Alcohol availability and domestic violence

From intimate partners to serial killers: Nearly 40 years of female homicides in King County, Washington (1978-2016)

An extreme, known potential outcome of intimate partner violence (IPV) is death, with national data revealing females are more likely to be killed by intimate partners than by others. In a novel pairing, the King County Medical Examiner's Office data management system and the Washington State Attorney General's Office's Homicide Information Tracking System were retrospectively analyzed (1978-2016) with information gathered pertaining to female homicide victims. Analyses show that female victims commonly knew their assailant(s) (79.3%) who were overwhelmingly male (92.8%) and commonly intimate partners (31.4%). Disproportionately represented were Black (20.17%) and Native American (4.25%) females; Asian/Pacific Islander (2.5 times that of Whites) and elderly (24%) females among homicide-suicide deaths; and Asian/Pacific Islander and Hispanic females in cases of IPV. "Domestic violence" was the most cited motive (34.3%) and most assaults occurred in a residence (58.73%). Females under 10 years of age were most commonly killed by a parent or caregiver (42.86%), while those over 70 were most likely to be killed by a child (23.08%) or spouse (21.80%). Serial murders, most commonly by the Green River Killer (80%) but including others, accounted for at least 7% of deaths, with victims notably young and commonly sex workers (68%). As compared to males, females were more likely to be killed by multiple modalities, asphyxia, and sharp force, though IPV-related deaths were more likely to be associated with firearms. This study reinforces the vulnerability of females to IPV, sexual assault, and serial murders as well as to caretakers at the extremities of age.

The role of alcohol outlet visits derived from mobile phone location data in enhancing domestic violence prediction at the neighborhood level

Domestic violence (DV) is a serious public health issue, with 1 in 3 women and 1 in 4 men experiencing some form of partner-related violence every year. Existing research has shown a strong association between alcohol use and DV at the individual level. Accordingly, alcohol use could also be a predictor for DV at the neighborhood level, helping identify the neighborhoods where DV is more likely to happen. However, it is difficult and costly to collect data that can represent neighborhood-level alcohol use especially for a large geographic area. In this study, we propose to derive information about the alcohol outlet visits of the residents of different neighborhoods from anonymized mobile phone location data, and investigate whether the derived visits can help better predict DV at the neighborhood level. We use mobile phone data from the company SafeGraph, which is freely available to researchers and which contains information about how people visit various points-of-interest including alcohol outlets. In such data, a visit to an alcohol outlet is identified based on the GPS point location of the mobile phone and the building footprint (a polygon) of the alcohol outlet. We present our method for deriving neighborhood-level alcohol outlet visits, and experiment with four different statistical and machine learning models to investigate the role of the derived visits in enhancing DV prediction based on an empirical dataset about DV in Chicago. Our results reveal the effectiveness of the derived alcohol outlets visits in helping identify neighborhoods that are more likely to suffer from DV, and can inform policies related to DV intervention and alcohol outlet licensing.

Ecological Research for Studies of Violence: A Methodological Guide

Ecological research is important to the study of violence in communities. The phrases "ecological research" and "ecologic study" describe those research studies that use grouped or geographic units of analysis, such as zip codes, cities, or states. This type of research allows for the investigation of group-level effects and can be inexpensive and relatively quick to conduct if the researcher uses existing data. And, importantly, ecological studies are an efficient means for hypothesis generation prior to, and can be used to justify, costlier individual-level studies. Ecological research designs may be employed to study violence outcomes when the research question is at the population level, either for theoretical reasons, or when an exposure or intervention is at the population level, or when individual-level studies are not feasible; however, ecological research results must not be used to make individual-level inferences. This article will discuss reasons to conduct ecological-level research, guidelines for choosing the ecological unit of analysis, frequently used research designs, common limitations of ecological research, including the ecological fallacy, and issues to consider when using existing data.

