Injuries and alcohol management plans in remote Indigenous communities: a two-community comparison

Abstract

To curb high rates of alcohol-related violence and injury in Indigenous communities, alcohol management plans (AMPs) were implemented in 2002-2003 and tightened in 2008. This project compares injury presentations and alcohol involvement from two Indigenous Cape York communities, one that entered full prohibition and one that did not. Aclinical file audit was performed for the period 2006-2011, capturing changes in alcohol availability. Medical files were searched for injury presentation documenting type of injury, cause of injury (including alcohol), date of injury and outcomes of all presenting injuries for the time period 1 January 2006 to 31 December 2011, capturing the major changes of the 2008 AMP restrictions. Findings indicated injury presentation rates were higher in both communities before prohibition than afterwards andreduction was more pronounced in community 2 (prohibition). Ongoing research is imperative, as this area is characterised by a near-absence of evidence.

Have Alcohol Management Plans Reduced Violence Against Women in Cape York, Australia?

“…Given that all study propositions could be evidenced, a strong case for dose–response relationship is provided: Clearly, the more restrictive AMPs reflected a stronger reduction in rates of violence against women in both health clinic presentations and reported assaults to police, especially for assaults involving alcohol. A similar direct relationship was evidenced in a study exploring overall injury presentations and AMPs (West, Muller & Clough, 2017).…”

Association between alcohol restriction policies and rates of alcohol-related harms in remote Australian Aboriginal and Torres Strait Islander communities: a systematic review

“…The impact of alcohol prohibition on the incidence of traumatic injuries was reported by Clough et al 53 and West et al 31,49 In Clough et al , 53 aeromedical retrievals for traumatic injury decreased from an average of 25.5 per 1000 people across all communities in 2008 prior to total prohibition, to an average of 12.9 per 1000 in 2012 after three years of prohibition. Presentations at the local health clinic for traumatic injuries, as reported by West et al , 31 also decreased both within Community 2 and in comparison with Community 1 (restrictions but not prohibition). Pre-prohibition, Community 2 had an injury rate of 703.1 per 1000 people, decreasing to 494.6 per 1000 by the end of 2011: a decrease of 29.3%.…”

“…West et al (2018) 49 reported specifically on violence against women from the same study locations as their 2017 publication 31 . All three of these papers included a phase of complete alcohol prohibition: Clough et al 53 in phase 2 (2009–2012) for three of the four study communities, while in West et al , 31,49 the community identified as “Community 2” was subject to prohibition from 2009 to 2011.…”

Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15–64 over the 9-year period 2007–2015 in North Queensland, Australia

“…Whilst rates of presentations for TBI were stable in other population groups, those for the Indigenous male population appeared to have been steadily increasing. In 2007, Queensland implemented a policy prohibiting alcohol sales, possession and consumption in several remote Indigenous localities in north Queensland on the back of laws first implemented in 2002, limiting the possession of alcohol in community areas declared restricted (Margolis et al 2011 , West et al 2017 ). The prospect that a rising trend in TBI rates is apparent despite alcohol restrictions, particularly among Indigenous males (Fig.…”