A Multilevel Model of Alcohol Outlet Density, Individual Characteristics and Alcohol-Related Injury in Argentinean Young Adults

Abstract

Objectives. Previous research from high-income countries has consistently shown an association between alcohol-related harms and neighborhood characteristics such as alcohol outlet density, but this research has not been extended to middle- and low-income countries. We assessed the role of neighborhood characteristics such as alcohol outlet density, overcrowding and crime rates, and individual characteristics including gender, age, alcohol and marijuana use, and geographic mobility associated with alcohol-related injuries in university students in Argentina. Methods. Data were collected from a randomized sample of students attending a national public university (n = 1346). Descriptive, bivariable, and multilevel logistic regression analyses were performed. Results. In the final model, on-premises alcohol outlet density—but not off-premises outlet density, overcrowding or crime—was associated with past-year and lifetime alcohol-related injury (median odds ratio = 1.16). At the individual level, quantity (odds ratio (OR) = 1.05, 95% CI = (1.01, 1.10)) and frequency (OR = 1.66, 95% CI = (1.41,1.97)) of alcohol consumption and age (OR = 0.81, 95% CI = (0.74, 0.88)) were associated with past-year and lifetime alcohol-related injury. Conclusions. This study contributes to an area with a paucity of information from non-high-income countries, finding differences with previous literature. Objectifs: Des recherches antérieures menées dans des pays à revenu élevé ont constamment montré une association entre les méfaits liés à l’alcool et les caractéristiques du quartier telles que la densité des points de vente d’alcool, mais cette recherche n’a pas été étendue aux pays à revenu moyen et faible. Nous avons évalué le rôle des caractéristiques du quartier telles que la densité des points de vente d’alcool, la surpopulation et les taux de criminalité, et les caractéristiques individuelles, y compris le sexe, l’âge, la consommation d’alcool et de marijuana, et la mobilité géographique associée aux blessures liées à l’alcool chez les étudiants universitaires en Argentine. Méthodes: Les données ont été recueillies auprès d’un échantillon aléatoire d’étudiants fréquentant une université publique nationale (n = 1 346). Des analyses de régression logistique descriptives, bivariables et multi-niveaux ont été effectuées. Résultats: Dans le modèle final, la densité des points de vente d’alcool sur place - mais pas la densité des points de vente hors établissement, le surpeuplement ou la criminalité - était associée aux blessures liées à l’alcool au cours de la dernière année et au cours de la vie (rapport de cotes médian = 1.16). Au niveau individuel, quantité (OR = 1.05, IC à 95% = (1.01, 1.10)) et fréquence (OR = 1.66, IC à 95% = (1.41,1.97)) de consommation d’alcool et âge (OR = 0.81, 95% IC = (0.74, 0.88)) étaient associés à des blessures liées à l’alcool au cours de la dernière année et de leur vie entière. Conclusions: Cette étude contribue à un domaine où les informations sur les pays qui ne sont pas à revenu élevé sont rares, trouvant des différences avec la littérature précédente.

Associations between alcohol intake and hospital contacts due to alcohol and unintentional injuries in 71,025 Danish adolescents – a prospective cohort study

“… 16 found that binge drinking once a month was associated with higher odds of self-reported unintentional injury (OR = 1.41 (0.56–4.50)). In retrospective studies, self-reported injuries (intentional and unintentional) have previously been shown to be associated with current alcohol use, 18 , 19 , 41 , 42 , 43 alcohol intake frequency, 12 , 13 , 17 and binge drinking. 14 , 15 , 16 Estimates ranged from OR = 1.10 to 6.0.…”

“… 6 , 7 , 8 , 9 Yet drinking alcohol at parties is an established social norm among many young people in Western countries, and binge drinking with the main purpose of intoxication is a widespread behaviour, not confined to a limited group of adolescents. 10 , 11 In retrospective studies, current alcohol use, 12 , 13 , 14 , 15 , 16 alcohol use frequency, 12 , 13 , 17 and binge drinking 14 , 15 , 16 have been estimated to increase the odds of self-reported injuries (OR = 1.10–6.0). However, self-reported data on poisonings and injuries may lead to recall bias, and it has been argued that differences in perception between genders, driven by social norms, and willingness to take risks may cause underreporting.…”

Alcohol licensing legislation and licensing system in South‐West Nigeria: Implications to regulate physical availability of alcohol

“…None of the liquor licence bylaws contained regulations on controlling physical availability of alcohol and outlet density a risk factor for high AOD, heavy episodic drinking, alcohol-related harm [9] and crime [33,34]. A participant stated that 'as a LGC if as many as possible can sell alcohol what's our own business, ours is to generate money from them'.…”

“…High levels of alcohol consumption have been associated with increased physical availability of alcohol and high alcohol outlet density (AOD) [9,10]. The World Health Organization SAFER initiative recommends strengthening restrictions on the physical availability of alcohol by regulating hours of sale and AOD [11,12].…”