Alcohol control and injury death in Alaska native communities: Wet, damp and dry under Alaska's local option law
Alcohol control and injury death in Alaska native communities: Wet, damp and dry under Alaska's local option law
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DOI：
10.15288/jsa.2000.61.311
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发表时间：
2000-03-01
期刊：
影响因子：
--
通讯作者：
May, P
中科院分区：
文献类型：
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作者：
Berman, M;Hull, T;May, P
目的：本文检验不同形式的社区酒精控制是否显著影响伤害死亡率极高的人群的伤害死亡。方法：1981年阿拉斯加地方选择法提供了一个自然的实验，用于研究社区一级控制的实施如何与居住在小社区的阿拉斯加原住民的伤害死亡变化（其中大多数与酒精有关）相关联。该研究比较了1980年至1993年间通过酒精限制的97个社区在不同酒精控制水平下的人口和社区特定死亡率，以及同一社区在没有限制的时期的死亡率。结果：在酒精销售、进口或持有受到限制的时期，伤害死亡率普遍低于没有限制的时期（湿）。更严格的控制（干燥）显著减少了凶杀；限制较少的控制选项（潮湿）减少了自杀。在禁止销售、进口或持有毒品的89个社区中，事故死亡率和凶杀死亡率平均分别下降了74 / 10万和66 / 10万。一个由61个没有改变法律控制地位的小社区组成的对照组显示，随着时间的推移，事故或凶杀死亡率没有显著变化。结论：意外和他杀死亡率的变化在统计上是显著的，尽管这些降低的死亡率仍然是全国死亡率的2.5至7倍。阿拉斯加村庄的孤立性质可能解释了为什么酒精控制在阿拉斯加比在其他州的印第安人的研究中发现的效果更大。
Objective: This article tests whether different forms of community-level alcohol control significantly affect injury deaths in a population with extremely high injury mortality. Method: The 1981 Alaska local option law provides a natural experiment for studying how implementation of community level controls may be associated with changes in injury deaths, most of which are alcohol-related, among Alaska Natives living in small communities. The study compares population and community-specific death rates under different levels of alcohol control for the 97 communities that passed restrictions between 1980 and 1993 with the death rates in the same communities during periods when no restrictions were in place. Results: Injury death rates were generally lower during periods when alcohol sales, importation or possession were restricted than when no restric-tions were in place (wet). More restrictive controls (dry) significantly reduced homicides; less restrictive control options (damp) reduced suicides. Accident and homicide death rates fell, on average, by 74 and 66 per 100,000, respectively, for the 89 communities that banned sale and importation or possession. A control group of 61 small communities that did not change control status under the law showed no significant changes over time in accident or homicide death rates. Conclusions: The changes in accidental and homicide death rates are statistically significant, although these reduced rates remain 2.5 to 7 times national death rates. The isolated nature of Alaskan villages may explain why alcohol control has more effect in Alaska than has been found in studies of Native Americans Living in other states.