This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Michael G. Landen, MD, MPH; Michael Beller, MD, MPH; Elizabeth Funk, MD, MPH; Michael Propst, MD; John Middaugh, MD; Ronald L. Moolenaar, MD

JAMA. 1997;278(21):1755-1758.

Abstract
Context.
—Injury is a major public health problem in Alaska, and alcohol consumption and injury death are associated.

Objective.
—To determine the association between injury death, particularly alcohol-related injury death, and alcohol availability in remote Alaska.

Design, Setting, and Participants.
—Survey using death certificate data and medical examiner records to compare mortality rates for total injury and alcohol-related injury during 1990 through 1993 among Alaskans aged 15 years and older who had resided in remote villages of fewer than 1000 persons.

Main Outcome Measures.
—Rate ratios of injury death among residents of wet villages (ie, those without a restrictive alcohol law) as compared with injury death among residents of dry villages (ie, those with laws that prohibited the sale and importation of alcohol).

Results.
—Of 302 injury deaths, blood alcohol concentrations (BACs) were available for 200 deaths (66.2%). Of these, 130 (65.0%) had a BAC greater than or equal to 17 mmol/L (80 mg/dL) and were, therefore, classified as alcohol related. The total injury mortality rate was greater among Alaska Natives from wet villages (rate ratio [RR],1.6; 95% confidence interval [CI], 1.3-2.1), whereas this difference was not present for nonnatives (RR, 1.1; 95% CI, 0.3-3.8). For Alaska Natives, the alcohol-related injury mortality rate was greater among residents of wet villages (RR, 2.7; 95% CI, 1.9-3.8) than among residents of dry villages. The strength of this association was greatest for deaths due to motor vehicle injury, homicide, and hypothermia.

Conclusions.
—Although insufficient data existed to adjust for the effects of all potential confounders, residence in a wet village was associated with alcohol-related injury death among Alaska Native residents of remote Alaska villages. These findings indicate that measures limiting access to alcoholic beverages in this region may decrease alcohol-related injury deaths.

Author Affiliations
From the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Landen and Moolenaar); Alaska Division of Public Health (Drs Landen, Beller, Funk, and Middaugh), and Office of the Medical Examiner, Alaska Division of Public Health (Dr Propst), Anchorage. Dr Landen is now with the New Mexico Department of Health Public Health Division, Las Cruces.

Footnotes
Reprints: Michael G. Landen, MD, MPH, New Mexico Department of Health Public Health Division, 1170 N Solano Dr, Las Cruces, NM 88001.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The impact of supply reduction through alcohol management plans on serious injury in remote indigenous communities in remote Australia: A ten-year analysis using data from the royal flying doctor service
Margolis et al.
Alcohol Alcohol 2008;43:104-110.
ABSTRACT | FULL TEXT  

American Indians and Suicide: A Neglected Area of Research
Olson and Wahab
Trauma Violence Abuse 2006;7:19-33.
ABSTRACT  

Epidemiology of severe trauma among status Aboriginal Canadians: a population-based study
Karmali et al.
CMAJ 2005;172:1007-1011.
ABSTRACT | FULL TEXT  

ALCOHOL USE AND CULTURAL CHANGE IN AN INDIGENOUS POPULATION: A CASE STUDY FROM VENEZUELA
Seale et al.
Alcohol Alcohol 2002;37:603-608.
ABSTRACT | FULL TEXT  

Alcohol Problems and Public Health Policy
Gordis
JAMA 1997;278:1781-1782.