Nicki Jackson

Social and socio-demographic neighborhood effects on adolescent alcohol use: a systematic review of multi-level studies.

There is growing interest in the role of the neighborhood environment on adolescent alcohol use. Multi-level designs are ideally suited to this investigation due to their ability to examine area-level effects over and above the effects due to neighborhood composition. To date, most research in this area has focused on the physical availability of alcohol in the neighborhood. We reviewed the multi-level evidence on neighborhood-level risk and protective factors which influence adolescent alcohol use, excluding studies which assessed the impact of neighborhood-level alcohol availability and advertising. Systematic searches in Medline, EMBASE, CINAHL Plus, PsycINFO, Sociological Abstracts and SCOPUS identified 23 studies, examining 11 different neighborhood-level exposures. The majority of studies found no associations with residential mobility, neighborhood disorder or crime, employment or job availability, neighborhood attitudes to drinking, social capital and collective efficacy. For studies examining neighborhood-level socio-economic disadvantage mixed results were found. High levels of both adult and adolescent alcohol use in the community appeared to be associated with alcohol use whilst protective effects were found for enforcement of liquor laws. Methodological limitations within studies were evident. The dearth of high-quality, multi-level studies indicate that further research is required to inform the development of multi-faceted place-based policy and preventative interventions to reduce adolescent alcohol use. Future studies should consider the neighborhood context from the outset of study design and identify the individual-level control variables to adequately isolate neighborhood effects. Inclusion of moderation and mediation analyses would greatly contribute towards the understanding of causal pathways of neighborhood effects.

The role of neighborhood disadvantage, physical disorder, and collective efficacy in adolescent alcohol use: a multilevel path analysis

Research into the salient exposures which explain neighborhood variation in adolescent alcohol use remains inconclusive. The Social Disorganization Theory suggests that neighborhood-level disadvantage may reduce collective efficacy to control adolescent risky behavior. Collective perceptions of physical disorder are also implicated in this neighborhood pathway. Drawing on data from a nationally-representative survey of urban high school students in New Zealand, multilevel path analysis was used to estimate the direct and mediating effects of neighborhood disadvantage, physical disorder, and collective efficacy on current drinking, frequency of binge drinking, and typical quantity of alcohol consumed. The findings supported an indirect pathway from disadvantage to binge drinking and high typical quantities in young adolescents (<16 years), mediated by physical disorder and reduced collective efficacy. Collective efficacy was not associated with current drinking in young adolescents. An opposing indirect effect was evident among older adolescents (≥16 years), whereby collective efficacy was positively associated with drinking outcomes. Implications for future research are discussed.

A critique of Fox's industry‐funded report into the drivers of anti‐social behaviour in the night‐time economies of Australia and New Zealand

Keywords: Aggression; alcohol; industry; intoxication; licensed premises; night-time economy; violence

New Zealand adolescents’ concerns about their alcohol use and access to services: Associations with ethnicity and other factors

ABSTRACT Using a national survey of 8,500 New Zealand high school students, we investigated adolescents’ concerns about their drinking, associated factors including help-seeking preferences and access to health care services, and how these varied by ethnicity and level of socioeconomic deprivation. Approximately 23.9% of the 3,704 current drinkers reported concerns (i.e., being worried about their drinking and/or having tried to cut down). Regression analyses revealed that Māori and Pacific youth were more likely than their New Zealand European peers to be concerned about their drinking. Concerned drinkers were more likely than nonconcerned drinkers to report hazardous drinking behaviors and alcohol-related problems, but these associations varied by age, ethnicity, and socioeconomic deprivation. Help-seeking preferences differed strongly by ethnicity. Concerned drinkers, and Māori and Pacific drinkers, were more likely to report difficulties accessing health care and alcohol and drug services. The factors associated with adolescents’ drinking concerns and paradoxical difficulties accessing health care highlight the importance of engaging adolescents in developing responsive and equitable services.

Disparities in Non-Fatal Health Outcomes in Pediatric General Trauma Studies

When prevention efforts fail, injured children require high-quality health services to support their recovery. Disparities in non-fatal injury outcomes, an indicator of health-care quality, have received minimal attention. We evaluated the extent to which general trauma follow-up studies published in the peer-reviewed scientific literature provide evidence of socially patterned inequities in health, functional or disability outcomes ≥4 weeks after childhood injuries. Using a systematic search, we identified 27 eligible cohort studies from 13 high-income countries. We examined the extent to which the reported health outcomes varied across the PROGRESS criteria: place of residence, race/ethnicity, occupation, gender/sex, religion, socio-economic status, and social capital. The available evidence on differential outcomes is limited as many studies were compromised by selection or retention biases that reduced the participation of children from demographic groups at increased risk of adverse outcomes, or the analyses mainly focused on variations in outcomes by sex. Given the limited research evidence, we recommend greater attention to systematic collection and reporting of non-fatal injury outcomes disaggregated by socio-demographic indicators in order to identify disparities where these exist and inform equity-focused interventions promoting the recovery of injured children.