Adolescent Drinking and Alcohol Policy

Policy approaches to prevention have considerable promise for addressing underage drinking and its associated problems. Based on the available evidence, the most effective policies appear to be (a) taxation or price increases, (b) increases in the minimum drinking age, and (c) graduated licensing or zero tolerance. Random breath testing and sobriety checkpoints also appear promising, although there is little evidence for their effectiveness specifically with young people. Major changes in the conditions of sale (e.g., privatization) may also affect the availability of alcohol to young people and thus underage drinking. The evidence is less convincing, however, for the effects of more modest license restrictions (e.g., limiting outlet density, hours of sale), responsible beverage service, advertising restrictions, warning labels, keg registration, and school policies. It is clear from the available research that no policy can be effective unless it is accompanied by enforcement and by awareness on the part of the intended targets of both the policy and the enforcement efforts.

Neighborhood Contextual Factors, Alcohol Use, and Alcohol Problems in the United States: Evidence From a Nationally Representative Study of Young Adults

BACKGROUND

There is considerable variation in alcohol use and problems across the United States, suggesting that systematic regional differences might contribute to alcohol involvement. Several neighborhood contextual factors may be important aspects of this "alcohol environment."

METHODS

Participants were 15,197 young adults (age 18 to 26) from Wave III of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative U.S. survey. Measures of past-year alcohol use and problems were obtained via structured in-home interviews. Tract-level neighborhood contextual factors (density of on- and off-premises alcohol outlets, neighborhood disadvantage, rural vs. urban residence) were derived from census indicators and geocoded state-level alcohol outlet licenses. Multivariate logistic regression, ordered logistic regression, or negative binomial regression models, including age, sex, race, and household income as covariates, were fit to examine the relation of the neighborhood contextual factors with alcohol use and problems.

RESULTS

The most consistent finding across 4 of the 5 measures of alcohol involvement was their association with neighborhood advantage; the active ingredient underlying this effect was primarily the proportion of educated residents in the neighborhood. The densities of alcohol outlets were associated with any alcohol use-they were not associated with binge drinking or alcohol problems, nor could they explain any of the neighborhood advantage effects. The influence of alcohol outlet densities on alcohol involvement did not differ for those above or below the legal age to purchase alcohol. Living in a rural versus an urban neighborhood was associated with a different alcohol use pattern characterized by a lower likelihood of any drinking, but among those who drank, consuming more alcohol per occasion.

CONCLUSIONS

Living in a more advantaged and educated urban neighborhood with greater densities of bars and restaurants is associated with greater alcohol involvement among 18- to 26-year-olds in the United States.

Alcohol Outlet Density and Intimate Partner Violence in a Nonmetropolitan College Town: Accounting for Neighborhood Characteristics and Alcohol Outlet Types

There is a growing evidence of an ecological association between alcohol outlet density and intimate partner violence. It is reasonable to assume, however, that not all types of alcohol outlets contribute equally to criminal behavior, and to date, most ecological studies have been of large urban cities. Using Bloomington, Indiana, block groups as units of analysis and controlling for several structural characteristics associated with violence rates, I estimated spatially lagged regression models to determine if the variation in alcohol outlet density, including total outlets and disaggregating by on- and off-premise outlets, is related to intimate partner violence density. Results suggested that total alcohol outlet density and off-premise alcohol outlet density were significantly associated with intimate partner violence density. On-premise alcohol outlet density was not significantly associated with intimate partner violence density. These results not only extend the geographic scope of this relationship beyond large metropolitan areas but also have important policy implications.

A Review of Existing Studies Reporting the Negative Effects of Alcohol Access and Positive Effects of Alcohol Control Policies on Interpersonal Violence

