Aleksandra J. Snowden

Reduction in Suicide Mortality Following a New National Alcohol Policy in Slovenia: An Interrupted Time-Series Analysis

OBJECTIVES We assessed the impact on suicide mortality of a new national policy in Slovenia that limits the availability of alcohol. METHODS We obtained monthly total, male, and female suicide counts in Slovenia between January 1997 and December 2005 and then employed autoregressive integrated moving average (ARIMA) techniques to model the effect of the alcohol policy (implemented in March 2003). RESULTS There was a significant decrease in the total number of monthly suicides following the policys implementation. Subsequent analyses revealed this association to be caused solely by the impact on male suicides. Specifically, there was an immediate and permanent reduction of 3.6 male suicides per month (95% confidence interval = -0.4, -6.9), or approximately 10% of the preintervention average. The policy had no statistically significant effect on female suicides. CONCLUSIONS Our results show the effectiveness of this specific policy in reducing male suicides in Slovenia and also hint at the potential of public policy in reducing the public health burden of alcohol-related harm more generally.

Alcohol and violence in a nonmetropolitan college town alcohol outlet density, outlet type, and assault

This study examined the association between alcohol outlet density and violence in a nonmetropolitan college town. Nearly all prior empirical research examining this association has been undertaken in large urban cities. Using data on Bloomington, Indiana, block groups, we estimated ordinary least squared and spatially lagged regression models to determine whether alcohol outlet density was associated with assault density, and we also took into account the seriousness of violence (i.e., simple and aggravated assault) and different alcohol outlet types (i.e., off-premise, restaurants, and bars). The results showed that total alcohol outlet density was significantly associated with both simple and aggravated assault density in a nonmetropolitan college town. In addition, restaurant and bar densities were significantly associated with simple assault density, whereas off-premise and bar densities were significantly associated with aggravated assault density. These results not only extend the geographic scope of this relationship to nonmetropolitan towns but also have important policy implications.

Alcohol Outlets, Social Disorganization, Land Use, and Violence in a Large College Town Direct and Moderating Effects

This study examined the direct and moderating effects of alcohol outlet density, social disorganization, and land use on violence in a large college town whose economy is driven by the presence of a flagship state university. Empirical literature points to a consistent association between alcohol outlet density and assault density, and recent research has found social disorganization and land use to moderate the association in urban areas. However, little research has been done to determine whether similar associations hold outside large urban cities. Using geocoded data on assaults and alcohol outlets in Bloomington, Indiana, we estimated ordinary least squares and spatially lagged regression models to determine whether social disorganization and land use moderate the association between alcohol outlet density and assault. We found a consistent association between outlet density and assault density. In contrast to the findings from urban areas, however, the direct effects of social disorganization and of seven land use types on simple assault density were nonsignificant, nor was social disorganization associated with aggravated assault. Further, the relationship between alcohol outlet density and assault density was moderated by neither social disorganization nor land use. Ecological characteristics like social disorganization and land use may matter less in smaller cities and towns than they do in large urban cities, both in terms of direct effects and when accounting for the relationship between alcohol outlet density and violence.

Alcohol outlets, social disorganization, and robberies: accounting for neighborhood characteristics and alcohol outlet types.

We estimated spatially lagged regression and spatial regime models to determine if the variation in total, on-premise, and off-premise alcohol outlet(1) density is related to robbery density, while controlling for direct and moderating effects of social disorganization.(2) Results suggest that the relationship between alcohol outlet density and robbery density is sensitive to the measurement of social disorganization levels. Total alcohol outlet density and off-premise alcohol outlet density were significantly associated with robbery density when social disorganization variables were included separately in the models. However, when social disorganization levels were captured as a four item index, only the association between off-premise alcohol outlets and robbery density remained significant. More work is warranted in identifying the role of off-premise alcohol outlets and their characteristics in robbery incidents.

Off-premise alcohol outlet characteristics and violence

Abstract Background: There is considerable evidence of an association between alcohol outlet density and violence. Although prior research reveals the importance of specific characteristics of bars on this association and that the relationship between bar density and violence may be moderated by these characteristics, there are few similar studies of the characteristics of off-premise outlets (e.g. liquor and convenience stores). Objectives: We examined whether immediate environment, business practice, staff, and patron characteristics of off-premise alcohol outlets are associated with simple and aggravated assault density. Methods: Cross-sectional design using aggregate data from 65 census block groups in a non-metropolitan college town, systematic social observation, and spatial modeling techniques. Results: We found limited effects of immediate environment, business practice, staff, and patron characteristics on simple assault density and no effect on aggravated assault density. Only two out of 17 characteristics were associated with simple assault density (i.e. nearby library and male patrons). Conclusion: This is the first study to examine the association between several off-premise alcohol outlet characteristics and assault. Our findings suggest that where the off-premise outlets are located, how well the immediate environment is maintained, what types of beverages the outlets sell, who visits them, and who works there matter little in their association with violence. This suggests the importance of outlet density itself as a primary driver of any association with violence. Public policies aimed at reducing alcohol outlet density or clustering may be useful for reducing violence.

