Morrison C.,Monash University |
Morrison C.,Pacific Institute for Research and Evaluation
Alcoholism: Clinical and Experimental Research | Year: 2015
Background: Lower-income populations are exposed to excess risks related to the presence of greater concentrations of alcohol outlets in their communities. Theory from economic geography suggests this is due to dynamic processes that shape urban retail markets (as outlets are attracted to areas of higher population density due to the increased demand but are excluded from higher-income areas due to land and structure rents). This mechanism may explain increased exposure to alcohol outlets for lower-income populations in rural areas. This study tests the hypothesis that the distribution of outlets between rural towns will reflect these market dynamics, such that outlets are concentrated in towns with (i) greater resident and temporary populations, (ii) with lower income, and (iii) which are adjacent to towns with higher income. Method: Bayesian conditional autoregressive Poisson models examined counts of bars, restaurants, and off-premise outlets within 353 discrete towns of rural Victoria, Australia (mean population = 4,236.0, SD = 15,754.1). Independent variables were each town's total resident population, net changes to population (due to commuter flow, visitors, and the flow of local residents to other towns [spatial interaction]), and income for the local and adjacent towns. Results: Lower local income and increased income in adjacent towns were associated with more outlets of all types. Greater resident populations and greater net population due to commuters also predicted greater numbers of all outlets. Bars and restaurants were positively related to greater net population due to visitors and negatively related to spatial interaction. Conclusions: The economic geographic processes that lead to greater concentrations of alcohol outlets in lower-income areas are common to all retail markets. Lower-income populations are exposed to increased risk associated with the presence of additional outlets that service demand from nonresidents. In rural areas, these processes appear to operate between discrete towns. © 2014 by the Research Society on Alcoholism.
Freisthler B.,University of California at Los Angeles |
Gruenewald P.J.,Pacific Institute for Research and Evaluation
Alcoholism: Clinical and Experimental Research | Year: 2013
Background: Despite well-known associations between heavy drinking and child physical abuse, little is known about specific risks related to drinking different amounts of alcohol in different drinking venues. This study uses a context-specific dose-response model to examine how drinking in various venues (e.g., at bars or parties) is related to physically abusive parenting practices while controlling for individual and psychosocial characteristics. Methods: Data were collected via a telephone survey of parents in 50 cities in California, resulting in 2,163 respondents who reported drinking in the past year. Child physical abuse and corporal punishment were measured using the Conflict Tactics Scale, Parent-Child version. Drinking behaviors were measured using continued drinking measures. Data were analyzed using zero-inflated Poisson models. Results: Drinking at homes, parties, or bars more frequently was related to greater frequencies of physically abusive parenting practices. The use of greater amounts of alcohol in association with drinking at bars appeared to increase risks of corporal punishment, a dose-response effect. Dose-response relationships were not found for drinking at homes or parties or drinking at bars for physical abuse nor for drinking at home and parties for corporal punishment. Conclusions: Frequencies of using drinking venues, particularly bars and home or parties, are associated with greater use of abusive parenting practices. These findings suggest that a parent's routine drinking activities place children at different risks of being physically abused. They also suggest that interventions that take into account parents' alcohol use at drinking venues are an important avenue for secondary prevention efforts. © 2012 by the Research Society on Alcoholism.
Miller T.R.,Pacific Institute for Research and Evaluation
Prevention Science | Year: 2015
Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on three more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8 %, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996–2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development; increase breast-feeding; and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand. © 2015, Society for Prevention Research.