Alcohol consumption often leads to elevated rates of violence yet alcohol access policies continue to relax across the globe. Our review establishes the extent alcohol policy can moderate violent crime through alcohol availability restrictions. Results were informed from comprehensive selection of peer-reviewed journals from 1950 to October 2015. Our search identified 87 relevant studies on alcohol access and violence conducted across 12 countries. Seventeen studies included quasi-control design, and 23 conducted intervention analysis. Seventy-one (82%) reported a significant relationship between alcohol access and violent offenses. Alcohol outlet studies reported the greatest percentage of significant results (93%), with trading hours (63%), and alcohol price following (58%). Results from baseline studies indicated the effectiveness of increasing the price of commonly consumed alcohol, restricting the hours of alcohol trading, and limiting the number of alcohol outlets per region to prevent violent offenses. Unclear are the effects of tax reductions, restriction of on-premises re-entry, and different outlet types on violent crime. Further, the generalization of statistics over broad areas and the low number of control/intervention studies poses some concern for confounding or correlated effects on study results, and amount of information for local-level prevention of interpersonal violence. Future studies should focus on gathering longitudinal data, validating models, limiting crime data to peak drinking days and times, and wherever possible collecting the joint distribution between violent crime, intoxication, and place. A greater uptake of local-level analysis will benefit studies comparing the influence of multiple alcohol establishment types by relating the location of a crime to establishment proximity. Despite, some uncertainties particular studies showed that even modest policy changes, such as 1% increases in alcohol price, 1 h changes to closing times, and limiting establishment densities to <25 outlets per postal code substantively reduce violent crime.

A Review of the Statistical and Quantitative Methods Used to Study Alcohol-Attributable Crime

Modelling the relationship between alcohol consumption and crime generates new knowledge for crime prevention strategies. Advances in data, particularly data with spatial and temporal attributes, have led to a growing suite of applied methods for modelling. In support of alcohol and crime researchers we synthesized and critiqued existing methods of spatially and quantitatively modelling the effects of alcohol exposure on crime to aid method selection, and identify new opportunities for analysis strategies. We searched the alcohol-crime literature from 1950 to January 2014. Analyses that statistically evaluated or mapped the association between alcohol and crime were included. For modelling purposes, crime data were most often derived from generalized police reports, aggregated to large spatial units such as census tracts or postal codes, and standardized by residential population data. Sixty-eight of the 90 selected studies included geospatial data of which 48 used cross-sectional datasets. Regression was the prominent modelling choice (n = 78) though dependent on data many variations existed. There are opportunities to improve information for alcohol-attributable crime prevention by using alternative population data to standardize crime rates, sourcing crime information from non-traditional platforms (social media), increasing the number of panel studies, and conducting analysis at the local level (neighbourhood, block, or point). Due to the spatio-temporal advances in crime data, we expect a continued uptake of flexible Bayesian hierarchical modelling, a greater inclusion of spatial-temporal point pattern analysis, and shift toward prospective (forecast) modelling over small areas (e.g., blocks).

Perceived physical availability of alcohol at work and workplace alcohol use and impairment: testing a structural model

This study develops and tests a new conceptual model of perceived physical availability of alcohol at work that provides unique insight into 3 dimensions of workplace physical availability of alcohol and their direct and indirect relations to workplace alcohol use and impairment. Data were obtained from a national probability sample of 2,727 U.S. workers. The results support the proposed conceptual model and provide empirical support for a positive relation of perceived physical availability of alcohol at work to workplace alcohol use and 2 dimensions of workplace impairment (workplace intoxication and workplace hangover). Ultimately, the findings suggest that perceived physical availability of alcohol at work is a risk factor for alcohol use and impairment during the workday, and that this relation is more complex than previously hypothesized.

Alcohol interventions, alcohol policy and intimate partner violence: a systematic review

BACKGROUND

Intimate partner violence (IPV) is a significant global public health issue. The consistent evidence that alcohol use by one or both partners contributes to the risk and severity of IPV suggests that interventions that reduce alcohol consumption may also reduce IPV. This study sought to review the evidence for effects on IPV of alcohol interventions at the population, community, relationship and individual levels using the World Health Organization ecological framework for violence.

METHODS

Eleven databases including Medline, PsycINFO, CINAHL and EMBASE were searched for English-language studies and grey literature published 1 January 1992 - 1 March 2013 investigating whether alcohol interventions/policies were associated with IPV reduction within adult (≥ 18) intimate relationships. Eleven studies meeting design criteria for attributing effects to the intervention and ten studies showing mediation of alcohol consumption were included in the review. The heterogeneity of study designs precluded quantitative meta analysis; therefore, a critical narrative approach was used.

