute use of alcohol and methods of suicide in a US national sample. Am J Public Health 2013; 104:171-8. [PMID: 23678938 DOI: 10.2105/ajph.2013.301352] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We explored age, gender, and racial/ethnic differences with alcohol use and firearms, hanging or asphyxiation, and poisoning methods of suicide. METHODS We analyzed data for 37,993 suicide decedents aged 18 years and older from the 2005-2010 National Violent Death Reporting System database. Multinomial logistic regressions examined associations of method with alcohol use defined by blood alcohol content. Two-way interactions tested the effects of age, gender, and race/ethnicity on the associations between alcohol use and method of suicide. RESULTS Alcohol was present among decedents who used the 3 leading methods of suicide: firearm (35.0%), hanging (36.8%), and poisoning (32.7%). Two-way interaction tests suggested that in young and middle adulthood, individuals were more likely to drink alcohol when they used a firearm or hanging (compared with poisoning), but in older adulthood, the reverse was true, with alcohol use more likely with poisoning. Interaction tests also suggested that Asians and Pacific Islanders were most likely to use alcohol in poisonings and that Blacks were least likely to use alcohol in hangings. CONCLUSIONS The results suggested that alcohol use before suicide was influenced by several factors, including age, race/ethnicity, and suicide method.
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Affiliation(s)
- Kenneth R Conner
- Kenneth R. Conner is with the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY. Nathalie Huguet is with the Center for Public Health Studies, Portland State University, Portland, OR. Raul Caetano is with the University of Texas School of Public Health, Dallas Regional Campus, Dallas. Norman Giesbrecht is with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, ON. Bentson H. McFarland is with the Department of Psychiatry, Oregon Health & Science University, Portland. Kurt B. Nolte is with the Office of the Medical Investigator, University of New Mexico School of Medicine, Albuquerque. At the time of the study, Mark S. Kaplan was with the School of Community Health, Portland State University
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14
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Fone D, Dunstan F, White J, Webster C, Rodgers S, Lee S, Shiode N, Orford S, Weightman A, Brennan I, Sivarajasingam V, Morgan J, Fry R, Lyons R. Change in alcohol outlet density and alcohol-related harm to population health (CHALICE). BMC Public Health 2012; 12:428. [PMID: 22691534 PMCID: PMC3409073 DOI: 10.1186/1471-2458-12-428] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 06/12/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community. METHODS/DESIGN A natural experiment of the effect of change in outlet density between 2005-09, in Wales, UK; population 2.4 million aged 16 years and over. Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. The study outcomes are change in (1) alcohol consumption using data from annual Welsh Health Surveys, (2) alcohol-related hospital admissions using the Patient Episode Database for Wales, (3) Accident & Emergency department attendances between midnight-6am, and (4) alcohol-related violent crime against the person, using Police data. The data will be anonymously record-linked within the Secure Anonymised Information Linkage Databank at individual and 2001 Census Lower Super Output Area levels. New methods of network analysis will be used to estimate outlet density. Longitudinal statistical analysis will use (1) multilevel ordinal models of consumption and logistic models of admissions and Accident & Emergency attendance as a function of change in individual outlet exposure, adjusting for confounding variables, and (2) spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration. DISCUSSION This inter-disciplinary study requires expertise in epidemiology and public health, health informatics, medical statistics, geographical information science, and research into alcohol-related violence. Information governance requirements for the use of record-linked data have been approved together with formal data access agreements for the use of the Welsh Health Survey and Police data. The dissemination strategy will include policy makers in national and local government. Public engagement will be through the Clinical Research Collaboration-Cymru "Involving People" network, which will provide input into the implementation of the research.
