Risk of violence-related injury from alcohol consumption and its burden to society in Latin America and the Caribbean

Abstract

In the estimates for the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), alcohol is the fifth leading risk factor for Latin America and the Caribbean (LAC) (1). Injuries constitute one-third of alcohol-attributable disability-adjusted life years (DALYs) in the LAC region (versus 42% in the Americas), and 12% of them are from intentional interpersonal violence (versus 19.5% in the Americas) (1, 2).Relative risk (RR) of injury from alcohol consumption is an important factor to consider when estimating the alcohol-attributable fraction (AAF) of injury. Risk is usually derived from 1) mortality data (rather than morbidity data) and 2) measures of chronic consumption of alcohol (rather than acute consumption) (3), with the latter measure more relevant when the research interest is the immediate effect of drinking on an event, such as injury (4). In addition, most risk estimates do not examine the dose-response relationship. Finally, risk estimates typically assume uniform risk across different alcohol consumption levels, gender and age groups, causes of injury, and countries or regions, so most research on the AAF of injury derived from RR estimates does not consider the effects of these potentially important moderating variables. ABSTRACT Objective. To determine the relative risk (RR) and societal burden of injury related to alcohol-attributable intentional interpersonal violence (alcohol-attributable fraction or AAF), and the dose-response relationship, in Latin America and the Caribbean (LAC), where both the RR and AAF for violence-related injuries are believed to be particularly high. Methods. A probability sample of 1 024 emergency department patients from 10 LAC countries who reported an intentional interpersonal violence-related injury (IVRI) was analyzed using case-crossover fractional polynomial analysis of the number of drinks consumed prior to the event. Results. A dose-response relationship with a sixfold increase in risk (

A Commentary on the Dose–Response Relationship of Alcohol and Injury: Effects of Country‐Level Drinking Patterns and Alcohol Policies

“…First, while the risk of alcohol‐related injury was greater at higher levels of DDP, this trend did not extend to violence‐related injuries following higher volume levels of alcohol consumption, where the risk of these injuries was higher among participants from lower DDP countries (e.g., Switzerland and New Zealand; Cherpitel et al., ). The authors speculate that this finding may reflect previous research showing lower rates of overall violence, but higher rates of alcohol‐related violence in these lower DDP countries compared with higher DDP countries (Cherpitel et al., ). A substantial body of research has attempted to explain country‐level differences in alcohol‐related violence (Graham and Livingston, ; Room and Rossow, ), with various authors offering explanations linked to culture, context, and norms and meaning surrounding alcohol use and intoxication (Babor et al., ; Room, ; Room and Rossow, ; Sudhinaraset et al., ).…”

“La ruptura en el cuidado”: Experiencias de mujeres madres con abuso de alcohol y su atención en México

“…Los resultados evidenciaron la falta de respuesta o escaso apoyo institucional y familiar hacia las mujeres madres que enfrentan problemas por el consumo de alcohol. Esta información confirma el papel de cuidado que se espera que las mujeres brinden a sus familiares (5) , siendo la razón por la cual ellas no reciben el apoyo oportuno cuando ingieren esta sustancia de forma problemática, a lo que se suma la violencia sistemática perpetrada contra ellas (13,16) .…”

“…Entre los daños asociados al alcohol que afectan a las mujeres, se identifica la violencia perpetrada contra ellas. En México, la intoxicación con bebidas alcohólicas por parte de las mujeres suele tomarse como una justificación para ofenderlas e incluso agredirlas (11,13,14) , especialmente si incumplen con las responsabilidades domésticas o parentales encomendadas (15) . A esto se añade la violencia de género que ejercen sus parejas con problemas por el alcohol.…”

Tailoring an evidence-based clinical intervention and training package for the treatment and prevention of comorbid heavy drinking and depression in middle-income country settings: the development of the SCALA toolkit in Latin America

“…Likewise, epidemiological studies highlight the high alcohol-attributable disease burden experienced in the global south [ 3 ]. In Latin America and the Caribbean, for example, the amount of alcohol consumed per capita is the second highest in the world [ 12 ], and it experiences particularly high rates of alcohol-attributable traffic injury including violence [ 13 , 14 ]. As a result, there have been numerous calls to implement more effective and cost-effective policies on alcohol and mental ill-health in this region [ 15 , 16 ].…”