Joint impacts of local alcohol and cannabis policies and outlet densities on violence

项目摘要/摘要 这份K99/R00提案审查了当地酒精和大麻政策对#年暴力的联合影响。 2018年，加利福尼亚州娱乐用大麻合法化前后。自我导向和人际暴力 是美国人死亡和受伤的主要原因。酒精和大麻使用的变化，是由 国家大麻合法化政策可能是这些结果的重要但未被承认的贡献者。 酒精在暴力中的作用是公认的。关于大麻对暴力的影响的证据有限，而且喜忧参半。 大麻合法化可通过大麻-酒精替代降低与酒精有关的暴力发生率。 现有关于大麻合法化的研究往往侧重于国家一级的变异。然而，大多数州都遵守 市和县政府执行大麻合法化政策，包括确定在哪里销售大麻 都被定位了。地方控制导致地方政策和网点密度在地方层面上存在巨大的异质性。高 酒精销售点的地理密度增加了暴力发生率；最近的研究报告了类似的模式 大麻销售点。在合法化的州，大麻销售点与酒精不成比例地共存 低社会经济地位(SES)社区的门店。然而，没有研究研究当地的酒精是否以及如何 和大麻政策共同促成了醉人的饱和(即，酒精和大麻的高密度 在低社会经济地位的社区)。此外，没有证据表明同一地点的大麻和 饮酒渠道相互作用，影响社区居民的健康。 我们将对公共政策、渠道和行政部门进行准实验性地理空间分析 健康数据：(1)评估加州241个城市和县的酒精和大麻政策如何影响奥特莱斯 密度和地理位置；(2)确定酒精和大麻出口的交互影响 急诊科就诊、住院和因自我伤害和死亡的比率密度 加州各地的性侵犯；(3)评估上述关系如何导致 酒精和大麻出口的位置、密度以及对自残和攻击的影响。 该研究计划得到了加州大学一支杰出的导师团队和培训计划的补充 加州、旧金山和NIAAA资助的预防研究中心。该计划建立在申请人的基础上 暴力预防研究背景，包括作为贡献者的酒精和药物使用方面的新培训 暴力、酒精和毒品管制政策以及地理空间统计方法。联合研究和 培训计划将使申请者为成功的独立流行病学研究职业生涯做好准备 如何设计最佳的酒精和毒品政策，以防止暴力和减少健康差距。 这项研究与NIAAA评估新政策的有效性和实施情况的战略目标一致 防止暴力等与酒精有关的后果的政策。这项研究是当务之急 其他地方考虑大麻合法化和监管模式。

PROJECT SUMMARY/ABSTRACT This K99/R00 proposal examines the joint impacts of local alcohol and cannabis policies on violence in California before and after recreational cannabis legalization in 2018. Self-directed and interpersonal violence are leading causes of death and injury in the United States. Changes in alcohol and cannabis use, driven by state cannabis legalization policies, may be important but unrecognized contributors to these outcomes. Alcohol’s role in violence is well established. Evidence on cannabis’ effects on violence is limited and mixed. Cannabis legalization could lower rates of alcohol-related violence through cannabis-alcohol substitution. Existing research on cannabis legalization often focuses on state-level variation. However, most states defer to city and county governments to implement cannabis legalization policies, including determining where outlets are located. Local control results in enormous local-level heterogeneity in local policies and outlet density. High geographic density of alcohol outlets increases rates of violence; recent studies report similar patterns for cannabis outlets. In legalizing states, cannabis outlets are being disproportionately co-located with alcohol outlets in low-socioeconomic status (SES) communities. However, no studies examine if and how local alcohol and cannabis policies together contribute to intoxicant saturation (i.e., high densities of both alcohol and cannabis outlets) in low-SES communities. Further, there is no evidence on whether co-located cannabis and alcohol outlets interact to affect the health of community residents. We will perform quasi-experimental geospatial analyses of publicly-derived policy, outlet, and administrative health data to: (1) assess how alcohol and cannabis policies in 241 California cities and counties impact outlet density and geographic co-location; (2) determine the interactive effects of alcohol and cannabis outlet densities on rates of emergency department visits, inpatient hospitalizations, and deaths due to self-harm and assault throughout California; (3) evaluate how the relationships documented above contribute to disparities in alcohol and cannabis outlet co-location, densities, and effects on self-harm and assault. The research plan is complemented by an exceptional mentorship team and training plan at the University of California, San Francisco and NIAAA-funded Prevention Research Center. The plan builds on the applicant’s background in violence prevention research and includes new training in alcohol and drug use as contributors to violence, alcohol and drug control policies, and geospatial statistical methods. The combined research and training plans will prepare the applicant for a successful independent epidemiology research career focused on how to design optimal alcohol and drug policies to prevent violence and reduce health disparities. This research aligns with NIAAA’s strategic goal to evaluate the effectiveness and implementation of new policies for preventing alcohol-related consequences such as violence. This research is urgently needed as other localities consider cannabis legalization and models for regulation.