RESULTS

Population-level pricing and taxation studies found weak or no evidence for alcohol price changes influencing IPV. Studies of community-level policies or interventions (e.g., hours of sale, alcohol outlet density) showed weak evidence of an association with IPV. Couples-based and individual alcohol treatment studies found a relationship between reductions in alcohol consumption and reductions in IPV but their designs precluded attributing changes to treatment. Randomized controlled trials of combined alcohol and violence treatment programs found some positive effects of brief alcohol intervention as an adjunct to batterer treatment for hazardous drinking IPV perpetrators, and of brief interventions with non-dependent younger populations, but effects were often not sustained.

CONCLUSIONS

Despite evidence associating problematic alcohol use with IPV, the potential for alcohol interventions to reduce IPV has not been adequately tested, possibly because studies have not focused on those most at risk of alcohol-related IPV. Research using rigorous designs should target young adult populations among whom IPV and drinking is highly prevalent. Combining alcohol and IPV intervention/policy approaches at the population, community, relationship and individual-level may provide the best opportunity for effective intervention.

Alcohol Outlet Density and Young Women's Perpetration of Violence Toward Male Intimate Partners

This paper examines the relationships between alcohol outlet density, alcohol use, and perpetration of intimate partner violence (IPV) among young adult women in the US. Data were from Wave III of the National Longitudinal Study of Adolescent Health (Add Health; N = 4,430 in present analyses). Multinomial logistic regression was used to examine occurrence of past year IPV perpetration toward a male partner based on tract-level on-premise and off-premise alcohol outlet density, controlling for individuals' demographic, alcohol use, and childhood abuse characteristics and neighborhood socio-demographic factors. Higher off-premise alcohol outlet density was found to be associated with young women's perpetration of physical only IPV, controlling for individual-level and ecological factors. Alcohol use had an independent association with IPV perpetration but was not a mediator of the outlet density-IPV relationship. Findings suggest that considering alcohol-related environmental factors may help efforts aimed at preventing young women's use of physical violence toward partners.

Perpetration of intimate partner violence by young adult males: the association with alcohol outlet density and drinking behavior

OBJECTIVE

This study examined the association between alcohol outlet density and male to female intimate partner violence (IPV).

METHOD

Data were analyzed from a national probability sample of males who reported a current heterosexual relationship (N=3194). Multinomial logistic regression was used to examine the likelihood of having perpetrated IPV.

RESULTS

High alcohol outlet density was associated with having perpetrated physical only IPV (odds ratio [OR]=2.51; 95% confidence interval [CI]: 1.21-5.20). Outlet density was not associated with greater odds of sexual IPV perpetration.

CONCLUSIONS

Alcohol outlet density was found to be associated with perpetration of physical IPV. Developing environmental strategies with respect to alcohol outlets could potentially reduce perpetration of male-to-female physical IPV.

Community organization moderates the effect of alcohol outlet density on violence

There is growing evidence from multiple disciplines that alcohol outlet density is associated with community levels of assault. Based on the theoretical and empirical literatures on social organization and crime, we tested the hypothesis that the association between alcohol outlet density and neighbourhood violence rates is moderated by social organization. Using geocoded police data on assaults, geocoded data on the location of alcohol outlets, and controlling for several structural factors thought to be associated with violence rates, we tested this hypothesis employing negative binomial regression with our sample of 298 block groups in Cincinnati. Our results revealed direct effects of alcohol outlet density and social organization on assault density, and these effects held for different outlet types (i.e., off-premise, bars, restaurants) and levels of harm (i.e., simple and aggravated assaults). More importantly, we found that the strength of the outlet-assault association was significantly weaker in more socially organized communities. Subsequent analyses by level of organization revealed no effects of alcohol outlet density on aggravated assaults in organized block groups, but significant effects in disorganized block groups. We found no association between social (dis)organization and outlet density. These results clarify the community-level relationship between alcohol outlets and violence and have important implications for municipal-level alcohol policies.

