Using Surveillance Data to Inform Community Action: The Effect of Alcohol Sale Restrictions on Intentional Injury-related Ambulance Pickups

Abstract

Youth violence disproportionately affects inner city, urban minority communities in the USA. This article illustrates the use of surveillance data to inform and evaluate community action directed at this serious problem. Community efforts in response to surveillance data indicating high rates of violence surrounding convenience stores with unrestricted alcohol beverage licenses provided a natural experiment to examine the impact of imposing licensing restrictions on intentional injury rates. Rates of ambulance pickups for intentional injuries in the 15- to 24-year-old population in five census tracts where alcoholic beverage sales were restricted were compared to five census tracts with similar demographic characteristics near stores where restrictions were not instituted. Time periods included an 18-month baseline period, a 6-month period during which restrictions were in effect in the intervention communities, and an 18-month period following lifting of this restriction resulting from legal action by store owners. The monthly average rate of ambulance pickups for violent injuries showed a significantly greater baseline-to-intervention phase decrease in the intervention communities (i.e., from 19.6 to 0 per 1,000) than in the control communities (i.e., 7.4 to 3.3 per 1,000). This rate subsequently increased to 11.4 in the intervention communities after the restriction was removed. This study illustrates the potential value of surveillance data for guiding community mobilization efforts and for evaluating the impact of such efforts. It also demonstrates the potential impact of restricting inexpensive, single-serve alcoholic beverages on rates of violence.

What is the role of culture, diversity, and community engagement in transdisciplinary translational science?

“…Researchers are tasked with increasing their ORIGINAL RESEARCH dissemination of findings of culturally responsive programs not only to other researchers, but also to stakeholders who make implementation decisions. For example, prevention researchers in Richmond, Virginia, in collaboration with African-American community leaders were able to influence widespread implementation of banning of 40-oz alcoholic beverage sales in high-risk communities [32]. This success was due to rigorous research, but more importantly, partnerships with the African-American community and involvement of community members in the local government.…”

Preventing Violence Among High-Risk Youth and Communities with Economic, Policy, and Structural Strategies

“…The 2008 homicide rate (46.0 per 100,000 population) was nearly three times the national average (5.7 per 100,000 population). Most homicide deaths were among racial/ethnic minority youth aged 15-24 years (10). Community leaders in Richmond examined data about violence-related injuries and alcohol use to develop a policy that restricted licenses for the sale of single-serve alcoholic beverages by convenience stores during January-June 2003 (10).…”

“…Most homicide deaths were among racial/ethnic minority youth aged 15-24 years (10). Community leaders in Richmond examined data about violence-related injuries and alcohol use to develop a policy that restricted licenses for the sale of single-serve alcoholic beverages by convenience stores during January-June 2003 (10). Despite strong initial support for these license restrictions, enforcement ended after 6 months in response to opposition by grocery store owners.…”

“…The timing of the licensing restrictions allowed researchers to evaluate its impact by tracking injuries before and during the restrictions, and after the restrictions were reversed. The CDCfunded Center of Excellence in Youth Violence Prevention at Virginia Commonwealth University (VCU) collaborated with the Virginia Alcohol Beverage Control Board, the VCU Health System, the Richmond Medical Examiner, the Richmond Vital Registry, the Richmond Ambulance Authority, and the Richmond Department of Juvenile Justice to examine the policy's impact (10).…”

“…Safe Streets is a street outreach and community mobilization strategy to interrupt the transmission of violence, change community norms about the acceptability of violence, and build positive community connections through community events (10). Safe Streets was implemented in four Baltimore, Maryland, neighborhoods that had rates of homicides and nonfatal shootings (NFS) within the top 25% in the city.…”