Date Published: May 13, 2008
Publisher: Public Library of Science
Author(s): Russell Bennetts, Rachel Seabrook
Abstract: Russell Bennetts and Rachel Seabrook discuss the implications of a new case-crossover study that links retail alcohol sales and violent assaults.
Partial Text: The relationship between alcohol sales, alcohol consumption patterns, and levels of violence is well established. In a meta-analysis of data from seven countries, Jason Bond and colleagues estimated that the fraction of violence-related injuries attributable to alcohol is between 28% and 43% . There is a stronger link between alcohol impairment and being a victim of violence than between alcohol impairment and suffering from accidental injuries .
Factors that have been shown to be important in the link between alcohol sales and violence include the volume of alcohol consumed and its pattern of consumption , cultural characteristics , social context , and income inequality . Alongside socioeconomic and sociodemographic variables [7,8], alcohol outlet density (i.e., the number of alcohol retail outlets per unit population) has previously been found to influence levels of violence. In a spatial analysis looking at the relationship between alcohol outlet density and assaults, Michael Livingston found a positive and non-linear relationship, with an accelerating increase in violence beyond a threshold density of outlets .
Ray and colleagues sought to add to the existing evidence on the link between alcohol sales and risk of assault. Survey data have been the preferred source of many previous studies, and the authors state that such methods tend to lack adequate controls. For this reason the authors used computerised medical records and accurate sales data from Ontario, Canada. Using an empirical case-crossover method seldom used in studying alcohol and violence, the authors aimed to elucidate further the link between alcohol sales and risk of being a victim of assault.
On first reading Ray and colleagues’ paper, a number of questions come to mind, such as, is there any evidence that the incidents studied were indeed alcohol-related? Was any information collected on the victims’ drinking behaviour, either at the time of the assault, or one week earlier (the control period)? Can the researchers be sure that alcohol was drunk within a few hours of purchase? Did the assault take place close to the victim’s home (the latter being the basis for identifying the closest liquor outlet)?
Whilst the simple empirical finding of an association between alcohol sales and violence is of value in itself, for a deeper understanding it is worthwhile considering possible mechanisms underlying this relationship. For alcohol bought and drunk on licensed premises, drinkers are already in a public place, surrounded by other people, with obvious opportunities for violence. For off-license (liquor store) sales, the focus of Ray and colleagues’ study, the course of events is less obvious.
This new study illustrates the role that alcohol sales from retail outlets play in affecting the risk of suffering a serious assault. The findings suggest that the relevant officials should consider restricting availability of alcohol from retail stores if they wish to reduce the likelihood of violence in their area of jurisdiction.