Neighborhood characteristics contribute to urban alcohol availability: Accounting for race/ethnicity and social disorganization

ABSTRACT This study examined the role that race/ethnicity and social disorganization play in alcohol availability in Milwaukee, Wisconsin, census block groups. This study estimated negative binomial regression models to examine separately the relationship between neighborhood racial/ethnic composition and social disorganization levels for (1) total, (2) on-premise, and (3) off-premise alcohol outlets. Results of this study suggest that proportion Hispanic was positively associated with total and with off-premise alcohol outlets. Second, proportion African American was negatively associated with on-premise alcohol outlets and positively associated with off-premise alcohol outlets. Proportion Asian was not associated with total, on-premise, or off-premise alcohol outlets. However, the effects of race/ethnicity on alcohol availability were either unrelated or negatively related to alcohol outlet availability once neighborhood social disorganization levels were taken into account, and social disorganization was positively and significantly associated with all alcohol outlet types. Neighborhood characteristics contribute to alcohol availability and must be considered in any efforts aimed toward prevention of alcohol-related negative health and social outcomes.

The 2003 Slovenian Alcohol Policy: Background, Supporters, and Opponents

High levels of wine, beer, and spirits consumption have historically characterized Slovenian drinking culture. The geographical location of the country provides an ideal environment for wine production, historical ties with the Austro-Hungarian Empire contribute to the tradition of beer drinking, and the custom of home distilling has resulted in a considerable level of spirits consumption. This combination of factors contributes to the high level and cultural acceptance of alcohol consumption in Slovenia. Alcohol-related harm in Slovenia was recognized as a problem as early as 1834, and since then Slovenian public health experts have implemented various programs and policies in an attempt to reduce alcohol-related harm and alcohol consumption in general. A report published by Slovenian public health experts and presented to the Slovenian Ministry of Health in the late 1990s showed that alcohol consumption and related harm were among the highest in the European region, and that there was a need for a policy to reduce consumption and alcohol-related harm in the country. This article outlines the events leading up to this policy. Although business interests and some politicians and public health experts opposed the policy, it was passed by the Slovenian National Assembly on January 28, 2003. Descriptive data revealing a subsequent decrease in the rate of registered alcohol consumption and in deaths due to liver disease, cirrhosis, and suicide may represent preliminary indicators of the effective implementation of the Act.

The Neighborhood-Level Association Between Alcohol Outlet Density and Female Criminal Victimization Rates

The aim of this study was to explore the neighborhood-level association between alcohol outlet density and non–intimate partner violent victimization rates among females. Violent offending and victimization are more prevalent for males than females, and most research on alcohol outlets and violence emphasizes males. Studies that do focus on alcohol outlets and female violent victimization tend to focus on intimate partner violence (IPV), yet non-IPV events are over three quarters of all female violent victimization incidents in the United States. We collected data on violent victimization rates, on- and off-premise alcohol outlet density, and neighborhood-level covariates of violence rates for Milwaukee block groups. We used spatially lagged regression models to test this association, to compare non-IPV results with those for overall female violent victimization rates, and to compare results for females with those for males. Our findings showed density of both on- and off-premise alcohol outlets was positively associated with non-IPV female violent victimization rates, which is an important finding given lack of research on this topic. We also found results for females (both overall and non-IPV violent victimization) were generally the same as for males, but the effect of off-premise outlets on non-IPV female violent victimization rates was weaker than the same association for males. Our findings have clear policy implications for local jurisdictions. Alcohol outlet density is important for both female and male violent victimization. Limiting the licensing of alcohol-selling establishments, especially those that engage in irresponsible retail practices, may be a suitable approach to address violent victimization.

Alcohol outlets, social disorganization, and non-violent crimes in urban neighborhoods

Abstract Many studies show an association between alcohol outlets and violence, though fewer consider non-violent crime. We add to this literature using block group data from Milwaukee, Wisconsin, to explore whether (1) on- and off-premise alcohol outlet density is related to thefts from vehicles and vandalism and (2) social disorganization moderates these associations. Using spatially informed regression models, we found positive effects of on-premise alcohol outlet density on thefts from vehicles. We also found positive effects of on- and off-premise alcohol outlet density on vandalism. Social disorganization was not a consistent moderator of these associations.