Scott E Hadland1,2,3, Ziming Xuan4, Vishnudas Sarda2, Jason Blanchette4, Monica H Swahn5, Timothy C Heeren4, Robert B Voas6, Timothy S Naimi4,7. 1. Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts; scott.hadland@bmc.org. 2. Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. 3. Department of Pediatrics, and. 4. Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts. 5. Institute of Public Health, Georgia State University, Atlanta, Georgia; and. 6. Calverton Center, Pacific Institute for Research and Evaluation, Calverton, Maryland. 7. Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts.
Abstract
BACKGROUND: Motor vehicle crashes (MVCs) are a leading cause of death among young people in the United States. We examined the relationship between states' alcohol policy environments and alcohol-related MVC fatalities among children, adolescents, and young adults under the minimum legal drinking age of 21 years. METHODS: We used the Alcohol Policy Scale (APS), an assessment of 29 alcohol policies across 50 states and Washington, DC, developed with the assistance of an interdisciplinary Delphi panel. Using the Fatality Analysis Reporting System, we examined APS scores in relation to fatalities of people ≤20 years old from 2000 to 2013 occurring in crashes in which ≥1 involved driver had a blood alcohol content ≥0.08%. Logistic regression was used with a 1-year lag between policies and MVC fatalities and adjusted for potential confounders. RESULTS: Of 84 756 MVC fatalities of those ≤20 years old during the study period, 23 757 (28.0%) were alcohol related, including deaths of 11 006 (46.3%) drivers, 10 212 (43.0%) passengers, and 2539 (10.7%) pedestrians, cyclists, and others. People killed in alcohol-related MVCs were predominantly male (72.7%) and older (65.5% were 18-20 years old), and 51.2% were non-Hispanic white. Restrictive policy environments were associated with fewer fatalities (adjusted odds ratio, 0.91 per 10-percentage-point increase in APS score; 95% confidence interval, 0.89-0.94). The association was observed for drivers and passengers, male and female decendents, and children, adolescents, and young adults. CONCLUSIONS: More restrictive alcohol policies are associated with reduced alcohol-related MVC mortality among young people. Studies should scrutinize the relationship between policies and fatalities to highlight mechanisms.
BACKGROUND: Motor vehicle crashes (MVCs) are a leading cause of death among young people in the United States. We examined the relationship between states' alcohol policy environments and alcohol-related MVC fatalities among children, adolescents, and young adults under the minimum legal drinking age of 21 years. METHODS: We used the Alcohol Policy Scale (APS), an assessment of 29 alcohol policies across 50 states and Washington, DC, developed with the assistance of an interdisciplinary Delphi panel. Using the Fatality Analysis Reporting System, we examined APS scores in relation to fatalities of people ≤20 years old from 2000 to 2013 occurring in crashes in which ≥1 involved driver had a blood alcohol content ≥0.08%. Logistic regression was used with a 1-year lag between policies and MVC fatalities and adjusted for potential confounders. RESULTS: Of 84 756 MVC fatalities of those ≤20 years old during the study period, 23 757 (28.0%) were alcohol related, including deaths of 11 006 (46.3%) drivers, 10 212 (43.0%) passengers, and 2539 (10.7%) pedestrians, cyclists, and others. People killed in alcohol-related MVCs were predominantly male (72.7%) and older (65.5% were 18-20 years old), and 51.2% were non-Hispanic white. Restrictive policy environments were associated with fewer fatalities (adjusted odds ratio, 0.91 per 10-percentage-point increase in APS score; 95% confidence interval, 0.89-0.94). The association was observed for drivers and passengers, male and female decendents, and children, adolescents, and young adults. CONCLUSIONS: More restrictive alcohol policies are associated with reduced alcohol-related MVC mortality among young people. Studies should scrutinize the relationship between policies and fatalities to highlight mechanisms.
Authors: Ziming Xuan; Jason G Blanchette; Toben F Nelson; Thien H Nguyen; Scott E Hadland; Nadia L Oussayef; Timothy C Heeren; Timothy S Naimi Journal: Pediatrics Date: 2015-06-01 Impact factor: 7.124
Authors: Ziming Xuan; Toben F Nelson; Timothy Heeren; Jason Blanchette; David E Nelson; Paul Gruenewald; Timothy S Naimi Journal: Alcohol Clin Exp Res Date: 2013-05-24 Impact factor: 3.455
Authors: Marlene C Lira; Ziming Xuan; Sharon M Coleman; Monica H Swahn; Timothy C Heeren; Timothy S Naimi Journal: Am J Prev Med Date: 2019-06-22 Impact factor: 5.043
Authors: Timothy S Naimi; Ziming Xuan; Vishnudas Sarda; Scott E Hadland; Marlene C Lira; Monica H Swahn; Robert B Voas; Timothy C Heeren Journal: JAMA Intern Med Date: 2018-07-01 Impact factor: 21.873
Authors: Timothy S Naimi; Ziming Xuan; Sharon M Coleman; Marlene C Lira; Scott E Hadland; Susanna E Cooper; Timothy C Heeren; Monica H Swahn Journal: J Stud Alcohol Drugs Date: 2017-09 Impact factor: 2.582
Authors: Niyousha Hosseinichimeh; Rod MacDonald; Kaigang Li; James C Fell; Denise L Haynie; Bruce Simons-Morton; Barbara C Banz; Deepa R Camenga; Ronald J Iannotti; Leslie A Curry; James Dziura; Linda C Mayes; David F Andersen; Federico E Vaca Journal: Soc Sci Med Date: 2022-01-19 Impact factor: 4.634
Authors: Marlene C Lira; Vishnudas Sarda; Timothy C Heeren; Matthew Miller; Timothy S Naimi Journal: Am J Prev Med Date: 2020-03-16 Impact factor: 5.043