Relationships among alcohol outlet density, alcohol use, and intimate partner violence victimization among young women in the United States

Greater access to alcohol has been widely found to be associated with many negative outcomes including violence perpetration. This study examines the relationship between alcohol outlet density, alcohol use, and intimate partner violence (IPV) victimization among young women in the United States. A direct association between alcohol outlet density in one's neighborhood and the likelihood of IPV victimization was examined. Data were from Wave III of the National Longitudinal Study of Adolescent Health (Add Health), which followed a nationally representative sample of adolescents into adulthood. Participants were young adult females age 18 to 26 at Wave III. Of the 4,571 female respondents who reported a current heterosexual relationship and had IPV data, 13.2% reported having been the victim of physical violence only and 6.5% experienced sexual only or physical and sexual violence in the relationship during the past year. In the regression models tested, there was no significant direct association between neighborhood alcohol outlet density and IPV victimization nor was there an association between outlet density and drinking behaviors, thus eliminating the possibility of an indirect association. Results of fully adjusted models indicate females who drank heavily, whether infrequently or frequently, were at significant risk for experiencing sexual only IPV or sexual and physical IPV. Asians and Native Americans were at significantly greater odds of experiencing sexual only or sexual and physical IPV compared with non-Hispanic Whites, while non-Hispanic Blacks were at significantly greater odds for physical only IPV. We conclude that a continuous measure of alcohol outlet density was not associated with IPV in models controlling for individual and other neighborhood characteristics. Young women who drink heavily, whether infrequently or frequently, have greater odds of experiencing sexual only or sexual and physical compared to abstainers. Similar to previous study findings, young women living with or married to their partner were at far greater risk of experiencing physical only and/or sexual only or sexual and physical IPV. The study adds to the growing body of literature that examines how community characteristics such as outlet density influence the likelihood of IPV.

Violence victimization of young men in heterosexual relationships: does alcohol outlet density influence outcomes?

This study examined whether alcohol outlet density is associated with male physical and sexual victimization by a female partner. Data were from the National Longitudinal Study of Adolescent Health (Add Health). A total of 3,179 young adult men identified a current heterosexual relationship and had complete intimate partner violence (IPV) victimization data. Almost 16% of this sample reported being the victim of physical only IPV in their relationship over the previous 12 months; an additional 6.4% were victims of sexual only or sexual and physical IPV. Multivariate analyses indicated high alcohol outlet density was associated with greater odds of experiencing physical IPV only (odds ratio [OR] = 2.07). Heavy drinkers experienced increased odds of physical and sexual IPV victimization. Alcohol outlet density should be addressed in prevention efforts.

Assessing the relationship between alcohol outlets and domestic violence: routine activities and the neighborhood environment

Studies have consistently found a positive relationship between alcohol outlet density and assault, but only a handful of studies have examined whether outlet density has an influence on domestic violence. Using a framework based in crime opportunity theories, this study estimates spatial econometric regression models to test whether the density of alcohol outlets across neighborhoods is positively associated with police calls for service for domestic violence. Models also were developed to test whether the relationships found were consistent across time periods associated with the use of alcohol outlets (weeknights and weekends). The findings indicate that off-premise outlets were associated with a significant increase in domestic violence, but on-premise outlets (specifically restaurants and nightclubs) were associated with a decrease in domestic violence. The risk for domestic violence in areas of high densities of off-premise outlets was found to be high during the weekend but not during the weeknight, suggesting different routine activities for domestic violence offenders during the week.

A longitudinal analysis of alcohol outlet density and domestic violence

AIMS

A small number of studies have identified a positive relationship between alcohol outlet density and domestic violence. These studies have all been based on cross-sectional data and have been limited to the assessment of ecological correlations between outlet density and domestic violence rates. This study provides the first longitudinal examination of this relationship.

DESIGN

Cross-sectional time-series using aggregated data from small areas. The relationships between alcohol outlet density and domestic violence were assessed over time using a fixed-effects model. Controls for the spatial autocorrelation of the data were included in the model.

SETTING

The study uses data for 186 postcodes from within the metropolitan area of Melbourne, Australia for the years 1996 to 2005.

