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Washington's liquor license system and alcohol‐related adverse health outcomes
Author(s) -
Phillips Aryn Z.,
Rodriguez Hector P.,
Kerr William C.,
Ahern Jennifer A.
Publication year - 2021
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.15234
Subject(s) - medicine , metropolitan area , environmental health , accidental , quarter (canadian coin) , propensity score matching , occupational safety and health , health care , injury prevention , poison control , demography , geography , surgery , economic growth , physics , archaeology , pathology , sociology , acoustics , economics
Background and Aims In June 2012, Washington state (USA) implemented Initiative 1183, privatizing liquor sales. As a result, off‐premises outlets increased from 330 to over 1400 and trading hours lengthened. Increased availability of liquor may lead to increased consumption. This study examines the impact of Initiative 1183 on alcohol‐related adverse health outcomes, measured by inpatient hospitalizations for alcohol‐related disorders and accidental injuries. It further assesses heterogeneity by urbanicity, because outlets increased most in metropolitan‐urban areas. Design County‐by‐quarter difference‐in‐difference linear regression models, estimated statewide and within metropolitan/rural strata. Setting and Participants Data are from AHRQ Healthcare Cost and Utilization State Inpatient Database 2010–2014 and HHS Area Health Resource File 2010–2014. Changes in the rates of hospitalizations in the 2.5 years following Initiative 1183 in Washington ( n  = 39 counties) are compared with changes in Oregon ( n  = 36 counties). Measurements County rates of hospitalizations per 1000 residents, including all records with any‐listed ICD‐9 Clinical Classification Software code denoting an alcohol‐related disorder, and all records with any‐listed external cause of injury code denoting an accidental injury. Findings The increase in the rate of accidental injury hospitalizations in Washington's metropolitan‐urban counties was on average 0.289 hospitalizations per 1000 county residents per quarter greater than the simultaneous increase observed in Oregon ( P  = 0.017). This result was robust to alternative specifications using a propensity score matched sample and synthetic control methods with data from other comparison states. The evidence did not suggest that Initiative 1183 was associated with differential changes in the rate of hospitalizations for alcohol‐related disorders in metropolitan‐urban ( P  = 0.941), non‐metropolitan‐urban ( P  = 0.162), or rural counties ( P  = 0.876). Conclusions Implementing Washington's Initiative 1183 (privatizing liquor sales) appears to have been associated with a significant increase in the rate of accidental injury hospitalizations in urban counties in that state but does not appear to be significantly associated with changes in the rate of hospitalizations specifically for alcohol‐related disorders within 2.5 years.

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