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Affiliation(s)
- David Fone
- Institute of Primary Care & Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | - Frank Dunstan
- Institute of Primary Care & Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | - James White
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | - Chris Webster
- School of City and Regional Planning, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WA, UK
| | - Sarah Rodgers
- Health Information Research Unit, School of Medicine, Swansea University, Swansea, SA2 8PP, UK
| | - Shin Lee
- School of City and Regional Planning, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WA, UK
| | - Narushige Shiode
- School of City and Regional Planning, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WA, UK
| | - Scott Orford
- School of City and Regional Planning, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WA, UK
- Wales Institute of Social and Economic Research, Data and Methods (WISERD), Cardiff University, 46 Park Place, Cardiff, CF10 3BB, UK
| | - Alison Weightman
- Support Unit for Research Evidence, Information Services, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | - Iain Brennan
- Department of Social Sciences, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Vas Sivarajasingam
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| | - Jennifer Morgan
- Institute of Primary Care & Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | - Richard Fry
- Health Information Research Unit, School of Medicine, Swansea University, Swansea, SA2 8PP, UK
| | - Ronan Lyons
- Health Information Research Unit, School of Medicine, Swansea University, Swansea, SA2 8PP, UK
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15
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Cunradi CB, Mair C, Ponicki W, Remer L. Alcohol outlet density and intimate partner violence-related emergency department visits. Alcohol Clin Exp Res 2012; 36:847-53. [PMID: 22339652 DOI: 10.1111/j.1530-0277.2011.01683.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Previous research has identified risk factors for intimate partner violence (IPV) severity, injury, and emergency department (ED) visits. These risk factors have been shown at both the individual level (heavy drinking and other substance use on the part of 1 or both partners) and the neighborhood level (residence in an area characterized by poverty and social disadvantage). Alcohol outlet density has been linked with assaultive violence in community settings, but has not been analyzed in relation to IPV-related ED visits. This study examined the effects of outlet densities on IPV-related ED visits throughout California between July 2005 and December 2008. METHODS Half-yearly counts of ED visits related to IPV (E-code 967.3) were computed for each zip code from patient-level public data sets. Alcohol outlet density measures, calculated separately for bars, off-premise outlets, and restaurants, were derived from California Alcohol Beverage Control records. Census-based neighborhood demographic characteristics previously shown to be related to health disparities and IPV (percent black, percent Hispanic, percentage below 150% of poverty line, percent unemployed) were included in models. This study used Bayesian space-time models that allow longitudinal analysis at the zip code level despite frequent boundary redefinitions. These spatial misalignment models control for spatial variation in geographic unit definitions over time and account for spatial autocorrelation using conditional autoregressive (CAR) priors. The model incorporated data from between 1,686 (2005) and 1,693 (2008) zip codes across California for 7 half-year time periods from 2005 through 2008 (n = 11,836). RESULTS Density of bars was positively associated with IPV-related ED visits. Density of off-premise outlets was negatively associated with IPV-related ED visits; this association was weaker and smaller than the bar association. There was no association between density of restaurants and IPV-related ED visits. CONCLUSIONS Further research is needed to understand the mechanisms by which environmental factors, such as alcohol outlet density, affect IPV behaviors resulting in ED visits.
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Affiliation(s)
- Carol B Cunradi
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California 94704, USA.
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16
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Abstract
PURPOSE OF REVIEW To address gaps identified in earlier reviews, namely, the comparative influence of substance use on attempted suicide and completed suicide; the proximal role of substance use as a trigger of suicidal behaviour; the association between substances and suicidal behaviour; suicide and substance use disorders in youth; and the influence of combinations of risk factors, including psychiatric morbidity, on suicide. RECENT FINDINGS The presence of an alcohol use disorder is confirmed as a distal risk factor for completed suicide, as well as attempted suicide. Alcohol use at the time of the suicide attempt is associated with low-risk methods. The use of other substances as a trigger of suicidal behaviour is highlighted in recent studies, but the circumstances leading to the suicidal act and the direct influence of substances in suicidal behaviour need to be explored further. Inhalant use and cocaine use are particularly associated with suicidal behaviour. Young people with multiple risk behaviours, such as substance use and risky sexual behaviours, are at high risk for suicidal behaviour. Psychiatric comorbidity with substance use escalates the risk for suicidal behaviour. Environmental interventions, such as reduction in the number of bars, may be helpful in reducing alcohol-related morbidity, including suicides. SUMMARY Prevention strategies for reducing suicidal behaviour among substance users need to be prioritized at the individual and the national level through effective design, policy and implementation.
