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Acute alcohol use among suicide decedents in 14 US states: impacts of off‐premise and on‐premise alcohol outlet density
Author(s) -
Giesbrecht Norman,
Huguet Nathalie,
Ogden Lauren,
Kaplan Mark S.,
McFarland Bentson H.,
Caetano Raul,
Conner Kenneth R.,
Nolte Kurt B.
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12762
Subject(s) - demography , medicine , odds ratio , confidence interval , alcohol , poison control , logistic regression , ethnic group , medical examiner , suicide prevention , injury prevention , blood alcohol content , blood alcohol , environmental health , biochemistry , sociology , anthropology , chemistry
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 U nited S tates by racial/ethnic groups and method of suicide. Design Analysis of US data, 2003–11, N ational V iolent D eath R eporting S ystem. 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 C ensus. 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 A merican I ndian/ A laska N ative 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 A merican I ndians/ A laska N atives.