Naimi Timothy S, Xuan Ziming, Coleman Sharon M, Lira Marlene C, Hadland Scott E, Cooper Susanna E, Heeren Timothy C, Swahn Monica H
Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts.
Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
J Stud Alcohol Drugs. 2017 Sep;78(5):781-788. doi: 10.15288/jsad.2017.78.781.
The purpose of this study was to examine the associations between the alcohol policy environment and alcohol involvement in homicide victims in the United States, overall and by sociodemographic groups.
To characterize the alcohol policy environment, the presence, efficacy, and degree of implementation of 29 alcohol policies were used to determine Alcohol Policy Scale (APS) scores by state and year. Data about homicide victims from 17 states from 2003 to 2012 were obtained from the National Violent Death Reporting System. APS scores were used as lagged exposure variables in generalized estimating equation logistic regression models to predict the individual-level odds of alcohol involvement (i.e., blood alcohol concentration [BAC] > 0.00% vs. = 0.00% and BAC ≥ 0.08% vs. ≤ 0.079%) among homicide victims.
A 10 percentage point increase in APS score (representing a more restrictive policy environment) was associated with reduced odds of alcohol-involved homicide with BAC greater than 0.00% (adjusted odds ratio [AOR] = 0.89, 95% CI [0.82, 0.99]) and BAC of 0.08% or more (AOR = 0.91, 95% CI [0.82, 1.02]). In stratified analyses of homicide victims, more restrictive policy environments were significantly protective of alcohol involvement at both BAC levels among those who were female, ages 21-29 years, Hispanic, unmarried, victims of firearm homicides, and victims of homicides related to intimate partner violence.
More restrictive alcohol policy environments were associated with reduced odds of alcohol-involved homicide victimization overall and among groups at high risk of homicide. Strengthening alcohol policies is a promising homicide prevention strategy.
本研究旨在探讨美国酒精政策环境与凶杀案受害者饮酒情况之间的关联，包括总体情况以及按社会人口学群体划分的情况。
为描述酒精政策环境，利用29项酒精政策的存在情况、效力和实施程度，确定各州和各年份的酒精政策量表（APS）得分。2003年至2012年期间17个州的凶杀案受害者数据来自国家暴力死亡报告系统。在广义估计方程逻辑回归模型中，将APS得分用作滞后暴露变量，以预测凶杀案受害者中饮酒（即血液酒精浓度[BAC]＞0.00%与=0.00%，以及BAC≥0.08%与≤0.079%）的个体层面几率。
APS得分提高10个百分点（代表更严格的政策环境）与BAC大于0.00%的涉酒凶杀案几率降低相关（调整优势比[AOR]=0.89，95%置信区间[CI][0.82，0.99]），以及与BAC为0.08%或更高的涉酒凶杀案几率降低相关（AOR=0.91，95%CI[0.82，1.02]）。在对凶杀案受害者的分层分析中，在女性、年龄21 - 29岁、西班牙裔、未婚、枪支凶杀案受害者以及与亲密伴侣暴力相关的凶杀案受害者中，更严格的政策环境在两个BAC水平上均对饮酒有显著保护作用。
更严格的酒精政策环境与总体及凶杀案高风险群体中涉酒凶杀案受害者几率降低相关。加强酒精政策是一项有前景的预防凶杀案策略。
