Korcha Rachael A, Witbrodt Jane, Cherpitel Cheryl J, Ye Yu, Andreceutti Gabriel, Kang Jaewook, Monteiro Maristela
Public Health Institute, Alcohol Research Group, WHO Collaborating Centre on Alcohol Epidemiology and Injury, 6001 Shellmound St. #450, Emeryville, CA 94608, 510-898-5800.
Department of Preventive Medicine, University of Sao Paulo Medical School, SP 01246-903, Brazil.
Rev Panam Salud Publica. 2018;42. doi: 10.26633/RPSP.2018.6.
The current work develops the International Alcohol Policy Injury Index (IAPII) to measure the effectiveness of control policies that impact reduction of alcohol-related injury.
Using cross-sectional data on alcohol policies from five policy domains ( and ), injury death, and alcohol-attributable fractions (AAFs) for vehicular deaths were accessed from the WHO database for 156 countries. A composite indicator, the International Alcohol Policy Injury Index (IAPII), was created to assess the association between policy and death due to injury.
Controlling for per-capita alcohol consumption, injury deaths and AAF deaths were inversely associated with four of the five policy domains. The domains were weighted according to effectiveness and used to construct the IAPII which produced acceptable sensitivity and specificity. Regression results, controlling for consumption, demonstrated the IAPII was significantly associated with AAF vehicular injury death for males, AAF vehicular injury death for females and overall injury death at < 0.01.
Findings support the IAPII as a reliable indicator of the relationship between alcohol policies and injury deaths; the stronger the policy the less the likelihood of both overall and vehicular injury death. Future work should test the effectiveness of the IAPII in reducing alcohol-related injury morbidity, which accounts for a larger share of the global burden of disease than alcohol-related injury mortality.
当前研究开发了国际酒精政策伤害指数（IAPII），以衡量影响减少酒精相关伤害的控制政策的有效性。
利用来自五个政策领域的酒精政策横断面数据以及伤害死亡数据，从世界卫生组织数据库获取了156个国家的车辆死亡酒精归因分数（AAFs）。创建了一个综合指标——国际酒精政策伤害指数（IAPII），以评估政策与伤害死亡之间的关联。
在控制人均酒精消费量的情况下，伤害死亡和AAF死亡与五个政策领域中的四个呈负相关。根据有效性对这些领域进行加权，并用于构建IAPII，其产生了可接受的敏感性和特异性。控制消费量的回归结果表明，IAPII与男性的AAF车辆伤害死亡、女性的AAF车辆伤害死亡以及总体伤害死亡显著相关，P值均<0.01。
研究结果支持IAPII作为酒精政策与伤害死亡之间关系的可靠指标；政策越强，总体伤害死亡和车辆伤害死亡的可能性就越小。未来的研究应测试IAPII在降低酒精相关伤害发病率方面的有效性，酒精相关伤害发病率在全球疾病负担中所占比例高于酒精相关伤害死亡率。
