Increasing alcohol restrictions and rates of serious injury in four remote Australian Indigenous communities

Abstract

Objective: To document rates of serious injuries in relation to government alcohol restrictions in remote Australian Indigenous communities. Design and setting: An ecological study using Royal Flying Doctor Service injury retrieval data, before and after changes in legal access to alcohol in four remote Australian Indigenous communities, Queensland, 1 January 1996 – 31 July 2010. Main outcome measures: Changes in rates of aeromedical retrievals for serious injury, and proportion of retrievals for serious injury, before and after alcohol restrictions. Results: After alcohol restrictions were introduced in 2002–2003, retrieval rates for serious injury dropped initially, and then increased in the 2 years before further restrictions in 2008 (average increase, 2.34 per 1000 per year). This trend reversed in the 2 years after the 2008 restrictions (average decrease, 7.97 per 1000 per year). There was a statistically significant decreasing time trend in serious‐injury retrieval rates in each of the four communities for the period 2 years before the 2002–2003 restrictions, 2 years before the 2008 restrictions, and the final 2 years of observations (2009–2010) (P < 0.001 for all four communities combined). Overall, serious‐injury retrieval rates dropped from 30 per 1000 in 2008 to 14 per 1000 in 2010, and the proportions of serious‐injury retrievals decreased significantly for all four communities. Conclusion: The absolute and the proportional rates of serious‐injury retrievals fell significantly as government restrictions on legal access to alcohol increased; they are now at their lowest recorded level in 15 years.

Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones

“…Participants recognized overall the ‘favourable’ impacts of AMPs on reducing violence, improving the safety of women and children, improved school attendance and community amenity, but with no overwhelming majority agreeing. These experiences are broadly consistent with the available objective evidence [18, 19] and other unpublished Queensland Government information [52] and commentary [14, 22, 53, 54]. Surrogate measures of alcohol-related injury progressively declined from 2002 after a period of poorly regulated alcohol availability beginning in the 1980s [18, 19].…”

“…The affected populations and the complex policy and regulatory underpinnings of Queensland’s AMPs have already been described in detail [19, 23, 26]. In sum, Queensland’s strategies to control alcohol in Aboriginal and Torres Strait Islander communities have featured ever-more-intense and complex techniques to restrict alcohol availability, until recently.…”

Study protocol - resilience in individuals and families coping with the impacts of alcohol related injuries in remote indigenous communities: a mixed method study

“…However, there remains a paucity of rigorous data to fully describe the positive changes in injury rates linked with Queensland’s controversial AMPs [3,4]. The limited available published evidence is supported by anecdote and it indicates that there have been some successes due to the AMPs, possibly changing a long term pattern of alcohol misuse which has had devastating effects in many remote Indigenous communities in Queensland [4,5]. The current Queensland Government has AMPs under review, bringing the prospect that alcohol may become readily available once more.…”

“…Initially the AMPs (2002–03) seemed to have had a number of positive impacts on injury rates, however the results varied across communities [5]. Data for the period 1995–2005 described Royal Flying Doctor Service (RFDS) aero-medical retrievals for serious injury in the four study communities which indicates substantial reductions in this indicator of serious injury [3].…”

“…However, two years after the 2002–03 AMP implementations, aero-medical retrievals again began to rise [3]. RFDS data on aero-medical retrievals for serious injury was again reviewed for the period 1996–2010 [5] showing overall, serious injury retrieval rates decreased significantly to what were, at that time, the lowest levels seen in 15 years [5]. Whether these interesting trends in injury indicators have declined in other Indigenous communities affected by AMPs is an important unanswered question.…”