Fell J.C.,Pacific Institute for Research and Evaluation |
Voas R.B.,Pacific Institute for Research and Evaluation
Addiction | Year: 2014
The National Transportation Safety Board recently recommended that states establish a per se blood alcohol concentration (BAC) limit of 0.05 or lower for all drivers who are not already required to adhere to lower BAC limits in a national effort to reduce alcohol-impaired driving. There is strong evidence for adopting this recommendation. A comprehensive review of the literature on BAC limits was conducted. The research indicates that virtually all drivers are impaired regarding at least some driving performance measures at a 0.05 BAC. The risk of being involved in a crash increases significantly at 0.05 BAC and above. The relative risk of being killed in a single-vehicle crash with BACs of 0.05-0.079 is 7-21 times higher than for drivers at 0.00 BAC. Lowering the BAC limit from 0.08 to 0.05 has been a proven effective countermeasure in numerous countries around the world. Most Americans do not believe a person should drive after having two or three drinks in 2 hours. It takes at least four drinks for the average 170-pound male to exceed 0.05 BAC in 2 hours (three drinks for the 137-pound female). Most industrialized nations have established a 0.05 BAC limit or lower for driving. Progress in reducing the proportion of drivers in fatal crashes with illegal BACs has stalled over the past 15 years. Lowering the BAC limit for driving from the current 0.08 to 0.05 has substantial potential to reduce the number of people who drink and drive in the United States and get involved in fatal crashes. © 2013 Society for the Study of Addiction.
Cunradi C.B.,Pacific Institute for Research and Evaluation
International Journal of Environmental Research and Public Health | Year: 2010
Indices of heavy drinking have consistently been linked with increased risk for intimate partner violence (IPV) among couples in the general household population. Because IPV is a 'private' event, most IPV research has focused on individual-level risk factors, but current social ecological theory suggests that alcohol outlets can act with neighborhood conditions to increase risks for IPV. This paper reviews the theoretical and empirical literatures relevant to identifying specific social mechanisms linking IPV to alcohol use in community settings, and discusses three social mechanisms relevant to these effects: greater numbers of alcohol outlets within a neighborhood may (1) be a sign of loosened normative constraints against violence; (2) promote problem alcohol use among at-risk couples, and; (3) provide environments where groups of persons at risk for IPV may form and mutually reinforce IPV-related attitudes, norms, and problem behaviors. Understanding these mechanisms is of critical public health importance for developing environmental strategies aimed at prevention of IPV, such as changes in zoning, community action and education, and policing. © 2010 by the authors.
Holder H.,Pacific Institute for Research and Evaluation
Addiction | Year: 2010
Prevention research concerning alcohol, tobacco and other drugs faces a number of challenges as the scientific foundation is strengthened for the future. Seven issues which the prevention research field should address are discussed: lack of transparency in analyses of prevention program outcomes, lack of disclosure of copyright and potential for profit/income during publication, post-hoc outcome variable selection and reporting only outcomes which show positive and statistical significance at any follow-up point, tendency to evaluate statistical significance only rather than practical significance as well, problem of selection bias in terms of selecting subjects and limited generalizability, the need for confirmation of outcomes in which only self-report data are used and selection of appropriate statistical distributions in conducting significance testing. In order to establish a solid scientific base for alcohol, tobacco and drug prevention, this paper calls for discussions, disclosures and debates about the above issues (and others) as essential. In summary, the best approach is always transparency. © 2009 Society for the Study of Addiction.
Zaloshnja E.,Pacific Institute for Research and Evaluation
Tobacco control | Year: 2010
To assess the impact of a tobacco control law adopted in Albania in 2007 and to estimate the share of illicit cigarettes on the market. Comparative analysis of two waves of a nationally representative household survey, one conducted before the new law went into effect and the other after 2 years. Official sales data were contrasted with the consumption estimate based on the survey. Smoking prevalence, quit attempts, exposure to cigarette advertising, exposure to second-hand smoke, total cigarette consumption, share of illicit packs among packs possessed by smokers. Despite the adoption of strong smoke-free policies and adverting restrictions, smoking prevalence in Albania has risen. The increase in prevalence has been driven by higher smoking rates among females (18.9% in 2007 vs 29.3% in 2009) and young adults (23.2% in 2007 vs 38.5% in 2009 among 18-19 year olds). Self-reported exposure to second-hand smoke and cigarette advertising have been reduced since 2007. The majority of respondents are still exposed to second-hand smoke and more than half are exposed to tobacco advertising. Nevertheless, there are signs that the consumption of illicit cigarettes is declining. The impacts of smoke-free policies and an advertising ban have been limited due to lack of enforcement and failure to adopt a comprehensive set of tobacco control measures. These measures should include sizeable and regular tobacco tax increases in excess of the general level of inflation and income growth. The decline in the share of illicit cigarettes should improve the effectiveness of the cigarette tax policy.
