Risk of Alcohol-Related Injury: Does Societal Drinking Context Make a Difference?

The aim of this study is to examine whether country-level frequency of drinking in a public context and in a private context is associated with rates of alcohol-related injury in emergency department studies from those same countries.

Emergency department data on 5,104 injured patients in 10 countries from the International Collaborative Alcohol and Injury Study (ICAIS) and aggregate level drinking context data from the Gender, Alcohol and Culture: An International Study (GENACIS) are analyzed. The association of societal drinking context (public and private) with variation in the rate of self-reported drinking before injury is examined using multilevel modeling.

Controlling for demographic characteristics, individual-level volume and drinking pattern, study-level volume, and country-level drinking pattern and alcohol control policy, societal public drinking context was significantly predictive of an alcohol-related injury (odds ratio [OR] = 1.08, CI [1.02, 1.13]), whereas societal private drinking context was not. Public drinking context was predictive of violence-related injury (OR = 1.09, CI [1.01, 1.17]), whereas private drinking context was predictive of injuries from falls (OR = 1.01, CI [1.01, 1.02]). Neither societal drinking context was significantly predictive of traffic-related injuries whereas both public (OR = 1.06, CI [1.01, 1.12]) and private (OR = 1.01, CI [1.01, 1.03]) contexts were predictive of injuries from other causes.

These data suggest that societal drinking context does make a difference in the likelihood of an alcohol-related injury, which is important for a better understanding of the role of drinking context in a country in the occurrence of an alcohol-related injury and may inform future recommendations for reducing this harmful consequence.