The Health and Social Impacts of Easy Access to Alcohol and Exposure to Alcohol Advertisements Among Women of Childbearing Age in Urban and Rural South Africa
The Health and Social Impacts of Easy Access to Alcohol and Exposure to Alcohol Advertisements Among Women of Childbearing Age in Urban and Rural South Africa
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DOI：
10.15288/jsad.2018.79.302
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发表时间：
2018-03-01
影响因子：
3.4
通讯作者：
London, Leslie
中科院分区：
文献类型：
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作者：
Amanuel, Hanna;Morojele, Neo;London, Leslie
目的：本研究的目的是在南非的一个城市和农村地区，分析容易获得酒精和接触酒精广告对女性酒精消费、生育史、健康和社会结果的影响。方法：通过随机抽样和分层整群随机抽样，分别在茨瓦内市(豪登省)的moot、Mamelodi和Eester us地区以及西开普省Cederberg、Bergrivier和Swartland市的农村地区对1018名育龄妇女进行面对面访谈。进行多因素Logistic回归分析，按城乡地点分层，控制4个人口学因素。结果：在Tshwane，最后一次妊娠并发症(OR=7.84，95%CI[1.77，34.80])、伴侣间酗酒(OR=6.50，95%CI[3.85，10.94])和社区饮酒(OR=7.92，95%CI[4.59，13.65])与酒精可及性呈正相关。性暴力(OR=4.16，95%CI[1.99，8.70])和社区饮酒(OR=3.39，95%CI[2.07，5.53])与饮酒呈正相关。在西开普省，社区饮酒(OR=10.26，95%CI[4.02，26.20])与饮酒可及性呈正相关，而支付医疗费用的能力(OR=0.48，95%CI[0.24，0.96])与饮酒可及性呈负相关。危险饮酒在酒精使用障碍识别测验(AUDIT；OR=2.26，95%CI[1.03，4.95])和CAGE(OR=4.51，95%CI[1.30，15.61])、伴侣间暴力(OR=1.69，95%CI[1.04，2.76])和社区饮酒(OR=3.39，95%CI[2.07，5.53])与接触酒精广告呈正相关。结论：容易接触酒精和接触酒精广告与不良健康和社会后果呈正相关。尽管还需要进一步的研究，但这些发现支持强调上游政策干预，以限制酒精和广告的获取。
Objective: The purpose of this study was to analyze the impact of easy access to alcohol and exposure to alcohol advertisements on women's alcohol consumption, reproductive history, and health and social outcomes in an urban and rural site in South Africa. Method: Trained fieldworkers conducted face-to-face interviews with 1,018 women of childbearing age in the Moot, Mamelodi, and Eesterus areas of the City of Tshwane (Gauteng province) and in the rural Cederberg, Bergrivier, and Swartland municipalities (Western Cape province), recruited through random sampling and stratified cluster random sampling, respectively. Multivariate logistic regression analyses were conducted, stratified according to the urban and rural sites and controlled for four demographic factors. Results: In Tshwane, complications in the last pregnancy (odds ratio [OR] = 7.84, 95% CI [1.77, 34.80]), interpartner binge drinking (OR = 6.50, 95% CI [3.85, 10.94]), and community drinking (OR = 7.92, 95% CI [4.59, 13.65]) were positively associated with alcohol accessibility. Interpartner violence (OR = 4.16, 95% CI [1.99, 8.70]) and community drinking (OR = 3.39, 95% CI [2.07, 5.53]) were positively associated with exposure to alcohol advertisements. In Western Cape, community drinking (OR = 10.26, 95% CI [4.02, 26.20]) was positively associated with alcohol accessibility, whereas ability to pay for health care (OR = 0.48, 95% CI [0.24, 0.96]) was inversely associated. Hazardous drinking on the Alcohol Use Disorders Identification Test (AUDIT; OR = 2.26, 95% CI [1.03, 4.95]) and CAGE (OR = 4.51, 95% CI [1.30, 15.61]), interpartner violence (OR = 1.69, 95% CI [1.04, 2.76]), and community drinking (OR = 3.39, 95% CI [2.07, 5.53]) were positively associated with exposure to alcohol advertisements. Conclusion: Easy access to alcohol and exposure to alcohol advertisements are positively associated with adverse health and social outcomes. Although further studies are needed, these findings lend support to emphasizing upstream policy interventions to limit access to alcohol and advertisements.