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Abstract
Neighborhood indicators of social disadvantage, such as poverty and unemployment, are associated with intimate partner violence (IPV). Despite the well-established link between heavy drinking and IPV, few studies have analyzed the contribution of alcohol outlet density to the occurrence of IPV. Greater numbers of alcohol outlets in a community may be a sign of loosened normative constraints against violence, promote problem drinking among at-risk couples, and provide environments where groups of persons at risk for IPV may form and mutually reinforce IPV-related attitudes, norms, and problem behaviors. This study used ecological data to determine if alcohol outlet density (number of bars, restaurants serving alcohol, and off-premise outlets per unit area) is related to rates of IPV-related police calls and IPV-related crime reports in Sacramento, California. Separate analyses for IPV calls and crime reports were conducted using Bayesian space-time models adjusted for area characteristics (poverty rate, unemployment rate, racial/ethnic composition). The results showed that each additional off-premise alcohol outlet is associated with an approximate 4% increase in IPV-related police calls and an approximate 3% increase in IPV-related crime reports. Bars and restaurants were not associated with either outcome. The findings suggest that alcohol outlet density, especially off-premise outlets, appear to be related to IPV events. Further research is needed to understand the mechanisms by which neighborhood factors, such as alcohol outlet density, affect IPV behaviors. Understanding these mechanisms is of public health importance for developing environmental IPV prevention strategies, such as changes in zoning, community action, education, and enforcement activities.
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Abstract
A case-control study of 149 intentionally self-inflicted gun injury cases (including completed gun suicides) and 302 population-based controls was conducted from 2003 to 2006 in a major US city. Two focal independent variables, acute alcohol consumption and alcohol outlet availability, were measured. Conditional logistic regression was adjusted for confounding variables. Gun suicide risk to individuals in areas of high alcohol outlet availability was less than the gun suicide risk they incurred from acute alcohol consumption, especially to excess. This corroborates prior work but also uncovers new information about the relationships between acute alcohol consumption, alcohol outlets, and gun suicide. Study limitations and implications are discussed.
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Affiliation(s)
- Charles C Branas
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA.
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Padilla H, Michael Gaziano J, Djoussé L. Alcohol consumption and risk of heart failure: a meta-analysis. PHYSICIAN SPORTSMED 2010; 38:84-9. [PMID: 20959700 DOI: 10.3810/psm.2010.10.1812] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Heart failure is highly prevalent among older adults and is associated with high treatment costs. Identifying modifiable determinants of heart failure may help in prevention. Alcohol consumption has emerged as a modifiable risk factor for cardiovascular diseases. Although many studies have suggested a positive association between heavy drinking and cardiomyopathy, the association between infrequent or light-to-moderate drinking and heart failure risk has been less conclusive. PURPOSE To examine the relation between various levels of alcohol intake and incident heart failure. METHODS We conducted a meta-analysis of 6 studies obtained through a PubMed literature search. Alcohol drinkers were classified as never, former, and current drinkers of 0.1 to 0.9, 1 to 7, 8 to 14, and > 14 drinks per week. RESULTS Compared with never drinkers, the pooled relative risks were 1.16 (95% confidence interval [CI], 0.90-1.51) for former drinkers, 0.90 (95% CI, 0.83-0.98), 0.80 (95% CI, 0.73-0.88), 0.78 (95% CI, 0.65-0.95), and 0.77 (95% CI, 0.63-0.95) for current drinkers of 0.1 to 0.9, 1 to 7, 8 to 14, and > 14 drinks per week, respectively, in a random effects model. CONCLUSION These data suggest that infrequent and light-to-moderate drinking is associated with a lower risk of heart failure.
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Affiliation(s)
- Heather Padilla
- Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02120, USA.
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