Fell J.C.,Pacific Institute for Research and Evaluation
Traffic Injury Prevention | Year: 2014
Objective: This analysis is an update of a Traffic Tech published by the National Highway Traffic Safety Administration (NHTSA) in March 1992. Drivers with prior driving-while-intoxicated (DWI) convictions are overrepresented in fatal crashes and the relative risk of fatal crash involvement is greater for these repeat DWI offenders. Methods: Although it is estimated that 2.1 percent of licensed drivers had a prior arrest for DWI within the past 3 years in 2010, 8.0 percent of intoxicated drivers (blood alcohol concentration [BAC] ≥ 0.08 g/dL) involved in fatal crashes had at least one prior DWI conviction in the past 3 years during that same year. Results: Drivers with prior DWI convictions are overrepresented in fatal crashes by a factor of 1.62 or are 62 percent more likely to be in a fatal crash. Similarly, drivers with prior DWI convictions are also overrepresented as drinking drivers in fatal crashes: those with low BACs (0.01-0.07) by a factor of 2.38 and those with high BACs (0.08+) by a factor of 3.81. Conclusion: Though repeat DWI offenders are at a substantially higher risk of fatal crash involvement, the vast majority of intoxicated drivers in fatal crashes do not have a DWI conviction in the past 3 years (11 out of 12) according to the Fatality Analysis Reporting System records for the year 2010. © 2014 Copyright Taylor & Francis Group, LLC.
Gruenewald P.J.,Pacific Institute for Research and Evaluation
Alcohol Research and Health | Year: 2011
Regulations on the availability of alcohol have been used to moderate alcohol problems in communities throughout the world for thousands of years. In the latter half of the 20th century, quantitative studies of the effects of these regulations on drinking and related problems began in earnest as public health practitioners began to recognize the full extent of the harmful consequences related to drinking. This article briefly outlines the history of this work over four areas, focusing on the minimum legal drinking age, the privatization of alcohol control systems, outlet densities, and hours and days of sale. Some historical background is provided to emphasize the theoretical and empirical roots of this work and to highlight the substantial progress that has been made in each area. In general, this assessment suggests that higher minimum legal drinking ages, greater monopoly controls over alcohol sales, lower outlet numbers and reduced outlet densities, and limited hours and days of sale can effectively reduce alcohol sales, use, and problems. There are, however, substantial gaps in the research literature and a near absence of the quantitative theoretical work needed to direct alcoholcontrol efforts. Local community responses to alcohol policies are complex and heterogeneous, sometimes reinforcing and sometimes mitigating the effects of availability regulations. Quantitative models of policy effects are essential to accelerate progress toward the formulation and testing of optimal control strategies for the reduction of alcohol problems.
Romano E.,Pacific Institute for Research and Evaluation |
Pollini R.A.,Pacific Institute for Research and Evaluation
Addiction | Year: 2013
Aims: To characterize drug prevalence among fatally injured drivers, identify significant associations (i.e. day of week, time of day, age, gender), and compare findings with those for alcohol. Design: Descriptive and logistic mixed-model regression analyses of Fatality Analysis Reporting System data. Setting: US states with drug test results for >80% of fatally injured drivers, 1998-2010. Participants: Drivers killed in single-vehicle crashes on public roads who died at the scene of the crash (n=16942). Measurements: Drug test results, blood alcohol concentration (BAC), gender, age and day and time of crash. Findings: Overall, 45.1% of fatally injured drivers tested positive for alcohol (39.9% BAC≥0.08) and 25.9% for drugs. The most common drugs present were stimulants (7.2%) and cannabinols (7.1%), followed by 'other' drugs (4.1%), multiple drugs (4.1%), narcotics (2.1%) and depressants (1.5%). Drug-involved crashes occurred with relative uniformity throughout the day while alcohol-involved crashes were more common at night (P<0.01). The odds of testing positive for drugs varied depending upon drug class, driver characteristics, time of day and the presence of alcohol. Conclusions: Fatal single-vehicle crashes involving drugs are less common than those involving alcohol and the characteristics of drug-involved crashes differ, depending upon drug class and whether alcohol is present. Concerns about drug-impaired driving should not detract from the current law enforcement focus on alcohol-impaired driving. © 2013 Society for the Study of Addiction.