MEASURES

Alcohol outlet density measures for three different types of outlets (hotel/pub, packaged liquor, on-premise) were derived from liquor licensing records and domestic violence rates were calculated from police-recorded crime data, based on the victim's postcode.

FINDINGS

Alcohol outlet density was associated significantly with rates of domestic violence, over time. All three licence categories were positively associated with domestic violence rates, with small effects for general (pub) and on-premise licences and a large effect for packaged liquor licences.

CONCLUSIONS

In Melbourne, the density of liquor licences is positively associated with rates of domestic violence over time. The effects were particularly large for packaged liquor outlets, suggesting a need for licensing policies that pay more attention to o off-premise alcohol availability.

Alcohol outlets, neighborhood characteristics, and intimate partner violence: ecological analysis of a California city

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.

Alcohol availability and violence among inner-city adolescents: A multi-level analysis of the role of alcohol outlet density

Researchers recognize that the connection between alcohol and peer violence may relate to community level ecological factors, such as the location of businesses that sell alcohol. Building on previous research among adults, this study examines the relationship between alcohol outlet density and violent behaviors among adolescents, taking into account demographic characteristics, individual alcohol use, and neighborhood level socioeconomic indicators. Data drawn from a diverse Emergency Department based sample of 1,050 urban adolescents, combined with tract level data from the state liquor control commission and U.S. Census, were analyzed. Results of multivariate multi-level regression analysis indicate that alcohol outlet density is significantly related to adolescents' violent behaviors, controlling for demographic characteristics and individual alcohol use. Census tract level socioeconomic indicators were not significantly associated with youth violence. Findings suggest that alcohol outlet density regulation should be considered as part of broader violence prevention strategies for urban adolescents.

Early adolescent, multi-ethnic, urban youth's exposure to patterns of alcohol-related neighborhood characteristics

This study identified heterogeneous classes of alcohol-related neighborhood characteristics to which multi-ethnic, early adolescents in urban communities are exposed. The sample comprised 4,215 youth from 42 community areas in Chicago, Illinois who completed surveys at the beginning of 6th grade (2002). Neighborhood measures included: (1) mean number of alcohol outlets per 1,000 population per community area; (2) alcohol purchase attempt rate by pseudo-underage youth; (3) average number of alcohol advertisements within 1,500 feet of each school per community; and (4) a Census 2000-based deprivation index. Parents and community leaders provided data on perceived neighborhood problems and parental prevention actions, and neighborhood strength and preventive action by communities, law enforcement, and community organizations, respectively. Multilevel latent class analysis identified the number and characteristics of heterogeneous latent neighborhood classes in which these youth are exposed. Five classes best described the heterogeneity among the sample: (1) Low social capital/low exposure/high access to alcohol (19.8%), (2) Low social capital/low exposure/low access to alcohol (24.5%), (3) Moderate social capital/low exposure/high access to alcohol (30.0%), (4) Moderate social capital/moderate exposure/low access to alcohol (20.1%), and (5) High social capital/moderate exposure/high access to alcohol (5.6%). The racial/ethnic distribution among the classes varied considerably. Results suggest there is substantive heterogeneity among this seemingly homogeneous urban population. Further, they highlight the socioeconomic disadvantage of these inner-city communities and the resource disparity across the racial/ethnic groups. Understanding the nuances among communities may lend to development of more efficacious preventive interventions and policy initiatives, inform theory, and help prioritize limited resources.

Neighborhoods, alcohol outlets and intimate partner violence: addressing research gaps in explanatory mechanisms

Indices of heavy drinking have consistently been linked with increased risk for intimate partner violence (IPV) among couples in the general household population. Because IPV is a 'private' event, most IPV research has focused on individual-level risk factors, but current social ecological theory suggests that alcohol outlets can act with neighborhood conditions to increase risks for IPV. This paper reviews the theoretical and empirical literatures relevant to identifying specific social mechanisms linking IPV to alcohol use in community settings, and discusses three social mechanisms relevant to these effects: greater numbers of alcohol outlets within a neighborhood may (1) be a sign of loosened normative constraints against violence; (2) promote problem alcohol use among at-risk couples, and; (3) provide environments where groups of persons at risk for IPV may form and mutually reinforce IPV-related attitudes, norms, and problem behaviors. Understanding these mechanisms is of critical public health importance for developing environmental strategies aimed at prevention of IPV, such as changes in zoning, community action and education, and policing.

