Community efforts can reduce alcohol fatalities

Communities can decrease alcohol-related fatal crashes by providing better access to substance abuse treatment while reducing the availability of alcohol in the community, according to a new study supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH). A report of the study appears in the April, 2005 issue of the journal Injury Prevention.

"These results show that concentrated, community-wide interventions can save lives," notes NIAAA Director Ting-Kai Li, M.D. "This is the first study to explore the effect of the combined use of increased individually-oriented substance abuse treatment and environmental strategies to reduce alcohol availability."

Researchers led by Ralph W. Hingson, Sc.D, Professor at the Boston University School of Public Health and Center to Prevent Alcohol Problems Among Young People, analyzed traffic fatality statistics in communities that had received "Fighting Back" grants from the Robert Wood Johnson Foundation. Beginning in January, 1992 twelve such grants were awarded to communities throughout the United States to support the implementation of 10-year programs aimed at reducing substance abuse and related problems. The communities developed 15 different kinds of programs or actions that targeted alcohol abuse, including increasing publicly-funded treatment, establishing awareness campaigns about treatment services, initiating hospital emergency department alcohol screening and referral, conducting responsible beverage trainings, and enacting ordinances to prohibit public drinking.

"The efforts of five Fighting Back communities - Kansas City, MO; Milwaukee, WI; San Antonio, TX; Santa Barbara, CA; and Vallejo, CA - were considered 'concentrated' because they implemented eight or more actions to restrict alcohol availability and expand treatment," explains Dr. Hingson. Other Fighting Back communities implemented between two and six actions.

The researchers found that Fighting Back communities that undertook concentrated alcohol interventions experienced significant declines in alcohol related fatal crashes during the 10 years of the program compared with the 10 years before the program. For example, Kansas City, Milwaukee, San Antonio, Santa Barbara, and Vallejo experienced a 22 percent decline in alcohol-related crashes involving blood alcohol concentrations (BACs) of 0.01% or higher, relative to same-state comparison communities. The concentrated intervention communities also saw declines of 20 percent for BACs of 0.08% or higher and 17 percent for BACs of 0.15% and higher. In contrast, Fighting Back communities with less concentrated efforts saw no decrease in alcohol-related traffic fatalities.

"As research further defines the types of community interventions that successfully reduce alcohol-related problems," says Dr. Hingson, "communities can focus on intervention strategies likely to produce desired results. Community organizing interventions may not be sufficient to reduce alcohol-related problems unless they specifically identify and implement proven interventions or those that have a plausible rationale for reducing alcohol problems."