Department of Geography, University of Miami, 1300 Campo Sano Ave, Coral Gables, FL, 33124, USA.
Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
BMC Public Health. 2019 Jul 29;19(1):1010. doi: 10.1186/s12889-019-7327-7.
Alcohol related homicide, suicide and aggravated assault represent the largest costs for the state of Illinois. Previous research has examined the impact of some alcohol-related policies on youth alcohol use and alcohol-related harm in the United States but findings have been mixed. To our knowledge, no study has provided a detailed epidemiology of the relationship between the impacts of alcohol policies on unintentional injury in Illinois. Therefore, the purpose of this study is to determine whether a legislation that prohibit minors under 21 years old in establishments that serve alcohol is more salient than individual level factors in predicting hospitalization for traumatic unintentional injuries.
A retrospective observational study of data abstracted from 6,139 patients aged 10 to 19 hospitalized in Illinois Level I and Level II trauma centers. Patient data from 2006 to 2015 was linked with the city-level alcohol-related legislation (n = 514 cities). The response variable was whether a patient tested positive or negative for blood alcohol concentration (BAC) at the time of admission. Mixed-effects logistic regression analyses were conducted to model the patient and city level legislation effect of having a positive BAC test result on hospitalizations after adjusting for the legislation and patient factors.
After adjustment, patients aged 15 to 19 and white patients who tested positive for BAC at the time of admission had the greater odds of hospitalization for traumatic alcohol-related unintentional injuries compared to patients who had a negative BAC test result. However, odds of hospitalization decreased for female patients and for those with private insurance, and over time, but a significant decrease in such hospitalizations occurred during 2010, 2014 and 2015. The alcohol-related legislation of interest was not a significant predictor of traumatic alcohol-related unintentional injury hospitalization.
Patient-level covariates were significant predictors of traumatic alcohol-related unintentional injury hospitalization; an alcohol-related legislation may not reduce hospitalizations for young patients aged 10 to 19. Therefore, to prevent underage drinking and consequences, interventions should target sex/gender, race/ethnicity and focus on both individual and environmental strategies.
酒精相关的凶杀、自杀和严重攻击行为给伊利诺伊州带来了最大的损失。先前的研究已经考察了一些与酒精有关的政策对美国青少年饮酒和与酒精有关的伤害的影响，但结果喜忧参半。据我们所知，没有研究详细描述过酒精政策对伊利诺伊州意外伤害的影响之间的关系。因此，本研究的目的是确定一项禁止 21 岁以下未成年人在供应酒精的场所饮酒的立法，是否比个人层面的因素更能预测伊利诺伊州创伤性意外伤害的住院治疗。
对 6139 名年龄在 10 至 19 岁、在伊利诺伊州一级和二级创伤中心住院的患者数据进行回顾性观察性研究。将 2006 年至 2015 年的患者数据与城市层面的酒精相关立法（n=514 个城市）联系起来。因变量是患者入院时的血液酒精浓度（BAC）检测结果呈阳性或阴性。在调整立法和患者因素后，采用混合效应逻辑回归分析模型，对患者和城市层面立法对 BAC 检测结果阳性患者的住院治疗效果进行建模。
调整后，与 BAC 检测结果阴性的患者相比，15 至 19 岁的患者和入院时 BAC 检测结果阳性的白人患者因创伤性酒精相关意外伤害住院的可能性更大。然而，女性患者和拥有私人保险的患者的住院可能性降低，随着时间的推移，这种住院治疗的数量显著减少，但在 2010 年、2014 年和 2015 年出现了显著减少。研究中感兴趣的酒精相关立法并不是创伤性酒精相关意外伤害住院的显著预测因素。
患者层面的协变量是创伤性酒精相关意外伤害住院的显著预测因素；酒精相关立法可能不会减少 10 至 19 岁年轻患者的住院治疗。因此，为了预防青少年饮酒和相关后果，干预措施应针对性别/性别、种族/民族，并注重个人和环境策略。