Ecological associations of alcohol outlets with underage and young adult injuries

OBJECTIVE

This paper argues that associations between rates of 3 specific problems related to alcohol (i.e., accidents, traffic crashes, and assaults) should be differentially related to densities of alcohol outlets among underage youth and young adults based upon age-related patterns of alcohol outlet use.

METHODS

Zip code-level population models assessed local and distal effects of alcohol outlets upon rates of hospital discharges for these outcomes.

RESULTS

Densities of off-premise alcohol outlets were significantly related to injuries from accidents, assaults, and traffic crashes for both underage youth and young adults. Densities of bars were associated with more assaults and densities of restaurants were associated with more traffic crash injuries for young adults.

CONCLUSIONS

The distribution of alcohol-related injuries relative to alcohol outlets reflect patterns of alcohol outlet use.

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

The density of alcohol outlets in communities may be regulated to reduce excessive alcohol consumption and related harms. Studies directly assessing the control of outlet density as a means of controlling excessive alcohol consumption and related harms do not exist, but assessments of related phenomena are indicative. To assess the effects of outlet density on alcohol-related harms, primary evidence was used from interrupted time-series studies of outlet density; studies of the privatization of alcohol sales, alcohol bans, and changes in license arrangements-all of which affected outlet density. Most of the studies included in this review found that greater outlet density is associated with increased alcohol consumption and related harms, including medical harms, injury, crime, and violence. Primary evidence was supported by secondary evidence from correlational studies. The regulation of alcohol outlet density may be a useful public health tool for the reduction of excessive alcohol consumption and related harms.

Alcohol consumption, alcohol outlets, and the risk of being assaulted with a gun

BACKGROUND

We conducted a population-based case-control study to better delineate the relationship between individual alcohol consumption, alcohol outlets in the surrounding environment, and being assaulted with a gun.

METHODS

An incidence density sampled case-control study was conducted in the entire city of Philadelphia from 2003 to 2006. We enrolled 677 cases that had been shot in an assault and 684 population-based controls. The relationships between 2 independent variables of interest, alcohol consumption and alcohol outlet availability, and the outcome of being assaulted with a gun were analyzed. Conditional logistic regression was used to adjust for numerous confounding variables.

RESULTS

After adjustment, heavy drinkers were 2.67 times as likely to be shot in an assault when compared with nondrinkers (p < 0.10) while light drinkers were not at significantly greater risk of being shot in an assault when compared with nondrinkers. Regression-adjusted analyses also demonstrated that being in an area of high off-premise alcohol outlet availability significantly increased the risk of being shot in an assault by 2.00 times (p < 0.05). Being in an area of high on-premise alcohol outlet availability did not significantly change this risk. Heavy drinkers in areas of high off-premise alcohol outlet availability were 9.34 times (p < 0.05) as likely to be shot in an assault.

CONCLUSIONS

This study finds that the gun assault risk to individuals who are near off-premise alcohol outlets is about the same as or statistically greater than the risk they incur from heavy drinking. The combination of heavy drinking and being near off-premise outlets resulted in greater risk than either factor alone. By comparison, light drinking and being near on-premise alcohol outlets were not associated with increased risks for gun assault. Cities should consider addressing alcohol-related factors, especially off-premise outlets, as highly modifiable and politically feasible approaches to reducing gun violence.

Alcohol availability and intimate partner violence among US couples

OBJECTIVES

We examined the relation between alcohol outlet density (the number of alcohol outlets per capita by zip code) and male-to-female partner violence (MFPV) or female-to-male partner violence (FMPV). We also investigated whether binge drinking or the presence of alcohol-related problems altered the relationship between alcohol outlet density and MFPV or FMPV.

