| Suicide and alcohol: do outlets play a role? | |
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MedLine Citation:
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PMID: 19764933 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to determine whether the number of alcohol outlets in local and adjacent areas, in particular bars, was related over time to completed suicide and suicide attempts. There is evidence both from studies of individuals and time series aggregate studies, mostly at the national level, of substantial alcohol involvement in suicide, but no small-area, longitudinal studies have been carried out. The present study is the first that is both longitudinal and based on a large number of small spatial units, California zip codes, a level of resolution permitting analysis of the relationship between local alcohol access and suicide rates over time. METHOD: Longitudinal data were obtained from 581 consistently defined zip code areas over 6 years (1995-2000) using data from the California Index Locations Database, a geographic information system that contains both population and place information with spatial attributes for the entire state. Measures obtained from each zip code included population characteristics (e.g., median age) and place characteristics (e.g., numbers of retail and alcohol outlets) which were related in separate analyses to (i) suicide mortality and (ii) the number of hospitalizations for injuries caused by suicide attempts. The effect of place characteristics in zip code areas adjacent to each of the 581 local zip codes (spatial lags) was also assessed. Analysis methods were random effects models corrected for spatial autocorrelation. RESULTS: Completed suicide rates were higher in zip code areas with greater local and lagged bar densities; and higher in areas with greater local but not lagged off-premise outlet densities. Whereas completed suicide rates were lower among blacks and Hispanics, completed suicide rates were higher among low income, older whites living in less densely populated areas, that is, rural areas. Rates of suicide attempts were higher in zip code areas with greater local but not lagged bar densities, and higher among low income younger whites living in smaller households and in rural areas. Rates of attempted suicide were also higher among blacks. Completed suicide and suicide attempt rates were lower in zip code areas with greater local restaurant densities; there were no lagged effects for restaurants. CONCLUSIONS: Bar densities in particular appear related to suicide, meaning, because this is an aggregate-level spatial analysis, that suicides, both attempted and completed, occur at greater rates in rural community areas with greater bar densities. Because the suicide rate is highest in rural areas, this study suggests that although the number of completed and attempted suicides is no doubt greater in absolute numbers in urban areas, the suicide rate, both completed and attempted, is greater in rural areas, which draws attention, perhaps much needed, to the problems of rural America. |
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Authors:
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Fred W Johnson; Paul J Gruenewald; Lillian G Remer |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-09-17 |
Journal Detail:
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Title: Alcoholism, clinical and experimental research Volume: 33 ISSN: 1530-0277 ISO Abbreviation: Alcohol. Clin. Exp. Res. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-07 Completed Date: 2010-02-17 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 7707242 Medline TA: Alcohol Clin Exp Res Country: England |
Other Details:
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Languages: eng Pagination: 2124-33 Citation Subset: IM |
Affiliation:
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Prevention Research Center, 1995 University Ave., Berkeley, CA 94704, USA. fred@prev.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Alcohol Drinking
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epidemiology* Alcoholic Intoxication / epidemiology California / epidemiology Hospitalization / statistics & numerical data Humans Longitudinal Studies Models, Statistical Patient Discharge / statistics & numerical data Population Population Density Rural Population Socioeconomic Factors Suicide / statistics & numerical data* Suicide, Attempted / statistics & numerical data Urban Population |
| Grant Support | |
ID/Acronym/Agency:
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P60 AA006282-30/AA/NIAAA NIH HHS; P60-AA006282/AA/NIAAA NIH HHS; R37 AA012927-07/AA/NIAAA NIH HHS; R37-AA012927/AA/NIAAA NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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