Racial/Ethnic Disparities in the Self-Reported Number of Drinks in 2 Hours Before Driving Becomes Impaired

Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016

OBJECTIVES

To analyze changes in racial/ethnic disparities for unintentional injury mortality from 1999-2016.

METHODS

Mortality data are from the National Center for Health Statistics (NCHS) for all unintentional injuries, analyzed separately by injury cause (motor vehicle accidents [MVA], poisonings, other unintentional) for white,black, and Hispanic populations within four age groups: 15-19, 20-34, 35-54, 55-74 for males and for females.

RESULTS

Rates across race/ethnic groups varied by gender, age and cause of injury. Unintentional injury mortality showed a recent increase for both males and females, which was more marked among males and for poisoning in all race/ethnic groups of both genders. Whites showed highest rates of poisoning mortality and the steepest increase for both genders, except for black males aged 55-74. MVA mortality also showed an increase for all race/ethnic groups, with a sharper rise among blacks, while Hispanics had lower rates than either whites or blacks. Rates for other unintentional injury mortality were similar across groups except for white women over 55, for whom rates were elevated.

CONCLUSIONS

Data suggest while mortality from unintentional injury related to MVA and poisoning is on the rise for both genders and in most age groups, blacks compared to whites and Hispanics may be suffering a disproportionate burden of mortality related to MVAs and to poisonings among those over 55, which may be related to substance use.

Race/Ethnicity, Community of Residence, and DUI Arrest After Beginning Treatment for an Alcohol Use Disorder

The purpose of this study was to examine whether racial/ethnic disparities in post-treatment arrests for driving under the influence (DUI) exist among clients receiving outpatient treatment for an alcohol use disorder (AUD) and to assess whether community characteristics were associated with this outcome. The sample included adults with an AUD entering publicly funded outpatient treatment in Washington State in 2012. Treatment data were linked with criminal justice and US Census data. Multilevel time-to-event analysis was employed to answer the research questions. Key independent variables included client race/ethnicity, community-level economic disadvantage, and racial/ethnic composition of the community. Latino clients and clients residing in communities with a higher proportion of Black residents had higher hazards of a DUI arrest post-treatment admission. Future research should examine whether disparities in DUI arrests are related to differences in treatment effectiveness or other factors (e.g., inequities in law enforcement) so that these disparities can be addressed.

Factors Associated with Self-Estimated Breath Alcohol Concentration Among Bar Patrons

BACKGROUND

Few studies have examined the context in which drinkers underestimate their breath alcohol concentration (BrAC) in natural drinking environments. This study examined factors associated with bar patrons' self-estimated BrAC in high-risk college town settings.

METHODS

Guided interview and BrAC data were collected from 510 participants recruited as they exited bars located close to large universities: 1 in Florida and 1 in Texas.

RESULTS

Participants with the highest measured BrACs underestimated their BrAC levels the most. Findings from multivariable linear regression analysis indicated that BrAC (std β = 0.014, p < 0.001), number of alcoholic drinks consumed (std β = 0.006, p < 0.01), and perceived drunkenness (std β = 0.024, p < 0.001) had significant positive associations with BrAC self-estimates, where the regression coefficients were scaled by values approximately equal to each variable's interquartile range. Among the 321 participants with BrAC levels ≥ 0.08 g/dl, 21.2% believed their BrAC was below the legal per se driving limit of 0.08 g/dl. Results from a logistic regression analysis indicated that higher levels of perceived drunkenness were associated with better self-recognition that one's BrAC level exceeded the legal driving threshold (OR = 3.312, p < 0.001). Further, participants under 26 years of age had reduced odds of recognizing that their BrAC was greater than 0.079 g/dl (OR = 0.245, p < 0.05).

CONCLUSIONS

These findings highlight the inaccuracy of self-estimated BrAC when drinking, particularly among younger drinkers. Adjusting for BrAC, situational factors were strongly associated with self-estimated BrAC. Future research is needed to better understand how altering drinking environments may improve accuracy of BrAC self-estimates and deter driving after drinking.

Cultural Correlates of DUI Risk Perceptions Among Documented and Undocumented Recent Latino Immigrants in South Florida

Latinos do not drink and drive more often than non-Latino Whites, yet are disproportionately involved in alcohol-related arrests and fatal crashes. These disparities have been linked to a failure in recognizing the impairing effects of alcohol on driving psychomotor abilities and low risk perceptions of being caught or prosecuted by law enforcement for DUI (driving under the influence). However, little is known about the role that cultural factors play in shaping drinking and driving risk perceptions among Latino immigrants. This study examines associations between cultural factors and DUI risk perceptions in a sample of 467 documented and undocumented recent Latino immigrants. Results revealed cultural risk factors were associated with higher alcohol use and decreased DUI risk perceptions. Cultural protective factors were linked with less drinking behaviors. Undocumented immigrants reported higher rates of alcohol use, lower levels of cultural protective factors, and higher levels of cultural risk factors. Findings contribute to the limited knowledge of drinking and driving among Latino immigrants early in the immigration process and suggest a need for greater attention to cultural factors in developing DUI prevention programs tailored toward Latino immigrants.

Alcohol use by urban bicyclists is associated with more severe injury, greater hospital resource use, and higher mortality

Alcohol use is a risk factor for severe injury in pedestrians struck by motor vehicles. Our objective was to investigate alcohol use by bicyclists and its effects on riding behaviors, medical management, injury severity, and mortality within a congested urban setting. A hospital-based, observational study of injured bicyclists presenting to a Level I regional trauma center in New York City was conducted. Data were collected prospectively from 2012 to 2014 by interviewing all bicyclists presenting within 24 h of injury and supplemented with medical record review. Variables included demographic characteristics, scene-related data, Glasgow Coma Scale (GCS), computed tomography (CT) scans, and clinical outcomes. Alcohol use at the time of injury was determined by history or blood alcohol level (BAL) >0.01 g/dL. Of 689 bicyclists, 585 (84.9%) were male with a mean age of 35.2. One hundred four (15.1%) bicyclists had consumed alcohol prior to injury. Alcohol use was inversely associated with helmet use (16.5% [9.9-25.1] vs. 43.2% [39.1-47.3]). Alcohol-consuming bicyclists were more likely to fall from their bicycles (42.0% [32.2-52.3] vs. 24.2% [20.8-27.9]) and less likely to be injured by collision with a motor vehicle (52.0% [41.7-62.1] vs. 67.5% [63.5-71.3]). 80% of alcohol-consuming bicyclists underwent CT imaging at presentation compared with 51.5% of non-users. Mortality was higher among injured bicyclists who had used alcohol (2.9% [0.6-8.2] vs. 0.0% [0.0-0.6]). Adjusted multivariable analysis revealed that alcohol use was independently associated with more severe injury (Adjusted Odds Ratio 2.27, p = 0.001, 95% Confidence Interval 1.40-3.68). Within a dense urban environment, alcohol use by bicyclists was associated with more severe injury, greater hospital resource use, and higher mortality. As bicycling continues to increase in popularity internationally, it is important to heighten awareness about the risks and consequences of bicycling while under the influence of alcohol.