METHODS

We linked individual and couple sociodemographic and behavioral data from a 1995 national population-based sample of 1,597 couples to alcohol outlet data and 1990 US Census sociodemographic information. We used logistic regression for survey data to estimate unadjusted and adjusted odds ratios between alcohol outlet density and MFPV or FMPV along with 95% confidence intervals (CIs) and p-values. We used a design-based Wald test to derive a p-value for multiplicative interaction to assess the role of binge drinking and alcohol-related problems.

RESULTS

In adjusted analysis, an increase of one alcohol outlet per 10,000 persons was associated with a 1.03-fold increased risk of MFPV (p-value for linear trend = 0.01) and a 1.011-fold increased risk of FMPV (p-value for linear trend = 0.48). An increase of 10 alcohol outlets per 10,000 persons was associated with 34% and 12% increased risk of MFPV and FMPV respectively, though the CI for the association with FMPV was compatible with no increased risk. The relationship between alcohol outlet density and MFPV was stronger among couples reporting alcohol-related problems than those reporting no problems (p-value for multiplicative interaction = 0.01).

CONCLUSIONS

We found that as alcohol outlet density increases so does the risk of MFPV and that this relationship may differ for couples who do and do not report alcohol-related problems. Given that MFPV accounts for the majority of injuries related to intimate partner violence, policy makers may wish to carefully consider the potential benefit of limiting alcohol outlet density to reduce MFPV and its adverse consequences.

Potential biases due to geocoding error in spatial analyses of official data

Geospatial methods have been used extensively to examine associations between alcohol outlet density and various harms; however, the literature offers too little methodological detail to assess possible geocoding biases in these studies. We used New Zealand liquor licensing and crime data to assess geocoding error. For the year with the best data, 69% of offences could be accurately mapped (91% of those in urban areas, 38% in rural areas). There was considerable urban-rural variation in the accuracy and specificity of location data. If similar error exists in other jurisdictions, previous findings may be biased. Greater consideration should be given to the effects of data quality in geospatial studies, and geocoding methods should be reported explicitly.

Preventing impaired driving using alcohol policy

Considerable progress has been made in the reduction of impaired driving crashes during the last two decades. Much of this progress is attributable to strengthening laws against impaired driving along with vigorous enforcement efforts aimed at deterring impaired driving. In addition, many useful strategies can also be applied that focus on the control of alcohol availability, use, and promotion. Alcohol policies include controls on the price of alcohol, the location, density, and opening hours of sales outlets, controls on the social availability of alcohol, and on the promotion and advertising of alcohol. Enforcement of these policies is an important aspect of their effectiveness. These strategies have been shown to be effective or promising in reducing impaired driving as well as other consequences related to alcohol use and misuse.

Secondhand effects of student alcohol use reported by neighbors of colleges: the role of alcohol outlets

This is a study of the secondhand effects of student alcohol use experienced by residents of neighborhoods near college campuses. We examined the relationship of a college's level of binge drinking and the number of alcohol outlets in the immediate area, to lowered quality of neighborhood life through such secondhand effects. Adults from 4661 households in the United States were interviewed through a stratified list-assisted random digit dialing telephone survey. The interview schedule included questions about residents' experiences of secondhand effects of alcohol use such as noise, vandalism or public disturbances. Reports about the quality of neighborhood life provided by respondents residing near colleges were compared with those of respondents who did not live near colleges; and reports of neighbors of colleges with high rates of binge drinking were compared with those of neighbors of colleges with lower rates. The presence of alcohol outlets in these areas was also compared. Residents near colleges and particularly near colleges with heavy episodic drinking reported the presence of more alcohol outlets within a mile. Those neighborhoods were characterized by lower socioeconomic status. Neighbors living near college campuses were more likely to report a lowered quality of neighborhood life through such secondhand effects of heavy alcohol use as noise and disturbances, vandalism, drunkenness, vomiting and urination. A path analysis indicated that the number of nearby alcohol outlets was an important factor mediating the relationship between colleges, especially those with high rates of binge drinking, and such secondhand effects. The results suggest that neighborhood disruptions around colleges due to heavy alcohol use may be reduced by limiting the presence of alcohol outlets in those areas, and the marketing practices that this engenders.