Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts.
Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts.
J Stud Alcohol Drugs. 2020 Jan;81(1):58-67. doi: 10.15288/jsad.2020.81.58.
U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years.
State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups.
APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range: -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74).
Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.
美国政策制定者和公共卫生从业者缺乏综合指标（指数）来评估和比较州级酒精政策环境的限制程度，这些政策环境被概念化为在特定时间和地点实施的多种政策。本研究的目的是描述 2018 年美国每个州和华盛顿特区的酒精政策环境，并检查过去 20 年的变化。
1999 年至 2018 年的州特定酒精政策量表（APS）评分基于 29 项政策，对每一项现行政策的有效性和实施程度进行加权。还根据两组相互排斥的政策子组计算了修改后的 APS 评分。
2018 年 APS 评分在各州之间差异很大，理论范围为 0 至 100 分，评分范围为 25.6 至 67.9；中位数评分为 43.5（基于 0-100 范围），43 个州的评分低于 50。1999 年至 2018 年各州 APS 评分的中位数变化为正值（+4.9，范围为-7.4 至+10.3），表明政策环境的限制程度增加，只有五个州的评分下降。APS 评分的增加主要归因于实施更严格的醉酒驾驶法，而减少过度饮酒的政策则保持不变。各州过度饮酒政策评分与醉酒驾驶评分之间没有相关性（r=0.05，p=0.74）。
根据该政策量表，很少有州具有限制政策环境。尽管在研究期间各州采取了针对醉酒驾驶的政策，但减少过度饮酒的政策没有变化。
